Abstract
With the rising prevalence of autism diagnoses, it is essential for research to understand how to leverage technology to support the diverse nature of autistic traits. While traditional interventions focused on technology for medical cure and rehabilitation, recent research aims to understand how technology can accommodate each unique situation in an efficient and engaging way. Extended reality (XR) technology has been shown to be effective in improving attention in autistic users given that it is more engaging and motivating than other traditional mediums. Here, we conducted a systematic review of 59 research articles that explored the role of attention in XR interventions for autistic users. We systematically analyzed demographics, study design and findings, including autism screening and attention measurement methods. Furthermore, given methodological inconsistencies in the literature, we systematically synthesize methods and protocols including screening tools, physiological and behavioral cues of autism and XR tasks. While there is substantial evidence for the effectiveness of using XR in attention-based interventions for autism to support autistic traits, we have identified three principal research gaps that provide promising research directions to examine how autistic populations interact with XR. First, our findings highlight the disproportionate geographic locations of autism studies and underrepresentation of autistic adults, evidence of gender disparity, and presence of individuals diagnosed with co-occurring conditions across studies. Second, many studies used an assortment of standardized and novel tasks and self-report assessments with limited tested reliability. Lastly, the research lacks evidence of performance maintenance and transferability.
Highlights
Autism is a lifelong neurodevelopmental condition clinically defined by difficulties with social communication and interaction and by the presence of restrictive and repetitive behaviors and interests [1]
Recent findings suggest that autism presents differently in females and that current diagnostic criteria are largely male-biased [16] resulting in underdiagnosis of females and those who identify as other genders
This section provides a concise overview of attention-based research for autism using XR
Summary
Autism is a lifelong neurodevelopmental condition clinically defined by difficulties with social communication and interaction and by the presence of restrictive and repetitive behaviors and interests [1]. Complex differences in sensory sensitivities, the nature of repetitive behaviors, and the various types of all-encompassing interests all contribute to an autistic individual’s ability to communicate. It is, more useful to consider autism as a constellation rather than a linear spectrum, as the latter oversimplifies this variability [2]. Diagnostic criteria were far stricter during the advent of autism research in the 1960s and 1970s, and autistic adults who were not diagnosed or misdiagnosed at the time may have continued to manage far
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