The use of serious games to develop social skills in children with autism: a literature review

INTRODUCTION

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent impairments in social communication and restricted and/or repetitive patterns of behavior.¹ Typical difficulties include social interactions, using and understanding basic social.² Baron-Cohen points out that impairments in social skills vary from person to person and fall within a broad spectrum.

At one end of the spectrum there are children who tend toward loneliness, avoiding interactions with others. At the other end of the spectrum, some children actively seek social engagement but lack important skills such as interpreting the thoughts and feelings of others, maintaining conversations, and participating in cooperative activities.³

The aim of this research is to study the role of serious games as a modern educational tool in improving the social and emotional intelligence of children with autism. More specifically, it attempts to investigate the degree of influence of serious games on the development of social skills, such as social interaction, emotion recognition and understanding social rules, answering the main question of whether these games influence the process of developing social skills, to what extent, and which aspects of it.

The necessity of this research stems, initially, from the importance of these skills in individuals with ASD and secondly, from the particular preference for technology and technological tools shown by children with autism, which also includes serious games.^4,5

The innovation presented by this new educational tool is therefore evident, which, combined with the limited number of studies investigating its impact on the social and emotional intelligence of children with autism, stimulates research interest.^6,7

Finally, it is worth mentioning the value that will be added to the educational and therapeutic community, as the promotion of new, evidence-based educational practices will improve the quality of life of children with autism.⁸

Serious games

Michael Zyda defines serious games as a mental competition that takes place through digital technology, following predetermined rules and using entertainment to achieve goals related to education, vocational training, health, public safety, and effective communication.⁹ On the other hand, Stokes offers a more comprehensive definition, arguing that these games are designed to entertain players while also educating and training them, thereby influencing their behavior.¹⁰ Thus, the entertainment dimension is emphasized as the means that will enhance the development of knowledge and skills.¹¹ The student-players participate experientially, practicing in a safe environment and acquiring knowledge about how to manage realistic everyday situations.¹²

These games are different from traditional games. The differences can be found in the constructivist learning theory they follow, the purpose they aim to achieve, the audience they target, the design they follow and the influence they have on players' behavior.¹³

Serious games have beneficial features such as creating positive emotions, interactivity, immediate feedback, enhancing cooperation, and logical thinking. Thus, students acquire knowledge through their own activity.^11,14

Autism and social skills

The lack of social skills in individuals with autism makes it difficult for children and their families to cope with the demands of everyday life, making it necessary to implement interventions that promote the development of social and emotional skills. Well-developed social skills increase levels of social functioning and have multiple benefits in individual, family, school, and social environments.^15-20

METHODS

The methodology of this research followed the structure of a systematic literature review, gathering and analyzing data from reliable sources in order to clarify the effectiveness of serious games as a tool for supporting children with autism. A systematic search was conducted in scientific databases such as Google Scholar, PubMed, Scopus, Web of Science and IEEE Xplore using the following keywords, “serious games”, “autism”, “social-emotional intelligence”, “special education”, “gamification”, “ASD interventions”.

Inclusion criteria

The criteria for inclusion were the language in which the articles were written, the time span of their publication, their focus on a specific population group with an exclusive diagnosis of autism spectrum disorder, and the use of serious games. In this way, articles written in English over the last fifteen years (2010-2025) were accepted, focus on children with ASD, and evaluate the effect of serious games exclusively on social and emotional intelligence.

Exclusion criteria

The exclusion criteria apply to articles that were not directly related to the topic and concern, for example, cognitive or motor skills, articles focusing on other population groups, and articles of non-scientific origin, such as personal opinions, unevaluated articles, or texts not published in reputable academic journals.

The review highlighted several studies that support the effectiveness of serious games in developing social and emotional skills in children with autism. More specifically, the study selection process began with the identification of 500 records from the following databases, Google Scholar, PubMed, Scopus, Web of Science and IEEE Xplore using the keywords. In addition, 22 entries were identified through manual searches and reference lists, bringing the total number of entries initially identified to 522. Applying the inclusion and exclusion criteria, 480 records remained, of which 30 were duplicates and were removed.

Proceeding to the evaluation of the suitability of the findings, it appeared that several of them were not entirely relevant to the topic, either in terms of the type of disability under study, the type of games used for intervention, or the skills targeted. Thus, of the 100 full-text articles that remained, 62 were removed because they did not meet methodological requirements, presenting incomplete research design and insufficient data regarding the intervention applied and the theoretical basis followed.

