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. 2026 Oct 21;73(5):e70132. doi: 10.1111/1440-1630.70132

Online gaming for autistic youth: Exploring the impact on participation from the perspectives of autistic adolescents and their caregivers

Maya Hayden‐Evans 1, Tahlia Inkster 1, Isabella Fimmano 1, Zoe Smith 1, Jessica Leamon 1, Sonya Girdler 1,2,3, Ben Milbourn 1,✉
PMCID: PMC13686341  PMID: 42905893

Abstract

Introduction

The rise in the number of adolescents diagnosed with autism spectrum disorder has highlighted the need for strength‐based approaches to support them. The accessibility of online gaming has made it a popular avenue for autistic adolescents to socialise and connect with others while enhancing skill development. This study aimed to explore online gaming from the perspectives of autistic adolescents and their caregivers, including the impact gaming may have on daily participation and functioning.

Methods

This study employed a mixed methods research design. Both autistic adolescents and their caregivers completed online surveys comprising a combination of Likert‐scale and open‐ended questions. The survey responses were descriptively and thematically analysed.

Consumer and Community Involvement

Survey questions were reviewed by volunteer staff (including autistic staff members) of a local autistic community coding club to ensure readability and accessibility of the survey.

Results

In total, 45 participants (23 caregivers and 22 autistic adolescents) responded to the survey. Themes relating to online gaming were identified, including social communication, emotion regulation, and skill development while also highlighting caregiver concerns of online safety and excessive screen use. Most autistic adolescents reported feeling happy when playing online games and most caregivers agreed online gaming supported their child to build better relationships with others. Over half of autistic adolescents agreed that online gaming helped them feel more confident in social situations with others.

Conclusion

Allied health professionals, including occupational therapists, may utilise online gaming, incorporating strength‐based learning and skill development, when working alongside autistic adolescents and their caregivers to facilitate social participation and promote online safety.

Keywords: lived experience, online gaming, strength‐based approaches

PLAIN LANGUAGE SUMMARY

Online gaming is becoming more common, giving autistic young people a way to make friends and learn new skills. This study explored how online gaming affects autistic teenagers, from both their own perspective and their caregivers'. The researchers collected information through online surveys from 22 autistic adolescents and 23 caregivers. The study found that online gaming helped many autistic teenagers feel happier, more confident, and better at talking to others. Many caregivers noticed that gaming helped their child build relationships. However, some caregivers were worried about online safety and too much screen time. Occupational therapists could use online gaming to help autistic youths develop social skills.

Key Points for Occupational Therapy.

  • Online gaming utilises the unique preferences and interests of autistic adolescents which promotes strength‐based skill development.

  • Autistic adolescents' development of social communication, fine motor, and problem‐solving skills can be supported by online gaming.

  • Concerns of online safety, emotional regulation, and excessive screen use should be considered by allied health professionals.

1. INTRODUCTION

Autism is a lifelong neurodevelopmental condition characterised by differences in reciprocal social communication, interaction and response to sensory input, and the presence of restricted or repetitive behaviours, interests, and activities (American Psychiatric Association, 2022; Hodges et al., 2020). It is estimated that 1 in 100 children are diagnosed with autism globally (Zeidan et al., 2022). Expanding awareness and understanding of autism has contributed to an increase in the rate of diagnosis, emphasising the need for deeper exploration into alternative mediums to provide strength‐based support to autistic adolescents (American Psychiatric Association, 2022; Hodges et al., 2020).

Living in a predominately neurotypical society, there is increased pressure for autistic individuals to adapt their communication skills to participate in society (Mitchell et al., 2021). Adolescents may experience increased social pressure in different social contexts, where there is often a lack of understanding in communication between neurotypical and autistic individuals (Chen et al., 2015; Deckers et al., 2014). Stigmatisation and negative reception of behaviours misinterpreted by neurotypical peers may contribute to higher levels of social anxiety and reduced social participation of autistic adolescents (Briot et al., 2020). Expression of autistic characteristics has traditionally been discouraged and autistic adolescents may consequently ‘mask’ their true selves, negatively impacting their mental wellbeing (Cage & Troxell‐Whitman, 2019; Hull et al., 2017). In comparison with their neurotypical peers, autistic individuals may experience higher incidences of anxiety, depression, and suicidality, attributing to discrimination, social isolation, and reduced likelihood of receiving appropriate health care and support services (Croen et al., 2015; Shattuck et al., 2011).

