Table 2.
Summary of studies included in the research.
| Author | Aim | Study Design/Intervention | Treatment Period | Sample Size | Sample Characteristics | Outcomes Measures | Main Findings |
|---|---|---|---|---|---|---|---|
| Smith et al., 2017 [52] | To evaluate whether improved interviewing skills, gained through VR-JIT, mediated the relationship between completing virtual interviews and receiving job offers within six months. | Randomized Controlled Trial. | From January 2012–May 2014. | A total of 79 trainees with mental disorders or ASD who participated in the VR-JIT program. | Age: The participants had an average age of 43.1 ± 14.8 years. Gender: There were a total of 56 males, making up 71% of the group. Clinical Scores: Correlation with Post-test Interview Skills: r = 0.82, p < 0.001 |
Pre- and post-test mock interviews. | The study found that completing more virtual interviews predicted improved interviewing skills, which, in turn, predicted a higher likelihood of receiving a job offer. Both relationships were statistically significant. |
| Yang et al., 2017 [54] | To identify pretreatment biomarkers using neuroimaging that could predict the response to VR-SCT in young adults with high-functioning ASD. | Uncontrolled Experimental Studies. | 17 young adults with high-functioning ASD. | A total od 17 young adults with high-functioning ASD. | Age: 22.50 years Gender: 2 females, 15 males. Clinical Scores: The research indicated a substantial enhancement in socio-emotional processing abilities after VR-SCT intervention, with notable progress from before treatment (M = 7.63, SD = 3.42) to after treatment (M = 9.63, SD = 3.78), supported by a Cohen’s drm of 0.55 (p = 0.03). |
MRI. | Neural predictors of changes in emotion recognition after VR-SCT were identified. Key predictors included brain activations related to language comprehension, socio-emotional experience, and emotional regulation. The study demonstrated that these predictors could forecast individual responses to VR-SCT. |
| Saiano et al., 2015 [55] | To evaluate the effectiveness of an integrated approach using virtual environments and natural interfaces to teach pedestrian safety skills (e.g., street crossing, following road signs) to adults with ASD. | Uncontrolled experimental studies | Ten sessions, with each session being 45 min long, conducted weekly. | Seven adults with ASD. | Age: 29 ± 10 years (range: 19–44) Gender: All males. Clinical Scores: The error rate for ‘crossing with red/yellow light’ showed a notable decrease (p = 0.0313; Wilcoxon’s sign test) from pre-treatment (T0) to post-treatment (T1) evaluations. |
A test questionnaire was administered before and after treatment to assess understanding of the practiced skills, and a separate questionnaire for parents/legal guardians and caregivers to evaluate real-life skill transfer. | Participants showed better navigation skills in the virtual environment but did not show a significant decrease in errors during street crossing, as found in the study. Despite this, parents and caregivers reported significant improvements in street crossing skills in real-life situations, indicating successful skill transfer. |
| Kim et al., 2024 [56] | To create and assess WorkplaceVR, a virtual reality system that aims to boost the self-confidence of individuals with autism in social workplace situations by combining simulated experiences with data visualizations of their responses. | Uncontrolled experimental studies | Not Specificated. | Fourteen young adults with autism participated in the study. | Age: 16 to 34 years. Gender: 2 females, 12 males. Clinical Scores: Not Specificated. |
PSES-VR | The VR system significantly improved participants’ self-efficacy, with a notable increase in perceived self-efficacy. Thematic analysis revealed that participants gained better self-awareness about their anxiety triggers and behaviors, which encouraged them to reflect on their experiences and develop self-advocacy strategies. |
| McCleery et al., 2020 [58] | To evaluate the safety, feasibility, and usability of an immersive VR training program for adolescents and adults with ASD, focusing on its potential to help develop practical life skills. | Uncontrolled experimental studies | The intervention involved either one or three VR sessions, each lasting for 45 min. | Sixty verbally fluent individuals with ASD participated in the study. | Age: 12–38 years old Gender: males and females (not specificated). Clinical Scores: The System Usability Scale adapted for verbally fluent adolescents and adults with ASD (SUS-ASD). For Cycle A, the SUS-ASD score averaged 83.58% (SD: 12.49%; range: 52.5–100%), indicating good usability. For Cycle B, the SUS-ASD score averaged 87% (SD: 7.89%; range: 67.5–100%), suggesting strong usability over multiple sessions. |
Recordings and semi-structured qualitative interview. | The study found that immersive VR is safe and feasible for use in verbally fluent adolescents and adults with ASD. The VR sessions were well-received, with high usability and enjoyment reported by participants. |
| Kourtesis et al., 2023 [57] | To evaluate the acceptability, usability, and user experience of a VR social skills training program designed for individuals with ASD. It also sought to understand the relationship between performance in VR social scenarios and various cognitive functions. | Uncontrolled experimental studies | Not Specificated. | A total of 25 participants with ASD. | Age: from 19 to 52 years. Gender: 6 females, 19 males. Clinical Scores: at the task completion score most participants showed a ceiling effect (high scores with little variance). |
