# Efficacy of gamified digital health interventions for children and adolescents with autism spectrum disorder: a systematic review and meta-analysis

## TL;DR

Gamified digital health interventions can improve skills in children and adolescents with autism, but their impact on behavior is unclear.

## Contribution

A systematic review and meta-analysis of 21 RCTs evaluating gamified interventions for autism.

## Key findings

- Significant improvements in emotional, social, and motor skills were observed.
- Sensor-based games showed superior efficacy in skill enhancement.
- No significant effect was found for reducing behavioral problems.

## Abstract

Autism spectrum disorder is a neurodevelopmental condition with a rising prevalence and limited effective pharmacological treatments. As non-pharmacological interventions gain traction, gamified digital health interventions have emerged as a promising alternative due to their accessibility and scalability. This systematic review and meta-analysis evaluated the efficacy of gamified digital health interventions in improving key functional domains in children and adolescents with autism spectrum disorder.

Following PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions, a systematic search was conducted in six electronic databases (PubMed, Web of Science, EMBASE, Cochrane Library, PsycINFO, and Scopus) and reference lists of relevant articles up to November 2024. A total of 21 randomized controlled trials (RCTs) comprising 1,050 participants met the inclusion criteria. Standardized mean differences (SMDs) were pooled using a random-effects model, and subgroup analyses were conducted to explore the effects of different types of interventions.

Meta-analysis revealed significant improvements in emotional skills (SMD = 0.56), social skills (SMD = 0.45), executive functions (SMD = − 0.43), and motor skills (SMD = 1.53). Subgroup analyses indicated that sensor-based games demonstrated superior efficacy. However, no significant effect was observed in reducing behavioral problems (SMD = − 0.14).

Gamified digital health interventions show promise in enhancing emotional, social, executive, and motor skills in children and adolescents with autism spectrum disorder. Future research should focus on optimizing intervention strategies, refining behavioral outcome measures, and conducting high-quality longitudinal studies to evaluate long-term effectiveness.

The online version contains supplementary material available at 10.1186/s13034-025-01009-w.