Strength‐based approaches focus on harnessing an individual's strengths and interests to build skills and positive experiences, diverging from a deficit‐focussed mindset (Lee et al., 2024). They challenge traditional notions of autistic traits by re‐evaluating them as potential strengths. Embedded in the social model of disability, a strength‐based approach takes a holistic view, emphasising that societal structures, not individual abilities, create barriers (Lee et al., 2020). Interventions can be adapted to suit autistic adolescents by leveraging their unique strengths and interests, including circumscribed interests, to increase engagement and participation (Dunn, 2017). The positive outcomes of this approach are credited to creating safe social environments and keeping activities interest‐based (Jones et al., 2021). Utilising the interests of autistic adolescents promotes a sense of accomplishment and builds confidence, empowering them to engage in different activities or challenges (Koegel et al., 2012).

One example of strength‐based interventions is online gaming. Video games, online gaming, and technology interventions have become increasingly popular through the rise of the internet and more accessible technologies in clinical, educational, and community settings (Fam, 2018; Kaplan et al., 2022; Odom et al., 2015). Online games can provide social skills training, cognitive and executive function training, treatment of mental health conditions, and an alternative mode of presenting educational material to adolescents with processing difficulties (Beaumont et al., 2019; Bocci et al., 2023; Crouch et al., 2023; Rashedi et al., 2022; Zayeni et al., 2020). Studies show adolescents are attracted to video and online games as they are motivationally fun, social, immersive, and provide a sense of achievement (Snodgrass et al., 2017). However, some autistic adolescents use online games to escape from dysphoric moods and problematic relationships within the real world (Snodgrass et al., 2017). This can lead to negative repercussions within their daily life if not adequately addressed, including behavioural and lifestyle changes (Granic et al., 2014; Kaplan et al., 2022).

Traditionally, research into online gaming interventions focussed exclusively on the perspectives of caregivers or autistic adolescents (Mazurek et al., 2012; Rashedi et al., 2022; Willis et al., 2022). However, there is frequently a discrepancy between these two views, with many caregivers voicing concerns about screen time and its effects on their children (Fam, 2018; Kaplan et al., 2022; Rashedi et al., 2022; Snodgrass et al., 2017). This contrasts with the experiences of autistic adolescents, who describe online games more positively, attributing these to outcomes such as self‐confidence, conversation skills, emotion recognition, and conflict resolution (Afsharnejad et al., 2022; Einfeld et al., 2018; Płatos et al., 2023; Snodgrass et al., 2017). There are limited studies exploring the perspectives of both populations and the impact online gaming may have on participation and functioning in daily activities. This study aims to bridge this gap in the literature by exploring both autistic adolescents' and caregivers' viewpoints of online gaming relating to everyday participation and functioning. Exploring the lived experiences of both autistic adolescents and their caregivers within the community can add to the growing body of research regarding the benefits and challenges of online gaming and provide recommendations to allied health professionals utilising and developing online gaming interventions.

2. METHODS

2.1. Study design

A mixed methods research design was used, with both qualitative and quantitative results converged in the discussion (Hunter & Brewer, 2015). Surveys with a variety of questions, including Likert scales and open‐ended questions, were used to collect data, providing complimentary perspectives on the content while also offering depth and breadth of the topic. Likert scales were used in the adolescent and caregiver surveys to encourage the selection of responses that best represented how they felt about online gaming, particularly its impact on social skills. Data were collected from autistic adolescents and their caregivers using online surveys hosted on Qualtrics (2024). Data were analysed using a thematic analysis approach to uncover themes of similar perspectives or shared meanings from the participants (Armstrong et al., 2021).

2.2. Participants

Participants were required to meet the following criteria: (1) adolescents aged 10 to 18 years, (2) with a primary diagnosis of autism, or (3) the primary caregiver of an autistic adolescent. A total of 45 participants (22 autistic adolescents; 23 caregivers) completed the surveys. Participants were recruited from a strength‐based coding club that promotes social interaction among autistic adolescents in Western Australia and from relevant autistic Facebook groups and communities. Autistic adolescents were offered a $10 online voucher as a token of appreciation for their time spent completing the survey.

2.3. Data collection

This study was approved by Curtin Human Research Ethics Committee (HRE2017‐0147‐99). All participants were provided with an information sheet detailing their potential involvement in the research and offered the opportunity to ask any questions prior to giving their informed consent to participate. Caregivers filled out and signed an external assent form if their adolescent did not complete the survey with them present.

Questions relating to the research topic were prepared and curated with a team of autism researchers, and data were collected using online survey platform, Qualtrics (Briot et al., 2020; Płatos et al., 2023; Qualtrics, 2024). Coproduction design ensured survey questions prompted in‐depth exploration of relevant aspects of online gaming (Armstrong et al., 2021). Questions were refined with the parent of an autistic child before being trialled with coding club facilitators (including autistic young adults) to ensure the suitability and engagement of the surveys for autistic adolescents.