Tower of London, Stroop Test, Digit Recall, Questionnaire, UEQ, SUS, CSQ-VR. | The VR social skills training was highly accepted by participants, and it was found to be usable with a positive user experience. Performance in social scenarios, self-reports, and executive functions were significantly correlated. In particular, the ability to plan was a significant factor in predicting performance in social situations and the usability of VR systems. |
| Miller et al., 2020 [59] | To evaluate the feasibility and effectiveness of using VR to teach air travel skills to autistic young adults. The objective was to determine if VR can improve attentiveness, language functions, and activity comprehension in this population. | Uncontrolled experimental studies | The VR-ATT program consisted of a single 20-min session each week over a period of three weeks. | Seven participants on the autism spectrum. | Age: The average age was 18.28 years (ranging from 10 to 22 years), including six individuals aged 16 to 22 years and one individual aged 10 years. Gender: 1 female, 6 males. Clinical Scores: (Air Travel Skill Acquisition): Test scores for comprehension improved by 10% from the initial session to the final session. Two participants had lower scores in the final test than in the first, whereas four participants demonstrated enhancement. |
Comprehension tests. | The study found improvements in attentiveness, specific language functions like vocabulary labeling, and activity comprehension among most participants. Clinical observations indicated that the VR technology was acceptable and engaging for the participants, suggesting its potential for delivering effective interventions. |
| Burke et al., 2018 [60] | To evaluate whether using a system could enhance job interviewing skills in individuals with autism and developmental disabilities. | Uncontrolled experimental studies | The treatment period consisted of sessions with the ViTA system, culminating in a final face-to-face interview. | A total of 32 participants with autism and developmental disabilities. | Age: 19 to 31 years old (Mean = 23, SD = 3.12). Gender: Majority males (n = 25, 78.13%). Clinical Scores: There was a significant 0.58 unit increase in the average MIAS score (SE = 0.12, t(118) = 5.04, p < 0.0001) from the initial ViTA session to the last in-person interview. |
MIAS. | The research revealed a significant improvement in participants’ MIAS scores from the initial ViTA session to the last in-person interview. Participants showed enhanced skills in identifying strengths, self-promotion, self-advocacy, and responding to various interview questions. |
| Yang et al., 2018 [61] | To investigate neural and behavioral changes in young adults with high-functioning ASD following a VR-SCT intervention, providing evidence on the neural mechanisms underlying behavioral improvements. | Uncontrolled experimental studies | Five weeks, with a total of 10 h of VR-SCT intervention. | A total of 17 young adults with high functioning of ASD. | Age: M = 22.50 years, SD = 3.89 Gender: 2 females, 15 males. Clinical Scores: The main clinical measure focused on emotion recognition, showing a noteworthy enhancement from before treatment (M = 11.41, SD = 4.42) to after treatment (M = 12.94, SD = 3.51), Δ = 1.53, t(16) = 2.32, p = 0.03, Hedges’s g_av = 0.38. |
Advanced Clinical Solutions for WAIS-IV and WMS-IV Social Perception Subtest. | Three significant brain-behavior changes were identified: increased activation in the right posterior superior temporal sulcus correlated with gains in theory-of-mind, highlighting improved socio-cognitive processing; Less activation in the left inferior frontal gyrus was associated with improved emotion identification. |
| Schmith et al., 2021 [63] | To develop and evaluate a proof-of-concept adaptive skills intervention using VR for adults on the autism spectrum, focusing on promoting the safe and appropriate use of public transportation. | Uncontrolled experimental studies | Summer 2018. | Nine participants: four expert testers and five participant testers with autism. | Age: The average age of the participants was 26.2 years, ranging from 22 to 34 years old. Gender: Not specificated. Clinical Scores: SUS score for Google Cardboard: 79.38; SUS score for Google Daydream: 84.38; Average SUS score across all participants: 79.58 (SD = 0.99); Average SUS score for expert reviewers: 81.88 |
Interview post exercises with VR. | The results indicate a positive learner experience with feasible and relevant intervention for adults on the autism spectrum, promoting skill acquisition and generalization effectively. |
| Kumazaki et al. 2022 [62] | To develop and evaluate the effectiveness of a GOT to help individuals with ASD acquire online job interview skills. | Exploratory pilot study | A total of 25 sessions for each participant. | A total of 15 individuals with ASD. | Age: 21.1 years (SD = 1.8). Gender: Male. Clinical Scores: The primary discovery of the research is demonstrated by the self-confidence score, which showed a significant improvement after the second simulated online interview in comparison to the first (3.27 vs. 2.27, p = 0.002). |
Mock online job interviews. | The GOT training program resulted in notable enhancements in the self-assurance, drive, empathy, communication skills, and overall interview ratings of the participants. |
Legend: Autism Spectrum Disorder (ASD), Virtual Reality-Social Cognition Training (VR-SCT), Magnetic Resonance Imaging (MRI), Virtual-Reality job interview training (VR-JIT), Virtual Reality (VR), Perceived Self-Efficacy for VR Social Skill Training Scale (PSES-VR), User Experience Questionnaire (UEQ), System Usability Scale (SUS), Cybersickness in Virtual Reality Questionnaire (CSQ-VR), virtual reality air travel training (VRATT), Virtual Interactive Training Agent (ViTA), Marino Interview Assessment Scale (MIAS), Virtual Reality-Social Cognition Training (VR-SCT), System Usability Scale (SUS), group-based online job interview training program using a virtual robot (GOT).