The Effect of Computerized Cognitive Training on the Improvement of Emotion Regulation in Children with Autism Spectrum Disorder

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in emotion regulation. Objectives: This study aimed to evaluate the effect of computerized cognitive training (CCT) on enhancing emotion regulation in children with ASD. Methods: A quasi-experimental pretest-posttest design was used, including both an experimental and a control group, with a two-month follow-up. The target population comprised children aged 7 to 10 years diagnosed with ASD in Tehran during the 2023 – 2024 academic year, referred to a specialized autism center. From this population, 50 boys with high-functioning autism were selected using convenience sampling, based on evaluations conducted with the Autism Spectrum Screening Questionnaire. The sample size was determined through power analysis, considering research feasibility, financial and time constraints, and an anticipated dropout rate of 10%. Participants were matched by age and met specific inclusion criteria, such as an interest in computer games and scores above a defined threshold on the screening questionnaire. Children with physical disabilities, sensory impairments, or recent participation in cognitive rehabilitation programs were excluded. Explicitly stating the recruitment setting and process provides context regarding the sample’s representativeness and the limits of generalizability. Participants were recruited from a rehabilitation center and then randomly assigned to either the experimental group, which received 20 sessions of computer-based cognitive training, or the control group, which engaged in mobile phone games. Parents completed an emotion regulation checklist before the intervention, after the final session, and again at the two-month follow-up. Data were analyzed using correlation analysis, regression analysis, and generalized estimating equations (GEE) through SPSS version 27. Results: Statistical analysis revealed that CCT significantly improved overall emotion regulation and specifically reduced the lability/negativity index, with effect sizes of -4.020 and -5.040, respectively. No significant changes were observed in the adaptive emotion regulation index. Improvements attributed to the intervention remained stable at the two-month follow-up. Conclusions: The findings indicate that computer-based cognitive training is an effective approach for promoting emotion regulation in children with ASD, offering a promising therapeutic intervention for practitioners. However, these results should be interpreted with caution due to limitations such as the specificity of the sample — limited to boys with high-functioning ASD from a single center — as well as considerations related to intervention dosage, control conditions, and potential biases, including the absence of blinding. Addressing these limitations in future research will be essential to confirm the effectiveness of the intervention and broaden its applicability to more diverse populations within the autism spectrum, ultimately enhancing the clinical utility of CCT as a treatment strategy.