Researchers handed out flyers with a QR code to caregivers attending the coding groups or dropping their adolescents off. The information flyer with QR codes and hyperlinks to the surveys was posted to Facebook and relevant Facebook groups by the research team. Individuals interested in participating in the study completed the Qualtrics survey (Qualtrics, 2024) via the QR code on the flyers or hyperlinks.

2.4. Data analysis

Demographic data, multiple‐choice responses, and Likert scales were exported from Qualtrics to Microsoft Excel (Microsoft Office 365, 2021a) and summarised using descriptive statistics. Researchers downloaded open‐text data to Microsoft Word (Microsoft Office 365, 2021c) for cleaning, coding, and analysis. The six‐step thematic analysis involved (1) researchers familiarising themselves with the data, (2) generating codes, and (3) identifying themes, providing a rich description of each theme; (4) remaining members of the team subsequently reviewed the codes, and (5) after several meetings with the whole team, (6) the findings were then written up (Braun & Clarke, 2006).

2.5. Rigour

To address credibility, research participants were emailed the recommendations the research team compiled based on the findings which constituted member checking (Varpio et al., 2017). The research team documented the research process and data with an audit trail stored throughout, de‐identified data, including removing personal names, stored this data in a protected drive, and uploaded it via Microsoft Teams (Microsoft Office 365, 2021b).

To ensure rigour and trustworthiness, the research team followed these criteria: credibility (member checking), transferability (thick description), dependability (audit trail), and confirmability (research supervisors were involved in confirming results) (Nowell et al., 2017).

2.6. Positionality statement

M.H.‐E., S.G., and B.M. are registered occupational therapists and active members of an autism research group exploring strength‐based approaches among other areas of research of importance to the autism community. T.I., I.F., Z.S. and J.L. were final‐year occupational therapy students at the time of the study who had received approximately 18 months of research training and were supervised by senior researchers within the autism research group.

3. RESULTS

3.1. Participant demographics and perspectives on online gaming

A total of 23 caregivers and 22 autistic adolescents completed the online survey. Caregivers were mostly female (73.9%) with the majority aged between 35 and 54 years (87%). Their children were mostly male (90.9%) and ranged in age from 10 to 15 years with most being 12 (26.1%) or 13 (30.4%) years old. Additional participant demographic information is included in Table 1.

TABLE 1.

Participant demographic information.

Response Number (%)
Caregiver gender
Female 17 (73.9)
Male 6 (26.1)
Caregiver age in years
25–34 1 (4.3)
35–44 10 (43.5)
45–54 10 (43.5)
55 and over 2 (8.7)
Child's gender
Female 2 (9.1)
Male 20 (90.9)
Child's age in years
Range 10–15
Mean 12.6
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Over a third (36.5%) of caregivers believed that their child played online games with their friends from school, and only 11.5% thought their child played games with unfamiliar people online. Over a third (34.8%) of caregivers stated there was an improvement in their child's ability to regulate their emotions, and a further 43.5% reported no change. Caregivers' responses on the number of hours their child spent online gaming indicated 60.9% spend 5–20 hours per week, and 17.4% stated their child spent more than 30 hours. Some caregivers (43.5%) were neutral to the statement ‘I have seen a reduction in social anxiety or stress related to social situations in my child’ (Figure 1), while a further 30.4% disagreed with the statement. More than half of caregivers (52.2%) agreed with the statement ‘online gaming has positively influenced my child's self‐esteem and confidence’, with 34.8% agreeing and 17.4% strongly agreeing. Similarly, most caregivers agreed online gaming had helped their child build better relationships with others, with 60.9% agreeing and one caregiver (4.3%) strongly disagreeing. In response to noticing a positive change in their child's social skills since they started participating in online gaming, the majority responded neutral with 39.1%, followed by 30.4% agreeing.

FIGURE 1.

FIGURE 1

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Caregivers' responses to online gaming statements.

3.2. Autistic adolescent perspectives on online gaming

Over three quarters (77.3%) of autistic adolescent participants reported they felt happy when playing online games, over half (54.5%) stated they felt excited and 4.5% of respondents reported feeling anxious and/or scared. When asked if they preferred online gaming to the real world, 72.7% of respondents reported that they sometimes prefer online gaming, while a further 9.1% responded that they do prefer online games. Responses showed 68.2% play online games with friends from school, and almost one third (31.8%) play online with unknown people. Over half of autistic adolescents (59.1%) agreed or strongly agreed that online gaming helped their confidence. Almost two thirds (63.6%) of autistic adolescents believed their strengths included listening to others and expressing their opinions, and over half (54.5%) said asking and answering questions was a strength. Only 22.7% stated following social rules and recognising/expressing emotion was a key area of strength, and a further 9.1% believed that their strengths included body language and starting conversations.

