Underwater virtual reality for neurodivergent participation in scuba diving: an integrative review and sensory-adapted framework

Purpose Despite growing interest in virtual reality (VR) as a tool to support neurodivergent individuals, limited attention has been given to how immersive and underwater virtual reality (UVR) can be designed and implemented as enabling technologies within leisure and therapeutic contexts. This study aims to develop a sensory-adapted framework to guide the design and implementation of UVR systems that support neurodivergent participation, well-being and accessibility. Design/methodology/approach An integrative review methodology was applied, guided by PRISMA-informed procedures. A total of 43 studies between 2005 and 2026 were analysed from databases including Web of Science and Scopus with a focus on conceptual integration rather than effect size. Findings The review identifies key mechanisms through which UVR can function as an enabling technology, including sensory regulation, controlled immersion and enhanced confidence-building in simulated environments. However, successful implementation depends on addressing barriers such as sensory overload risks, limited staff training, technological complexity and institutional constraints. The study proposes a sensory-adapted framework encompassing micro (individual sensory and emotional processes), meso (technological and interactional features) and macro (institutional and structural conditions) dimensions, alongside practical recommendations, including the need for user-centred design, graduated immersion protocols, staff training and the development of ethical and safety guidelines to support sustainable adoption. Originality/value This article introduces a sensory-adapted framework that conceptualises UVR as an enabling technology, offering a multi-level, sensory-adapted framework that integrates individual, technological and systemic factors. It contributes novel insights into the design and implementation of immersive systems to support inclusive leisure and therapeutic participation.