Virtual Reality to Improve Joint Attention Skills in Children With Autism: Protocol for a Randomized Controlled Trial

Joint attention (JA) deficits are frequently one of the earliest indicators of autism spectrum disorder (ASD), making them a crucial focus for early interventions.Despite the importance of JA, existing interventions often face barriers such as high costs, limited adaptability, and resource demands.Virtual reality (VR) offers a novel, immersive, and flexible approach that may overcome these challenges by creating engaging and individualized environments for children with ASD.This protocol describes a randomized controlled trial evaluating a VRbased intervention designed to improve JA and related social-communication skills in schoolaged autistic children.Participants will receive either VR therapy plus standard interventions or a sham VR condition plus standard interventions.The primary outcome is JA performance, with secondary outcomes focusing on broader social communication abilities.By testing this innovative, technology-supported intervention in naturalistic school settings, the trial aims to provide high-quality evidence on the feasibility and potential impact of VR as a supplemental therapy for autism.Key limitations include the relatively small sample size and short-term follow-up, which will guide recommendations for larger, long-term studies.