Autistic adolescent participants' responses showed 59.1% agree/strongly agree that online gaming has helped them feel more confident in social situations, with 36.4% neutral and one adolescent strongly disagreeing (Figure 2). Results show that 65% of autistic adolescents agreed that they enjoyed the social aspect of online gaming, with the remaining 25% neutral and 10% disagreeing. Autistic adolescents' responses for enjoyment showed overwhelmingly positive results with 47.6% strongly agreeing and 47.6% agreeing that they enjoy participating in online gaming, with the remaining one participant's response disagreeing.

FIGURE 2.

FIGURE 2

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Autistic adolescents' responses to statements.

3.3. Qualitative responses to open‐ended questions

Thematic analysis of the qualitative data identified the perspectives of both the autistic adolescents and their caregivers on online gaming with five dominant themes emerging, including (1) online safety, (2) social communication, (3) emotion regulation, (4) developing new skills, and (5) strength‐based interests.

3.3.1. Online safety

Participants expressed the importance of online safety for autistic adolescents when engaging in online gaming. Participants identified concerns, including the risk of online bullying, being unaware of who autistic adolescents were playing with, and the risk of interacting with and sharing information online.

3.3.2. Caregiver concerns

Caregivers identified an array of concerns for online gaming, including online bullying, lack of safeguards for online games, and online predators. Caregivers described concerns regarding the inability to control who their children were talking to online, which, from their perspective, increased risk of predation. Caregivers also reflected on issues surrounding the lack of regulation on the internet as it is a new phenomenon. For example, one participant stated, ‘my first concern was about safety and privacy’ (P5). Caregivers reported they had concerns setting boundaries around online gaming as it resulted in their autistic adolescent experiencing ‘rages’ and ‘lashing out’ (P22).

3.3.3. Autistic adolescent awareness

Autistic adolescents described the most important things they have learnt from online gaming as ‘not talking to strangers’ (P25) and ‘don't leak information’ (P43). For example, one adolescent stated, ‘not everyone is who they said they are’ (P24). Participants echoed their mutual awareness of the seriousness of the dangers of online gaming, with a preference for only playing with people they knew.

3.4. Social communication

Participants shared how online gaming provided a way for autistic adolescents to connect with their peers and improve their social communication. Participants noted a positive response in improved social skills, and that gaming ‘helps with communication’ (P16). Further, participants described having ‘more confidence’ (P18) while interacting with people online and offline and stated they felt their communication skills also improved. For example, one autistic adolescent articulated that being able to ‘talk to people and make them laugh’ (P40) was their favourite part of online gaming. Participants shared how online gaming provides opportunities for multiplayer games, enabling autistic adolescents to play and connect with people with common interests. As one participant stated, ‘gaming in general helps me find people with similar interests to me’ (P44).

3.5. Emotion regulation

Participants reflected on the impact that online gaming has on autistic adolescents' emotion regulation. Caregivers reported both positive and negative examples relating to emotion regulation. Some reasons for emotional outbursts included difficulty transitioning away from online gaming to other activities and caregivers setting boundaries around screen time. For example, one caregiver described, ‘the more I try to place boundaries the more his behaviour escalates’ (P22). Conversely, caregivers shared how autistic adolescents utilised online gaming to regulate their emotions. One caregiver expressed that online gaming ‘helps with emotional regulation after school’ (P8).

3.6. Developing new skills

Participants described online gaming as providing them the opportunity to develop new fine motor and problem‐solving skills.

3.6.1. Fine motor skills

Participants identified fine motor skills as a strength for autistic adolescents during online gaming. Several practical fine motor skills were identified, including speed typing, hand–eye coordination, and dexterity skills. Participants noted how these skills were often transferable to real‐life situations. One participant noted having ‘excellent hand‐eye‐coordination’, (P27) which they used during online gaming and in other situations.

3.6.2. Executive functioning skills

Participants reported improved executive functioning skills through engagement in online gaming, such as problem‐solving and critical thinking. Participants stated multiplayer games allowed them to employ problem‐solving skills to ensure clear communication and that players work together. For example, one adolescent described benefits, including ‘I like to think I have good problem solving skills and it helps in escape rooms in Roblox’ (P44). Autistic adolescents preferred games that involved puzzles and critical thinking tasks as it gave them opportunities to use problem‐solving skills for ‘testing new things’ and ‘finding bugs’ (P24). An adolescent stated, ‘knowing (critical thinking and problem solving) gives me a head start’ in online gaming, and another said they ‘know what to do before something happens’ (P24).

