Metaverse-based social skills training program for children with autism spectrum disorder to improve social interaction ability: A Randomized Controlled Trial

Background: Autism spectrum disorder (ASD) is characterized by abnormalities in social interactions and restricted and repetitive behaviors. Children with high-functioning ASD (HFASD) who lack social communication skills do not interact with others and lack peer relationships. Objective: This study aimed to develop a metaverse-based social skills training program to improve the social skills of children with HFASD aged 7–12 years and verify the effectiveness of the program developed through a randomized controlled trial (RCT). Method: This single-blind RCT was conducted on children aged 7–12 years with ASD with an IQ ≥ 90. A total of 15 children were randomly assigned to the intervention and control groups. The intervention group participated in the metaverse-based social skills training program once a week for 60 min per session for four weeks. The control group received no intervention. Results: Overall, 15 children (median [IQR] age, intervention group: 9.0 [8.0–10.0)]; control group: 8.5 (8.0–10.0) participated in the program. The intervention group included nine participants (60%), and the control group included six (40%). In the results of the intervention effect to evaluate children’s sociality, and emotional and behavioral problems in the pre- and post-interventions between the intervention and control groups, significant effect size was reported in the total score of SRS-2 ( r, 0.49; 95% CI: 0.06–0.84), interpersonal problems in the CDI ( r, 0.45; 95% CI: 0.05–0.75), anxiety and depression in the K-CBCL ( r, 0.43; 95% CI: 0.06–0.78). Conclusion: To the best of our knowledge, this is the first randomized clinical trial to demonstrate a metaverse-based social skills training program for children with HFASD. Our findings suggest that children with HFASD can be educated on real-life social situations to improve sociality and reduce emotional and behavioral problems. The results of this study can be extended and applied to target groups who have difficulty interacting with peers offline. Trial Registration CRIS Registration Number; KCT0006859