Improving adaptive and cognitive skills of children with an intellectual disability and/or autism spectrum disorder: Meta-analysis of randomised controlled trials on the effects of serious games

The aim of this meta-analysis is to investigate the effectiveness of serious games on social and cognitive skills of children with an intellectual disability (ID) and/or autism spectrum disorder (ASD). Randomised controlled trials of the effectiveness of serious games were identified through a systematic search of PubMed, Web of Science, PsycINFO, and Embase, using keywords related to serious games and the target groups. Eleven studies with a total of 654 participants (mean age 4–11 years) were included. The methodological quality of the studies was assessed using the Cochrane risk of bias assessment tool V2. Serious games were associated with improved adaptive and cognitive skills of children with ID or ASD compared with controls, with a small effect size (g = 0.420, 95% confidence interval 0.130–0.710; p = .009; number needed to treat = 4.28), with moderate to high heterogeneity. Multiple influence analyses showed that zero heterogeneity could be achieved with exclusion of three studies, one by one, while retaining a significant effect size. Moderation analyses showed no significant differences between the skills examined, the type of controls, involvement of another person, duration of the intervention, or age of the children. These findings indicate that serious games are linked to improvements in adaptive and cognitive functioning of children with ID or ASD, but the association is not necessarily straightforward. Although more study is needed into the effective elements of these games, these results represent an important first step in implementing serious games proven to strengthen daily functioning and social participation of children with ID or ASD