3.7. Strength‐based interests

Autistic adolescent responses reflected that the popularity of online gaming is due to increasing identification, appeal, and recognition of autistic strengths. The use of autistic adolescents' strengths while online gaming provides them with a sense of accomplishment. Online gaming drawing on strengths of autistic adolescents, such as ‘using creativity to make a castle and a house’ (P34), provided them with a strong sense of achievement, which improved their self‐efficacy. For example, one participant expressed how online gaming enabled their interests of ‘working with friends’ (P35).

4. DISCUSSION

This study aimed to explore the real‐world impact of online gaming on participation and the strengths and limitations of online gaming from the perspectives of autistic adolescents and their caregivers. Findings from the study indicated that caregivers and autistic adolescents identified many benefits from engaging in online gaming, including improved social communication and confidence, problem‐solving skills, fine motor skills, and supporting a strength‐based approach. These findings are consistent with research by Crouch et al. (2023) which indicated online gaming can be beneficial for increasing fine motor skills, social health, and executive functioning. Participants also reflected common concerns, including online safety and bullying, the need to monitor screentime, emotion regulation, and adolescents' preference for online worlds over the real world.

The findings of this study support the use of online mediums incorporating strength‐based principles to encourage participation of autistic adolescents both in and beyond therapeutic contexts. Jones et al. (2021) previously identified that online gaming utilises several strength‐based components, such as being interest‐based and catering to the unique learning needs and preferences of autistic participants. Participants' perspectives, combined with the findings of earlier studies, suggest that using online gaming as an alternative therapeutic medium may promote opportunities for building self‐efficacy and confidence in autistic adolescents, as well as fostering feelings of support from peers with similar interests (Black et al., 2025). Participants reported that online gaming contributed to a sense of accomplishment, indicating that self‐esteem may be supported through online gaming achievements, encouraging autistic adolescents to attempt other activities or tasks that feel difficult outside of the gaming context (Jones et al., 2023). Increased confidence can empower autistic adolescents to engage in activities and promote skill development, addressing the challenges they may face in other occupational contexts such as at home or school (White et al., 2023). By utilising their strengths and creating safe environments through online gaming, autistic adolescents may feel empowered to approach new challenges outside of the gaming environment, ultimately increasing their independence and autonomy in other major life areas (Patten et al., 2024).

The findings of this study indicated that autistic adolescents feel more confident when communicating with their peers online. Previous research has highlighted that socialisation via online gaming increases confidence and comfort during face‐to‐face communication by reducing barriers such as shyness and social stigma among autistic adolescents (Hughes & Nguyen, 2024; Turnock et al., 2022). This sentiment was shared by participants in the current study, who reported that they believed online gaming improved their confidence communicating offline as well. Building autistic adolescents' confidence within environments where they feel comfortable supports the transfer of confidence to other environments, including peer and familial relationships (Granic et al., 2014). This may also apply to the broader community and societal contexts as it fosters increased engagement and participation in daily interactions outside of the gaming context, including at school, where adolescents experience the majority of their social interactions (Lee et al., 2024). Given that autistic adolescents are at increased risk of experiencing negative mental health outcomes (Croen et al., 2015), the findings of the current study suggest that fostering better connection and relationships through improving social communication via activities such as gaming may improve the overall wellbeing of autistic adolescents.

In addition to social communication skills, online gaming provided participants with opportunities to develop a range of diverse and practical skills, including fine motor and executive functioning skills. Similarly, Borecki et al. (2013) demonstrated that computer‐based games can support fine motor skill acquisition which was important for mastery and a sense of accomplishment. In addition, fine motor skills are essential for a wide variety of occupations, including manipulating tools required for writing, cooking, eating, and engaging in recreational hobbies. While previous studies suggest that online gaming can help develop skills required for other activities, the results of this study indicate that skills and abilities honed outside of gaming (e.g., hand–eye coordination) can also enhance the gaming experience, contributing to improved performance and satisfaction during gaming. Aligning with the results of the current study, Jiménez‐Muñoz et al. (2022) also identified that online gaming has the potential to improve executive functioning, which is important given some of the complexities around autistic adolescents' executive functioning. Building these skills may increase quality of life for autistic adolescents as they are necessary for enabling participation within the community, including improving their employability in prospective jobs and future tertiary study. The present study's results support online gaming as an avenue for implicit and explicit skill development among autistic adolescents. Foundational development of these skills during adolescence may increase their independence and meaningful participation in society and create a sense of purpose and belonging for the individual (Stone et al., 2019).

