Skip to main content

Video Games for the Treatment of Autism Spectrum Disorder: A Systematic Review

Abstract

Video games are a promising area of intervention for children diagnosed with Autism Spectrum Disorders (ASD). However, reviews on this topic are scarce. This review on studies exploring video games for the treatment of ASD followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and its protocol was registered in PROSPERO. PubMed, PsycInfo, Embase, WebOfScience and clinicaltrials.gov databases were searched. Twenty-four articles were included in the review. Video game-based interventions were effective for alleviating ASD symptoms, albeit with small effect sizes. High rates of acceptability and adherence to treatment were obtained. Conclusion: Video games are a promising area for improving the treatment of children with ASD. Exploring commercial video games is one of the lines for future research.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  • Anderson-Hanley, C., Tureck, K., & Schneiderman, R. L. (2011). Autism and exergaming: Effects on repetitive behaviors and cognition. Psychology research and behavior management, 4, 129–137. https://doi.org/10.2147/PRBM.S24016

    Article  PubMed  PubMed Central  Google Scholar 

  • Antão, J., Abreu, L. C., Barbosa, R., Crocetta, T. B., Guarnieri, R., Massetti, T., Antunes, T., Tonks, J., & Monteiro, C. (2020). Use of augmented reality with a motion-controlled game utilizing alphabet letters and numbers to improve performance and reaction time skills for people with autism spectrum disorder. Cyberpsychology, behavior and social networking, 23(1), 16–22. https://doi.org/10.1089/cyber.2019.0103

    Article  PubMed  Google Scholar 

  • Baker, M. J. (2000). Incorporating the thematic ritualistic behaviors of children with autism into games: Increasing social play interactions with siblings. Journal of Positive Behavior Interventions, 2, 66–84.

    Article  Google Scholar 

  • Beaumont, R., Walker, H., Weiss, J., & Sofronoff, K. (2021). Randomized controlled trial of a video gaming-based social skills program for children on the autism spectrum. Journal of autism and developmental disorders. https://doi.org/10.1007/s10803-020-04801-z

    Article  PubMed  PubMed Central  Google Scholar 

  • Ben-Sasson, A., Lamash, L., & Gal, E. (2013). To enforce or not to enforce? The use of collaborative interfaces to promote social skills in children with high functioning autism spectrum disorder. Autism, 17(5), 608–622. https://doi.org/10.1177/1362361312451526

    Article  PubMed  Google Scholar 

  • Bernardini, S., Porayska-Pomsta, K., & Smith, T. J. (2014). ECHOES: An intelligent serious game for fostering social communication in children with autism. Information Sciences, 264, 41–60.

    Article  Google Scholar 

  • Bono, V., Narzisi, A., Jouen, A. L., Tilmont, E., Hommel, S., Jamal, W., Xavier, J., Billeci, L., Maharatna, K., Wald, M., Chetouani, M., Cohen, D., Muratori, F., & MICHELANGELO Study Group. (2016). GOLIAH: A Gaming Platform for Home-Based Intervention in Autism - Principles and Design. Frontiers in psychiatry, 7, 70. https://doi.org/10.3389/fpsyt.2016.00070

    Article  PubMed  PubMed Central  Google Scholar 

  • Buescher, A. V., Cidav, Z., Knapp, M., & Mandell, D. S. (2014). Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA pediatrics, 168(8), 721–728. https://doi.org/10.1001/jamapediatrics.2014.210

    Article  PubMed  Google Scholar 

  • Carson, V., Hunter, S., Kuzik, N., Gray, C. E., Poitras, V. J., Chaput, J. P., Saunders, T. J., Katzmarzyk, P. T., Okely, A. D., Connor Gorber, S., Kho, M. E., Sampson, M., Lee, H., & Tremblay, M. S. (2016). Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Applied physiology, nutrition, and metabolism, 41(6 Suppl 3), S240–S265. https://doi.org/10.1139/apnm-2015-0630

