Social CommunicationAutism & Neurodivergent

Systematic review (2025) of VR + AR + MR training for autism social skills: 7 studies, 417 individuals - broader scope than VR-only autism reviews, occupational-therapy lens

Ahn S · 2025 · Hong Kong Journal of Occupational Therapy · Systematic Review · n = 417 · 7 studies of VR/AR training for autistic individuals (pooled) · DOI
Evidence certainty: Moderate certainty
How this was rated

Systematic review methodology with explicit risk-of-bias assessment. Published in Hong Kong Journal of Occupational Therapy (SAGE, Scopus-indexed). 7 included studies with 417 individuals - modest pool but appropriate for the scoping question. Single-author review (Ahn S-N) - replication or multi-author review would strengthen confidence. The review explicitly notes all included studies had unclear risk of bias regarding randomization process - a meaningful caveat.

Ratings use a simplified four-tier scheme (High, Moderate, Low, Very Low) informed by the GRADE working group. Learn more about how studies are rated.

A systematic review published in the Hong Kong Journal of Occupational Therapy synthesizing VR + augmented reality + mixed reality (VAMR) training for social skills in autistic individuals. Literature search across MEDLINE, EMBASE, ERIC, Web of Science. Seven studies were included totaling 417 autistic individuals. All studies were judged to have unclear risk of bias regarding the randomization process. The review's contribution is breadth - including AR and MR alongside VR - and the occupational-therapy framing relevant for OTs and allied clinicians working with autistic individuals.

Clinical bottom line

A systematic review distinguishing VR + AR + MR training for autism social skills - the broader extended-reality (XR) framing rather than VR-only. 7 included studies / 417 participants. Published in Hong Kong Journal of Occupational Therapy with an occupational-therapy clinical lens. Useful for OT clinicians and for clinicians working at the intersection of speech-language pathology and occupational therapy with autistic clients.

Key findings

  • Systematic review of Virtual + Augmented + Mixed Reality (VAMR) training for autism social skills, published 2025 in Hong Kong Journal of Occupational Therapy
  • Literature search: MEDLINE, EMBASE, ERIC, Web of Science
  • 7 studies included, totaling 417 autistic individuals - modest pool
  • ALL included studies judged to have UNCLEAR RISK OF BIAS regarding the randomization process - a meaningful methodological caveat for interpreting the synthesis
  • Broader XR framing (VR + AR + MR) rather than VR-only - distinct contribution among the 2025 autism+VR reviews (Altın 2025 and Yang 2025 are VR-focused)
  • Occupational-therapy clinical lens - relevant for OTs and clinicians working at the SLP/OT intersection with autistic clients
  • Single-author (Ahn S-N) - replication or multi-author work would strengthen confidence
  • Published in Hong Kong Journal of Occupational Therapy (SAGE, Scopus-indexed)

Background

Most published autism+VR reviews focus on VR alone. Augmented reality and mixed reality are distinct XR modalities with their own clinical considerations. By 2025, an XR-broad review was warranted to map the field beyond VR.

What they did and found

Systematic review of VAMR (Virtual + Augmented + Mixed Reality) training for autism social skills. MEDLINE, EMBASE, ERIC, Web of Science searches. 7 included studies / 417 individuals. All studies judged to have unclear risk of bias regarding randomization.

Why it matters

Broader XR framing complements the VR-only reviews. Occupational-therapy lens useful for OT clinicians and SLP/OT intersection practitioners.

Limitations

Single-author review. Modest pool (7 studies). All included studies had unclear randomization risk-of-bias.

Implications for practice

For OT clinicians and SLP/OT-intersection practitioners working with autistic clients, this review provides occupational-therapy-framed evidence on VAMR training. For SLP-only clinicians, the broader VR-only reviews (Altın 2025, Yang 2025, Bailey 2022, Parsons & Cobb 2011) are more directly applicable. The risk-of-bias finding is clinically relevant: the published VAMR-for-autism literature has not yet produced clearly low-risk-of-bias RCTs at scale.

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Cite this study

If you reference this study in your work, the canonical citation formats are:

APA 7th
Ahn, S. (2025). Virtual, augmented, and mixed reality training for improving social skills in individuals with Autism Spectrum Disorder: A systematic review. Hong Kong Journal of Occupational Therapy. https://doi.org/10.1177/15691861251369043.
AMA 11th
Ahn S. Virtual, augmented, and mixed reality training for improving social skills in individuals with Autism Spectrum Disorder: A systematic review. Hong Kong Journal of Occupational Therapy. 2025. doi:10.1177/15691861251369043.
BibTeX
@article{ahn2025,
  author = {Ahn, S.},
  title = {Virtual, augmented, and mixed reality training for improving social skills in individuals with Autism Spectrum Disorder: A systematic review},
  journal = {Hong Kong Journal of Occupational Therapy},
  year = {2025},
  doi = {10.1177/15691861251369043},
  url = {https://withvr.app/evidence/studies/ahn-2025}
}
RIS
TY  - JOUR
AU  - Ahn, S.
TI  - Virtual, augmented, and mixed reality training for improving social skills in individuals with Autism Spectrum Disorder: A systematic review
JO  - Hong Kong Journal of Occupational Therapy
PY  - 2025
DO  - 10.1177/15691861251369043
UR  - https://withvr.app/evidence/studies/ahn-2025
ER  -

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Funding & independence

Single-author affiliation: Ahn S-N (Hong Kong, OT research). Funding sources reported in published article. Peer-reviewed in Hong Kong Journal of Occupational Therapy (SAGE, Scopus-indexed). No withVR BV involvement.

Last reviewed: 2026-05-17 Next review due: 2027-05-17 Reviewed by: Gareth Walkom