The effect of fully immersive virtual reality technology combined with psychological and behavioral intervention on autism spectrum disorder.

Abstract

Objective: At present, there is a lack of targeted support models for individuals with autism spectrum disorder (ASD), mainly relying on comprehensive treatment with rehabilitation, education, and medication as supplements. Although there is some effectiveness, there are shortcomings such as long treatment cycles and limited engagement from some autistic children, especially in traditional formats. This study explores the effectiveness of fully immersive virtual reality (FIVR) combined with psychological and behavioral interventions for ASD.

Methods: In this retrospective cohort study, 124 children with autism who received treatment at Hongxinkang New Traditional Chinese Medicine Hospital in Tongren from January 2024 to July 2024 were included. 62 patients who received FIVR combined with psychological and behavioral intervention were matched in a 1:1 ratio with the queue receiving psychological and behavioral intervention. The main endpoint is the Childhood Autism Rating Scale (CARS) and Aberrant Behavior Checklist (ABC), as well as the scores of Psychoeducational Profile-third edition (PEP-3) after three months of intervention. The secondary outcome is the satisfaction of the child's family members.

Results: After three months of intervention, both groups showed reductions in ABC and CARS scores, with the FIVR group exhibiting more pronounced improvements. ANCOVA confirmed significant adjusted group differences favoring the FIVR group (ABC adjusted mean difference = - 5.67, 95% CI [-6.34, - 5.01], partial η² = 0.712; CARS adjusted mean difference = - 3.36, 95% CI [-4.10, - 2.61], partial η² = 0.408). Similarly, PEP-3 total scores were significantly higher in the FIVR group (adjusted mean difference = 8.21, 95% CI [6.48, 9.95], partial η² = 0.430), with consistent gains across subdomains, particularly in language and adaptive behavior. Family satisfaction was also greater in the FIVR group (95.2% vs. 82.3%; χ² = 5.153, P = 0.023; Cramér's V = 0.20, 95% CI [0.012, 0.362]).

Conclusions: Integrating FIVR with psychological and behavioral interventions may yield robust improvements in behavioral regulation, autism severity, neuropsychological development, and caregiver satisfaction. By incorporating ANCOVA adjusted for baseline covariates and reporting effect sizes with 95% confidence intervals, the robustness and clinical relevance of these findings were strengthened. Nevertheless, given the retrospective and non-randomized design, these results should be interpreted as preliminary. Future prospective randomized controlled trials are essential to confirm the effectiveness, durability, and mechanisms of FIVR-based interventions.