    Article  PubMed  Google Scholar 

  • Christensen, D. L., Braun, K., Baio, J., Bilder, D., Charles, J., Constantino, J. N., Daniels, J., Durkin, M. S., Fitzgerald, R. T., Kurzius-Spencer, M., Lee, L. C., Pettygrove, S., Robinson, C., Schulz, E., Wells, C., Wingate, M. S., Zahorodny, W., & Yeargin-Allsopp, M. (2018). Prevalence and characteristics of autism spectrum disorder among children aged 8 years–autism and developmental disabilities monitoring network, 11 sites, United States 2012. Morbidity and mortality weekly report. Surveillance summaries (Washington D.C.: 2002), 65(13), 1–23. https://doi.org/10.15585/mmwr.ss6513a1

    Article  Google Scholar 

  • Chukoskie, L., Westerfield, M., & Townsend, J. (2018). A novel approach to training attention and gaze in ASD: A feasibility and efficacy pilot study. Developmental neurobiology, 78(5), 546–554. https://doi.org/10.1002/dneu.22563

    Article  PubMed  Google Scholar 

  • Chung, U. S., Han, D. H., Shin, Y. J., & Renshaw, P. F. (2016). A prosocial online game for social cognition training in adolescents with high-functioning autism: an fMRI study. Neuropsychiatric disease and treatment, 12, 651–660. https://doi.org/10.2147/NDT.S94669

    Article  PubMed  PubMed Central  Google Scholar 

  • Edwards, J., Jeffrey, S., May, T., Rinehart, N. J., & Barnett, L. M. (2017). Does playing a sports active video game improve object control skills of children with autism spectrum disorder? Journal of sport and health science, 6(1), 17–24. https://doi.org/10.1016/j.jshs.2016.09.004

    Article  PubMed  Google Scholar 

  • El-Sattar, H.K.H.A. (2008). "A Novel Interactive Computer-Based Game Framework: From Design to Implementation," 2008 International Conference Visualisation, London, pp. 123–128, Doi: https://doi.org/10.1109/VIS.2008.29.

  • Fang, Q., Aiken, C. A., Fang, C., & Pan, Z. (2019). Effects of exergaming on physical and cognitive functions in individuals with autism spectrum disorder: A systematic review. Games for health journal, 8(2), 74–84. https://doi.org/10.1089/g4h.2018.0032

    Article  PubMed  Google Scholar 

  • Ferguson, B. R., Gillis, J. M., & Sevlever, M. (2013). A brief group intervention using video games to teach sportsmanship skills to children with autism spectrum disorders. Child & Family Behavior Therapy, 35(4), 293–306. https://doi.org/10.1080/07317107.2013.846648

    Article  Google Scholar 

  • Finke, E., Hickerson, B., & Kremkow, J. (2018). “To be quite honest, if it wasn’t for video games I wouldn’t have a social life at all”: Motivations of young adults with autism spectrum disorder for playing video games as leisure. American Journal of Speech-Language Pathology, 27(2), 672–689. https://doi.org/10.1044/2017_AJSLP-17-0073

    Article  PubMed  Google Scholar 

  • Fridenson-Hayo, S., Berggren, S., Lassalle, A., Tal, S., Pigat, D., Meir-Goren, N., O’Reilly, H., Ben-Zur, S., Bölte, S., Baron-Cohen, S., & Golan, O. (2017). “Emotiplay”: a serious game for learning about emotions in children with autism: results of a cross-cultural evaluation. European child & adolescent psychiatry, 26(8), 979–992. https://doi.org/10.1007/s00787-017-0968-0

    Article  Google Scholar 

  • Frye, R. E. (2018). Social skills deficits in autism spectrum disorder: Potential biological origins and progress in developing therapeutic agents. CNS Drugs, 32(8), 713–734. https://doi.org/10.1007/s40263-018-0556-y

    Article  PubMed  PubMed Central  Google Scholar 

  • Gillespie-Lynch, K., Kapp, S. K., Shane-Simpson, C., Smith, D. S., & Hutman, T. (2014). Intersections between the autism spectrum and the internet: perceived benefits and preferred functions of computer-mediated communication. Intellectual and developmental disabilities, 52(6), 456–469. https://doi.org/10.1352/1934-9556-52.6.456

    Article  PubMed  Google Scholar 

  • Granic, I., Lobel, A., & Engels, R. C. M. E. (2014). The benefits of playing video games. American Psychologist, 69(1), 66–78.