Although online gaming is well placed to foster connections between rural and remote adolescents who may have limited access to social groups, the benefits of in‐person gaming groups should not be dismissed. Establishing community‐based programs with opportunities for face‐to‐face interaction can reduce isolation among adolescents (Corbella‐González et al., 2025). Structured gaming programs facilitated by a health professional that incorporate reflective exercises and opportunities to embed social skills practice are more likely to support the transfer of social skills to other everyday contexts than simply engaging in online gaming recreationally (Alahmari et al., 2025; Mirzaei et al., 2022). Autistic adolescents in this study disclosed their preference for participating in online gaming rather than real‐world activities. Participants' responses are consistent with those from Caro and Popovac (2021) who identified that some youths use gaming as a tool to aid in stress reduction and to distract the users from life difficulties and increasing strain felt in the real world. In a similar study, Mazurek et al. (2015) also found that autistic adolescents enjoyed the sense of achievement and creativity involved with online gaming, aligning with the present study's findings of enjoying winning games. Studies by Jones et al. (2021) and Wei et al. (2013) explored autistic traits such as attention to detail, memory, and a preference for visual perception provided strengths for autistic people using technology, which in turn promoted an interest in online gaming activities. Activation of these autistic strengths is key in fostering a sense of inclusion alongside participation within society away from the online context (Jones et al., 2021). Due to the increasing prevalence of autism in the Australian community (Australian Bureau of Statistics, 2018), more autistic adolescents are seeking access to strength‐based therapeutic mediums and services that promote participation in the community (Jones et al., 2021). Using online gaming as a conduit to work alongside autistic adolescents may build necessary skills for participation and engage autistic adolescents in a strength‐based manner. Although the National Disability Insurance Scheme (NDIS) no longer funds specific gaming therapy, allied health professionals are still in a position where they can engage autistic adolescents through this medium when building capacity for participation and engagement in daily activities (Parliament of Australia, 2024).

Rashedi et al. (2022) and Mazurek et al. (2015) discuss that online games may increase the risk of aggression, arguments, frustration, and meltdowns. The present study highlighted the experiences of anger and frustration relating to online gaming were often due to factors, including the skill difficulty of the game, winning or losing the game, and parameters around acceptable time use. This is relevant to note, as autistic adolescents play online games with both neurotypical and autistic peers and frequent emotion regulation difficulties may lead to strained relationships and disengagement (Briot et al., 2020). Disengagement from peers may result in increased social isolation and feelings of loneliness for autistic adolescents (Briot et al., 2020; Browne et al., 2024). Autistic adolescents may place higher value on online relationships due to difficulty forming meaningful relationships offline, and difficulties with emotion regulation, specifically due to online gaming, could jeopardise this.

Autistic and neurotypical adolescents all commonly experience developmental and hormonal changes throughout puberty, which can cause emotional fluctuations and difficulty managing emotions in various aspects of life (Bailen et al., 2019). With the likelihood of increased emotion regulation difficulties during this period of development, online gaming could provide a unique opportunity for autistic adolescents to learn crucial self‐regulation strategies. Granic et al. (2014) discussed how online games encourage autistic adolescents who are faced with barriers in games and feelings of frustration or anger to adapt and regulate their emotions to overcome the challenges presented for effective gameplay. The present study supports these findings and promotes the benefits of exposing autistic adolescents to a full range of emotions in a safe and supportive environment. Skills and strategies to manage emotion regulation may be developed in this environment, which can further be transferred to additional situations and experiences autistic adolescents may face in daily life (Grynszpan et al., 2014). Gaming interventions that incorporate principles of cognitive behavioural therapy and mindfulness, including setting clear boundaries and expectations, may be particularly useful in supporting the development of emotion regulation strategies among adolescents that can be used during and outside of gameplay (Shechtman, 2025; Simione et al., 2024).

