The effects of virtual reality interventions on outcomes related to well-being among autistic children: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Virtual reality (VR) interventions have been increasingly employed in therapeutic and educational contexts for autistic children. OBJECTIVE: To conduct a systematic review and meta-analysis of randomized controlled trials to examine the effects of VR interventions on outcomes related to subjective well-being (SWB) and psychological well-being (PWB) among autistic children. METHOD: This meta-analysis was performed in accordance with the PRISMA guidelines. First, seven electronic databases were searched: PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, ProQuest Central, and IEEE Xplore. Subsequently, ten eligible studies were identified. Finally, data extraction was conducted, and effect sizes were pooled using random-effects models for SWB-related outcomes and PWB-related outcomes, respectively. Heterogeneity tests, sensitivity analyses, publication bias tests, and quality assessment were also performed. RESULTS: VR yielded a positive yet nonsignificant effect on SWB-related outcomes (g = 0.37, 95% CI [-0.03, 0.78], z = 1.80, p = 0.07), whereas VR produced a statistically significant positive effect on PWB-related outcomes (g = 0.45, 95% CI [0.27, 0.63], z = 4.87, p < 0.05). CONCLUSION: Pooled analyses revealed a statistically significant positive effect of VR interventions on PWB-related outcomes among autistic children. However, this finding should be interpreted with caution given that 70% of included randomized trials had some concerns regarding risk of bias and only eight effect sizes contributed to this pooled estimate. Current evidence supports tentative promise for VR within research-oriented clinical and educational contexts rather than immediate real-world clinical application, while its potential for enhancing SWB-related outcomes remains to be further investigated. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261411309.