    Article  Google Scholar 

  • Grove, R., Hoekstra, R. A., Wierda, M., & Begeer, S. (2018). Special interests and subjective wellbeing in autistic adults. Autism Research, 11(5), 766–775.

    Article  Google Scholar 

  • Grynszpan, O., Martin, J., & Nadel, J. (2007). Exploring the influence of task assignment and output modalities on computerized training for autism. Interaction Studies: Social Behaviour and Communication in Biological and Artificial Systems, 8(2), 241–266. https://doi.org/10.1075/is.8.2.04gr

    Article  Google Scholar 

  • Hobbs, L., Hartley, C., Bentley, S., Bibby, J., Bowden, L., Hartley, J., & Stevens, C. (2020). Shared special interest play in a specific extra-curricular group setting: A Minecraft club for children with special educational needs. Educational and Child Psychology, 37(4), 81–95.

    Google Scholar 

  • Hobson, R. P. (1989). Beyond cognition: A theory of autism. In G. Dawson (Ed.), Autism: Nature, diagnosis and treatment. New York: Guilford.

    Google Scholar 

  • Huanca, F. (2011). Influencia de los juegos de Internet en el comportamiento de los dolescents de la ciudad de Puno. Revista de Investigación en Comunicación y Desarrollo, 2(2), 37–44.

    Google Scholar 

  • Johnston, D., Egermann, H., & Kearney, G. (2020). SoundFields: A virtual reality game designed to address auditory hypersensitivity in individuals with autism spectrum disorder. Applied Sciences, 10(9), 2996.

    Article  Google Scholar 

  • Jouen, A. L., Narzisi, A., Xavier, J., et al. (2017). GOLIAH (Gaming open library for intervention in autism at home): A 6-month single blind matched controlled exploratory study. Child and Adolescent Psychiatry Mental Health, 11, 17.

    Article  Google Scholar 

  • Kang, Y. S., & Chang, Y. J. (2019). Using game technology to teach six elementary school children with autism to take a shower independently. Developmental neurorehabilitation, 22(5), 329–337. https://doi.org/10.1080/17518423.2018.1501778

    Article  PubMed  Google Scholar 

  • Keshavan, M. S., Vinogradov, S., Rumsey, J., Sherrill, J., & Wagner, A. (2014). Cognitive training in mental disorders: Update and future directions. American Journal of Psychiatry, 171, 510–522. https://doi.org/10.1176/appi.ajp.2013.13081075

    Article  Google Scholar 

  • Liu, S., Yu, C., Conner, B. T., Wang, S., Lai, W., & Zhang, W. (2017). Autistic traits and internet gaming addiction in Chinese children: The mediating effect of emotion regulation and school connectedness. Research in developmental disabilities, 68, 122–130. https://doi.org/10.1016/j.ridd.2017.07.011

    Article  PubMed  Google Scholar 

  • Lopes, S., Magalhães, P., Pereira, A., Martins, J., Magalhães, C., Chaleta, E., & Rosário, P. (2018). Games used with serious purposes: A systematic review of interventions in patients with cerebral palsy. Frontiers in psychology, 9, 1712. https://doi.org/10.3389/fpsyg.2018.01712

    Article  PubMed  PubMed Central  Google Scholar 

  • Lopez-Rodriguez, M. M., Fernández-Millan, A., Ruiz-Fernández, M. D., Dobarrio-Sanz, I., & Fernández-Medina, I. M. (2020). New technologies to improve pain, anxiety and depression in children and adolescents with cancer: A systematic review. International journal of environmental research and public health, 17(10), 3563. https://doi.org/10.3390/ijerph17103563

    Article  PubMed Central  Google Scholar 

  • Ma, Y. (2015). The Discrepancy Between Video Game Purchase and Consumption in A Content Distribution Network. Proceedings Of The 2015 Joint International Mechanical, Electronic And Information Technology Conference. Doi:https://doi.org/10.2991/jimet-15.2015.46

  • Macoun, S. J., Schneider, I., Bedir, B., Sheehan, J., & Sung, A. (2020). Pilot study of an attention and executive function cognitive intervention in children with autism spectrum disorders. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-020-04723-w

    Article  Google Scholar 

  • Mazurek, M. O., & Engelhardt, C. R. (2013). Video game use in boys with autism spectrum disorder, ADHD, or typical development. Pediatrics, 132(2), 260–266. https://doi.org/10.1542/peds.2012-3956

