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. 2025 Apr 4:13:1498563.
doi: 10.3389/fped.2025.1498563. eCollection 2025.

The effect of game-based interventions on children and adolescents with autism spectrum disorder: A systematic review and meta-analysis

Jiaxin Gao #  1   2 , Wei Song #  2 , Dunbing Huang  2 , Anren Zhang  2 , Xiaohua Ke  2
Affiliations

The effect of game-based interventions on children and adolescents with autism spectrum disorder: A systematic review and meta-analysis

Jiaxin Gao et al. Front Pediatr. .

Abstract

Purpose: The purpose of this meta-analysis was to conduct a comprehensive evaluation of randomized controlled trials (RCTs) of game-based interventions (GBI) for children and adolescents with autism spectrum disorder (ASD) to identify the clinical efficacy of GBI on core symptoms and other concomitant symptoms of ASD.

Methods: PubMed, Web of Science, Embase and the Cochrane Library were systematically searched for articles published until July 2023.

Results: Twenty-four studies with 1,801 patients met the inclusion criteria. The results showed that GBI had a significant positive effect on social skills (g = -0.59, p = 0.004), social behaviors (g = 0.45, p < 0.001), and cognition (g = 0.57, p < 0.001) in children and adolescents with ASD, while the effects of language expression (g = 0.15), anxiety (g = -0.13), and parenting stress (g = -0.51) were small and nonsignificant.

Conclusions: The results of the current meta-analysis showed that GBI was effective in improving social skills, social behaviors and cognition in children and adolescents with ASD in the existing studies and was not significant in improving language skills, anxiety and parental stress, but due to the limited number and low quality of the included studies, the above conclusions need to be validated by conducting more large-sample, high-quality RCTs.

Systematic review registration: www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023390793, identifier: CRD42023390793.

Keywords: adolescence; autism spectrum disorder; children; game-based interventions; meta-analysis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the literature search and screening process.
Figure 2
Figure 2
Risk of bias graph.
Figure 3
Figure 3
Forest plot of meta-analysis of social skills.
Figure 4
Figure 4
Forest plot of the meta-analysis of ADOS.
Figure 5
Figure 5
Forest plot of the meta-analysis of social behaviors.
Figure 6
Figure 6
Forest plot of meta-analysis of cognition.
Figure 7
Figure 7
Forest plot of meta-analysis of language understanding and language expression.
Figure 8
Figure 8
Forest plot of the meta-analysis of anxiety.
Figure 9
Figure 9
Forest plot of the meta-analysis of parenting stress.
Figure 10
Figure 10
Funnel plot of publication bias.
See this image and copyright information in PMC

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