Figure 1.

Study flow and assessment schedule. This was a nonrandomized controlled study. All participants had autism spectrum disorder. The study was conducted in a psychosocial rehabilitation facility. Participants were assigned to 1 of 2 groups: the TCR (a training system that enables users to perform role-based behaviors using a computer graphics avatar in a real, bustling commercial facility) group (n=20, received TCR alongside communication guidance from teachers [CGT] in a classroom setting) and the control group (n=18, received only CGT) based on the chronological order of enrollment. Both groups underwent a 5-day intervention. The experimental procedures were performed from days 0 to 56. The interventions were conducted once per week for 5 weeks (days 14, 21, 28, 35, and 42). During the intervention period, the control group received only CGT, whereas the TCR group received TCR training and CGT. Anxiety, self-confidence, motivation, metacognition, and self-efficacy were assessed in a real-world setting at 5 time points: before the intervention (day 0), immediately before the intervention (day 14), during the intervention (day 28), immediately after the intervention (day 42), and 2 weeks after the intervention (day 56). There were no missing data at either the participant (0%) or the item level (0%) in this study. All enrolled participants (n=38) were included in the final analysis, and no attrition or loss to follow-up occurred.