Results of the present study suggest that many caregivers had concerns regarding the safety of their child while online gaming. Research from Kloosterman et al. (2013) and Kowalski et al. (2019) found that cyberbullying and online safety concerns have become increasingly prevalent in Western culture and society. A study by Macmillan et al. (2020) indicated that autistic people are twice as likely to be at risk of online bullying and sexual exploitation than neurotypical counterparts. In the present study, caregivers described the need for online safety and regulation to minimise harm given the heightened vulnerabilities of autistic adolescents. The increase in research about online safety has had positive effects within the neurotypical population on awareness and implementation of protective factors to minimise risk of harm when engaging in online contexts (Finkelhor et al., 2021). As shown in this study's results, the importance of developing resources for caregivers, allied health professionals, schoolteachers, and autistic adolescents regarding the dangers of online gaming due to the continually changing online environment needs to be continued (Australian Government, 2024). Online safety concerns are often juxtaposed with autistic adolescent participants' desire to use an online gaming medium to meet and connect with friends (Hughes & Nguyen, 2024). In the present study, a specific concern from caregivers was regarding the lack of ability to monitor who their children are interacting with online. Autistic adolescent participants were found to be aware of online safety measures which included identity verification and being cautious of who has access to information (Zhao et al., 2019). Focussed interests aligning with online gaming and familiarity of online processes have opportunity to provide autistic adolescents with safe practice, which included avoiding giving out information online and talking to strangers.

5. IMPLICATIONS

Online gaming has been evidenced to support the differing learning needs and goals of autistic adolescents as an alternative to traditional learning methods (Odom et al., 2015; Rashedi et al., 2022). Online gaming interventions may be used to address specific learning barriers for autistic adolescents, including communication, academics, and challenging behaviours (Odom et al., 2015). Online gaming shows potential for allied health professionals to support the strengths of autistic adolescents while facilitating learning and skill development (Beaumont et al., 2021). Additionally, NDIS participants in remote and rural areas incur higher costs connected to travel fees and reduced choice of service providers resulting in long waiting periods (Veli‐Gold et al., 2023). The findings of this study indicate that online gaming has potential to increase engagement in autistic adolescents living regionally and rurally in therapeutic approaches when supporting skill development (Crouch et al., 2023; Granic et al., 2014; Rashedi et al., 2022). Providing online gaming in the home setting may be beneficial for autistic adolescents due to the increased appeal technology has for this demographic and lead to increased comfort in therapeutic environments (Crouch et al., 2023; Mazurek et al., 2015). In addition, research suggests that education for caregivers surrounding regulation of controls and limits for their children when accessing online games should be implemented to minimise the risk of harm and to increase safety (Crouch et al., 2023; Kaya et al., 2024; Zhu et al., 2021).

The NDIS ACT amendment states that interventions must be evidence based for individuals to receive disability funding, and due to these recent changes, specific gaming therapy has become a less feasible intervention (Parliament of Australia, 2024). Further research into online gaming and its benefits is more pertinent than ever, as online gaming can still promote and support skill development of autistic adolescents. Allied health professionals, including occupational therapists, would benefit from utilising knowledge, skills and principles that leverage autistic strengths through the medium of online gaming when working alongside autistic adolescents.

This study identified aspects of online gaming which allied health professionals, including occupational therapists, may utilise when implementing online gaming groups for autistic adolescents, to ensure they provide strength‐based interventions while also ensuring they are accommodating the concerns of caregivers (see Table 2).

TABLE 2.

Practical considerations for working alongside autistic individuals that may be utilised by allied health professionals.

What the study identified Practical considerations for working alongside autistic individuals that may be utilised by allied health professionals
Applying strength‐based principles

  • Ensure facilitators are educated on strength‐based communication and support autistic adolescents to communicate in a neuro‐affirming way (Jones et al., 2021)

  • Ensure the room is supportive of the sensory needs of autistic adolescents and provide space and opportunity for them to regulate (Jones et al., 2021)

  • Connect autistic adolescents with others who share their interests in particular games, for example, Minecraft groups (Black et al., 2025)

  • Promote team building through setting challenges within online games to facilitate effective communication strategies and problem solving (Black et al., 2025)

  • Encourage mentoring from older autistic adolescents of younger members to promote self‐efficacy and a supportive environment (O'Hagan et al., 2023)
Autistic adolescents did not always feel their social skills converted when they were in ‘real‐world’ situations

  • Where possible, in‐person gaming groups should be facilitated to provide autistic adolescents with face‐to‐face socialisation and encourage communication among other group members (Corbella‐González et al., 2025)

  • Facilitate a 5‐ to 10‐minute debrief at the end of sessions for reflection of the activities and games completed (Alahmari et al., 2025)

  • Allied health professionals should embed social skill practice opportunities into overarching intervention plan, for example, communicating about turn taking on iPads/computers, role allocation, and asking for help (Mirzaei et al., 2022)
Strategies to support emotional regulation related to online gaming

  • Validate the autistic adolescents' emotions and assist in educating that all emotions are ‘ok’ to feel at times (Simione et al., 2024)

  • Set clear boundaries and expectations for sessions, gaming time limits, and outlining how sessions will run (Shechtman, 2025)

