Using Virtual Reality to Support Emotion and Sensory Regulation in Autism Spectrum Disorder: A Systematic Review

Abstract

Despite growing interest in virtual reality (VR) for autism, evidence on regulation as a primary therapeutic target remains limited. This systematic review (PROSPERO: CRD420251039552) synthesised evidence from 13 studies examining VR interventions targeting emotion and sensory regulation in autistic individuals. VR showed short-term benefits, particularly in reducing anxiety, emotional lability, and sensory hypersensitivity. Interventions incorporating structured repetition, ecological validity, personalisation, immersive exposure, and physiological biofeedback showed the most promising outcomes. Regulation gains were associated with broader improvements in classroom engagement, social interaction, and workplace confidence. VR shows particular promise for reducing dysregulation within safe, controllable environments while supporting transfer of regulatory skills to everyday contexts. Evidence remains limited by small samples, short follow-up periods, and underrepresentation of autistic adults and women and girls. Future research should prioritise co-designed, longitudinal studies with more diverse samples.