Most SLTs know VR exists - almost none have used it with autistic children - and what would change that is very specific
How this was rated
Cross-sectional survey with 53 respondents in UK and Ireland. Design is well suited to describing current attitudes and barriers; not designed to measure effects. Self-selection toward tech-interested clinicians is possible.
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 UK and Ireland survey of 53 speech and language therapists working with autistic children found that 92% were aware of VR but had not used it clinically. Only one SLT (1.8%) had used it with an autistic child. The barriers cited were specific and addressable: autism-specific VR knowledge, workplace support, training, and clear clinical guidelines. 80% said they would try VR with proper training and evidence.
The gap between awareness of VR and use in autism-focused SLT practice is enormous - but receptive. Clinician interest exists and is conditional on neuro-affirming evidence, training, and workplace support. Any VR tool introduced into this area needs a co-design and training plan alongside the technology.
Key findings
- 92% of SLTs were aware of VR but had not used it clinically
- Only 1.8% (1 respondent) had used VR with an autistic child
- Three themes identified: (1) mixed general knowledge of VR with poor knowledge of autism-specific applications; (2) positive and negative attitudes with uncertainty about autism-specific considerations; (3) barriers requiring improved neuro-affirming evidence base, clinical guidelines, and training
- Main barriers: insufficient autism-specific VR knowledge, workplace support, absence of clinical guidelines
- 80% expressed willingness to adopt VR with training and evidence
- Authors called for neuro-affirming, co-designed VR tools rather than generic products
Background
VR has been promoted in autism-focused therapy for years, but whether speech and language therapists actually use it - and what would help them start - has rarely been quantified. Mills and Duffy surveyed UK and Ireland SLTs to map current awareness, use, and the specific conditions that would support adoption.
What the researchers did
A cross-sectional online survey of 53 SLTs working with autistic children. Questions covered VR awareness, clinical experience, barriers, facilitators, and willingness to adopt with specific supports in place.
What they found
Awareness was near-universal (92%) but clinical use was nearly absent - a single respondent had used VR with an autistic child. The barriers cited were practical: not enough autism-specific VR knowledge, no workplace support, no budget, no guidelines. Crucially, 80% said they would adopt VR if given training, evidence, and workplace backing. The authors emphasized that VR tools for autism need to be co-designed with autistic input and framed around participation rather than social skills remediation.
Why this matters
This is the clearest picture to date of where VR sits in autism-focused SLT practice: known but not used, with specific addressable reasons. The neuro-affirming framing is significant - it shifts the question from “can VR teach social skills” toward “can VR support autistic children in situations that matter to them.” That framing changes what counts as good VR design.
Limitations
Self-report, self-selection toward tech-interested clinicians, and a UK and Ireland sample limit generalizability. Perspectives of autistic individuals and their families were not included. Effects of VR on outcomes were not assessed.
Implications for practice
For SLTs working with autistic children: be cautious of VR marketing that frames VR as a social skills 'fix' - the neuro-affirming framing in this paper matters. If you introduce VR, check whether the tool was designed with autistic input, and whether it supports participation goals rather than normalization goals. This study shows your colleagues share that concern.
Implications for research
Co-design studies involving autistic children, families, and SLTs are needed before efficacy work. Implementation research tracking what happens after training rollouts would fill an important gap. Replication with larger, more diverse samples would strengthen the geographic applicability of findings.
Cite this study
If you reference this study in your work, the canonical citation formats are:
@article{mills2025,
author = {Mills, J. and Duffy, O.},
title = {Speech and Language Therapists' Perspectives of Virtual Reality as a Clinical Tool for Autism: Cross-Sectional Survey},
journal = {JMIR Rehabilitation and Assistive Technologies},
year = {2025},
doi = {10.2196/63235},
url = {https://withvr.app/evidence/studies/mills-2025}
}TY - JOUR
AU - Mills, J.
AU - Duffy, O.
TI - Speech and Language Therapists' Perspectives of Virtual Reality as a Clinical Tool for Autism: Cross-Sectional Survey
JO - JMIR Rehabilitation and Assistive Technologies
PY - 2025
DO - 10.2196/63235
UR - https://withvr.app/evidence/studies/mills-2025
ER - Know of research that should be in this hub? If a relevant peer-reviewed study is not listed here, send the reference to hello@withvr.app. The hub is kept up to date as the literature grows.
Funding & independence
No withVR BV involvement in funding, study design, or authorship. Summary prepared independently by withVR using the published paper.