    Article  PubMed  Google Scholar 

  • Mercado, J., Escobedo, L., & Tentori, M. (2020). A BCI video game using neurofeedback improves the attention of children with autism. Journal on Multimodal User Interfaces. https://doi.org/10.1007/s12193-020-00339-7

    Article  Google Scholar 

  • Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., Stewart, L. A., & PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews, 4(1), 1. https://doi.org/10.1186/2046-4053-4-1

    Article  PubMed  PubMed Central  Google Scholar 

  • Mura, G., Carta, M. G., Sancassiani, F., Machado, S., & Prosperini, L. (2018). Active exergames to improve cognitive functioning in neurological disabilities: A systematic review and meta-analysis. European journal of physical and rehabilitation medicine, 54(3), 450–462. https://doi.org/10.23736/S1973-9087.17.04680-9

    Article  PubMed  Google Scholar 

  • NPD Group. (2011). The video game industry is adding 2–17-year-old gamers at a rate higher than that age group’s population growth. Retrieved from: https://www.npd.com/wps/portal/npd/us/news/pressreleases/pr_111011

  • Orsmond, G. I., Shattuck, P. T., Cooper, B. P., Sterzing, P. R., & Anderson, K. A. (2013). Social participation among young adults with an autism spectrum disorder. Journal of autism and developmental disorders, 43(11), 2710–2719. https://doi.org/10.1007/s10803-013-1833-8

    Article  PubMed  PubMed Central  Google Scholar 

  • Pallavicini, F., Ferrari, A., & Mantovani, F. (2018). Video games for well-being: A systematic review on the application of computer games for cognitive and emotional training in the adult population. Frontiers in psychology, 9, 2127. https://doi.org/10.3389/fpsyg.2018.02127

    Article  PubMed  PubMed Central  Google Scholar 

  • Peñuelas-Calvo, I., Jiang-Lin, L. K., Girela-Serrano, B., Delgado-Gomez, D., Navarro-Jimenez, R., Baca-Garcia, E., & Porras-Segovia, A. (2020). Video games for the assessment and treatment of attention-deficit/hyperactivity disorder: a systematic review. European child & adolescent psychiatry. https://doi.org/10.1007/s00787-020-01557-w

    Article  Google Scholar 

  • Rodriguez-Ayllon, M., Cadenas-Sánchez, C., Estévez-López, F., Muñoz, N. E., Mora-Gonzalez, J., Migueles, J. H., Molina-García, P., Henriksson, H., Mena-Molina, A., Martínez-Vizcaíno, V., Catena, A., Löf, M., Erickson, K. I., Lubans, D. R., Ortega, F. B., & Esteban-Cornejo, I. (2019). Role of physical activity and sedentary behavior in the mental health of preschoolers, children and adolescents: A systematic review and meta-analysis. Sports medicine, 49(9), 1383–1410. https://doi.org/10.1007/s40279-019-01099-5

    Article  PubMed  Google Scholar 

  • Serret, S., Hun, S., Thümmler, S., Pierron, P., Santos, A., Bourgeois, J., & Askenazy, F. (2017). Teaching literacy skills to French minimally verbal school-aged children with autism spectrum disorders with the serious game SEMA-TIC: An exploratory study. Frontiers in psychology, 8, 1523. https://doi.org/10.3389/fpsyg.2017.01523

    Article  PubMed  PubMed Central  Google Scholar 

  • Spaniol, M. M., Shalev, L., Kossyvaki, L., & Mevorach, C. (2018). Attention training in autism as a potential approach to improving academic performance: A school-based pilot study. Journal of autism and developmental disorders, 48(2), 592–610. https://doi.org/10.1007/s10803-017-3371-2

    Article  PubMed  Google Scholar 

  • Stone, B., Bessie, G., Mills, K. A., & Saggers, B. (2019). Online multiplayer games for the social interactions of children with autism spectrum disorder: A resource for inclusive education. International Journal of Inclusive Education., 23(2), 209–228.

