Feasibility and acceptability of therapist-guided immersive virtual reality for autism rehabilitation in Nepal: a rapid qualitative study

Objectives To explore stakeholder perceptions of the acceptability and feasibility of a therapist-guided immersive virtual reality rehabilitation system for autistic children in Nepal.Methods A rapid qualitative exploratory study was conducted in a rehabilitation center in Nepal. Participants included four therapists, four parents of atistic children, and one autistic child who participated in a therapist-guided virtual reality session. Data were collected through semi-structured interviews, observational field notes, and brief feasibility ratings. Data were analyzed using reflexive thematic analysis informed by the Technology Acceptance Model and the Consolidated Framework for Implementation Research.Results Five themes were identified: immersive engagement as a therapeutic possibility; therapist-guided use and Usability Challenges; infrastructure as an active determinant of feasibility; Language and Cultural Adaptation Considerations for System Use; and negotiating therapeutic engagement and sensory risk. Therapists and parents perceived the virtual reality system as engaging and useful for rehabilitation. Child observations provided context only and did not inform themes. Themes emphasized therapist support, usability, cultural adaptation, and infrastructural constraints across groups.Conclusions Stakeholders perceived therapist-guided immersive virtual reality as a potentially acceptable and feasible complementary tool for autism rehabilitation in Nepal. Successful implementation may require contextual adaptation, therapist training, and adequate infrastructure.