  • Assist autistic adolescents to identify emotional triggers and supply them with appropriate strategies, for example, taking a break from gaming and breathing techniques (Jasni et al., 2026)

  • Explore what can be and cannot be controlled within the environment, for example, WIFI disruptions and noise levels (Jones et al., 2021)

  • Select games that are age appropriate and are suitable to the individual's context and emotional threshold (Black et al., 2025)
Caregivers expressed concern for online safety

  • Facilitate group sessions that provide education to caregivers and autistic adolescents of online safety and risk management (Finkelhor et al., 2021)

  • Ensure all games used within the groups are accessible by participants only, to reduce interaction with strangers (Sevilla‐Fernández et al., 2025)

  • Autistic adolescents are provided with resources and are educated on who they can talk to if they believe they are experiencing online bullying (Zhu et al., 2021)
Caregivers are unsure how to monitor and regulate screentime

  • Caregivers and autistic adolescents are educated on dangers of too much screentime (Muppalla et al., 2023)

  • Caregivers are provided with strategies for limiting screentime or access to the internet (Muppalla et al., 2023)

  • Online gaming groups should encourage and select games which have clear ends to ease transitioning from gaming to another activity, for example, use of timers and level completion (Colder Carras et al., 2020)
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6. LIMITATIONS

The participants of the study provided valuable insights into their perspectives of online gaming and its impact on daily functioning, which may guide further allied health research interventions. Given the limited sample size of this study, the results provided by the participants may not appropriately describe the perspectives of all autistic adolescents and their caregivers. Further, not all participants attempted every question within the surveys which may have limited the results and provides consideration to the suitability of survey questions for autistic individuals (Denne et al., 2023). Use of surveys within this study may have impacted the level of detail in participant responses, as surveys may not be aligned with the preferred communication style of autistic adolescents. Focus groups and semi‐structured interviews accommodate varying literacy levels and communication styles of autistic adolescents, making them a more accessible and appropriate data collection tool than surveys (Tyrrell & Woods, 2018). However, the use of surveys as a data collection method resulted in an increased number of participant responses compared to semi‐structured interviews. The researchers being occupational therapy students acknowledge the potential researcher bias as a limitation of this study due to their passion and interest in autism research prior to commencing this study (Landy et al., 2020). Practical strategies to manage this bias included regular meetings with researcher supervisors to recognise and mitigate this bias. In future, to further limit this bias, researchers propose keeping a reflective diary to improve reflexivity of the study when analysing open‐ended responses (Vicary et al., 2017). A further limitation to consider is the disproportionate representation of gender in the sample of autistic adolescents. Historically, autism has been more prevalent in males than females (Halladay et al., 2015) and as such consideration may be given to the overrepresentation of males in our sample. It is therefore important for any future research in this area to consider the strengths and interests of autistic females when it comes to online gaming.

7. CONCLUSION

This multimethod study explored the perspectives of autistic adolescents and their caregivers on the impact online gaming can have on participation in daily activities. Findings indicate that online gaming provides benefits such as social communication and the development of fine motor and problem‐solving skills. Strength‐based interests can be utilised by adolescents, their caregivers, and allied health professionals to increase engagement and participation in challenging situations. Caregivers also voiced concerns surrounding online safety, emotion regulation, and preference for online presence over face‐to‐face interaction. Understanding their collective experiences and perspectives provides valuable knowledge for allied health professionals to utilise when developing therapeutic approaches for skill development, in a strength‐based and holistic manner. Awareness surrounding the concerns presented in this study must continue to be addressed when collaborating with caregivers and allied health professionals by providing learning resources and implementing safeguards for autistic adolescents participating in online gaming.

AUTHOR CONTRIBUTIONS

All authors contributed to the study concept and design. Tahlia Inkster, Isabella Fimmano, Zoe Smith, and Jessica Leamon were involved in recruitment, as well as collecting and analysing data, under the supervision of Ben Milbourn and Sonya Girdler. Tahlia Inkster, Isabella Fimmano, Zoe Smith, and Jessica Leamon prepared the original manuscript with input from Ben Milbourn and Sonya Girdler. The final editing and preparation of the manuscript were completed by Maya Hayden‐Evans and reviewed by the authorship team.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflicts of interest with respect to the research, authorship, and/or publication of this article.

ACKNOWLEDGEMENTS

The authors acknowledge the support of the staff and volunteers at CoderDojo WA and express their gratitude to the families who shared their experiences. Open access publishing facilitated by Curtin University, as part of the Wiley ‐ Curtin University agreement via the Council of Australasian University Librarians

DATA AVAILABILITY STATEMENT

Research data are not shared.

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