    Article  Google Scholar 

  • Tanaka, J. W., Wolf, J. M., Klaiman, C., Koenig, K., Cockburn, J., Herlihy, L., Brown, C., Stahl, S., Kaiser, M. D., & Schultz, R. T. (2010). Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let’s Face It! program. Journal of child psychology and psychiatry, and allied disciplines, 51(8), 944–952. https://doi.org/10.1111/j.1469-7610.2010.02258.x

    Article  PubMed  Google Scholar 

  • Travers, B. G., Mason, A. H., Mrotek, L. A., Ellertson, A., Dean, D. C., 3rd., Engel, C., Gomez, A., Dadalko, O. I., & McLaughlin, K. (2018). Biofeedback-based, videogame balance training in autism. Journal of autism and developmental disorders, 48(1), 163–175. https://doi.org/10.1007/s10803-017-3310-2

    Article  PubMed  PubMed Central  Google Scholar 

  • Valentine, A. Z., Brown, B. J., Groom, M. J., Young, E., Hollis, C., & Hall, C. L. (2020). A systematic review evaluating the implementation of technologies to assess, monitor and treat neurodevelopmental disorders: A map of the current evidence. Clinical psychology review, 80, 101870. https://doi.org/10.1016/j.cpr.2020.101870

    Article  PubMed  Google Scholar 

  • Vukićević, S., Đorđević, M., Glumbić, N., Bogdanović, Z., & Đurić Jovičić, M. (2019). A demonstration project for the utility of kinect-based educational games to benefit motor skills of children with ASD. Perceptual and motor skills, 126(6), 1117–1144. https://doi.org/10.1177/0031512519867521

    Article  PubMed  Google Scholar 

  • Wang, X., Xing, W., & Laffey, J. M. (2018). Autistic youth in 3D game-based collaborative virtual learning: Associating avatar interaction patterns with embodied social presence. British Journal of Educational Technology, 49(4), 742–760. https://doi.org/10.1111/bjet.126

    Article  Google Scholar 

  • Wass, S. V., & Porayska-Pomsta, K. (2014). The uses of cognitive training technologies in the treatment of autism spectrum disorders. Autism: the international journal of research and practice, 18(8), 851–871. https://doi.org/10.1177/1362361313499827

    Article  Google Scholar 

  • Wijnhoven, L., Creemers, D., Vermulst, A. A., Lindauer, R., Otten, R., Engels, R., & Granic, I. (2020). Effects of the video game “Mindlight” on anxiety of children with an autism spectrum disorder: A randomized controlled trial. Journal Behaviour Therapy Experimental Psychiatry, 68, 101548. https://doi.org/10.1016/j.jbtep.2020.101548

    Article  Google Scholar 

  • Winter-Messiers, M. A. (2007). From tarantulas to toilet brushes: Understanding the special interest areas of children and youth with asperger syndrome. Remedial and Special Education. https://doi.org/10.1177/07419325070280030301

    Article  Google Scholar 

  • Zablotsky, B., Black, L. I., & Blumberg, S. J. (2017). Estimated prevalence of children with diagnosed developmental disabilities in the United States, 2014–2016. NCHS Data Brief, 291, 1–8.

    Google Scholar 

Download references

Acknowledgments

This study received grant support from the Instituto de Salud Carlos III (ISCIII CM19/00026), and the Conchita Rábago Foundation.

Author information

Authors and Affiliations

Authors

Contributions

LJM conceptualized and designed the study, conducted the literature search, identified and abstracted data, drafted the initial manuscript, and approved the final manuscript. IPC conceptualized and designed the study, conducted the literature search, identified and abstracted data, and approved the final manuscript. PCR, IDO, MM and EBG critically reviewed and revised the manuscript and approved the final manuscript. APS conceptualized and designed the study, coordinated and supervised the data collection, critically reviewed and supervised the data collection, critically reviewed the manuscript, and approved the final manuscript.

Corresponding author

Correspondence to Inmaculada Peñuelas-Calvo.

Ethics declarations

Conflict of interest

The authors declare they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (docx 43 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Jiménez-Muñoz, L., Peñuelas-Calvo, I., Calvo-Rivera, P. et al. Video Games for the Treatment of Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord 52, 169–188 (2022). https://doi.org/10.1007/s10803-021-04934-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-021-04934-9

Keywords

  • Autism Spectrum Disorder
  • ASD
  • Video games
  • EHealth
  • Training
  • Children
  • Cognition