A total of 38 studies were included after a systematic review of the maximum suitability for the research topic.

The research questions that this study seeks to answer are as follows: Do serious games contribute to improving the social and emotional intelligence of children with ASD, and if so, how? What social and emotional intelligence skills can be developed through serious games in children with ASD, and how? What characteristics make these games effective in improving social interaction and emotional understanding? What are the most effective types of serious games for educating children with ASD? (e.g., digital games, board games, virtual reality games), What factors influence the success of using serious games with children with ASD (e.g., age, degree of autism spectrum, interaction with adults or peers)? and What are the challenges and limitations in using serious games for the education of children with ASD?

RESULTS

The results of this study are presented in the following sections. First, we discuss the impact of serious games on the development of social and emotional skills. Next, we list the characteristics that make serious games more effective, as well as the limitations that come with them and that are important to keep in mind when designing and implementing educational or therapeutic interventions. The studies included are summarized in the Table 1.

The use of serious games in developing social and emotional intelligence in children with autism

Social intelligence involves the ability to understand, analyze, and interpret social situations, recognizing the intentions of others, and creating and maintaining interpersonal relationships. Children with ASD have difficulty understanding nonverbal signals, such as facial expressions, body language, and tone of voice, as well as a lack of reciprocity in communication.²⁴ Emotional intelligences, on the other hand, involves skills such as recognizing, expressing, and regulating emotions both themselves and others, while often showing limited empathy and expressing their emotions in less acceptable ways.^21,22 Technological advances have brought innovative educational tools such as serious games. There is a lot of research highlighting the effectiveness of these games in developing the social and emotional intelligence of children with autism.^22-24

Social intelligence

The study by Bernardini, Porayska-Pomsta, and Smith describes "ECHOES," an interactive game that allows children with ASD to practice social communication.²⁵ Through interaction with a virtual environment, children showed increased use of eye contact, better understanding of social signals, and enhanced attention to social stimulations. Equally important are the findings of the study by Honrado et al and Hourcade et al in which studies have shown the development of social initiative, cooperation, and participation in team activities.^26,27

The researchers' games Nawahdah et al and Ribeiro et al, highlight the collaborative nature of play.^28,29 Through cooperative scenarios, children are encouraged to make decisions collectively and resolve disagreements. The authors Terlouw et al point out that the teamwork setting and cooperative puzzles of the escape room serious game that they developed improve children's sense of initiative, communication, and cooperation.³⁰

The researchers report that serious games have positive effects on the behavior of children with autism, improving their levels of social and emotional interaction.³¹ The study of Caruso et al emphasized that virtual reality facilitates the engagement of children with ASD in social scenarios. However, they emphasize the importance of properly adapting VR environments to meet the needs of children with ASD in order to avoid overstimulation and enhance the user's engagement.³²

Similarly, Almurashi et al argue that combining AR with the picture exchange communication system (PECS) enhances nonverbal communication and understanding of social concepts. Furthermore, they highlighted that AR in combination with educational scenarios facilitates the transfer of knowledge into everyday life.³³

A systematic review by Barajas, Shirmohammadi and Carneiro and colleagues suggests that serious games provide a safe and enjoyable learning environment, particularly useful for practicing social skills. ASC-Inclusion, a platform that combines cognitive technologies with games, has contributed to improving social understanding.^7,34,35

The research by Vallefuoco et al recognizes that serious games have the ability to improve communication, the learning process, social behavior, and the physical abilities in individuals.³⁶

Strengthening theory of mind—the ability to understand that others have different beliefs, desires, and intentions—is also very important. The research by Chung et al uses an online game that presents everyday social situations, leading to neurologically documented improvements in the functional connectivity of brain regions related to social cognition.³⁷

The multimedia characteristics of serious games, which utilize visual, audio, and kinaesthetic elements, make them exceptionally effective for educating students about advanced social concepts.^21,38

Emotional intelligence

The application “Emotiplay” employed multimedia stimuli to train children with ASD in emotion recognition, yielding positive outcomes in the accuracy of identifying emotional expressions.²¹ The “LIFEisGAME” focused on the reproduction of facial expressions through animated characters, enabling children to practice in a way that was both engaging and effective.³⁸ Another game, “the emotion detectives”, demonstrates that serious games can serve as effective tools for supporting socio emotional learning, as discussed by Löytömäki et al.³⁹ Emotion recognition technology based on biometric signals, such as facial expression and voice, has contributed to the personalization of learning processes by accounting for individual reactions, according to Garcia et al.⁴⁰

At the same time, Carvalho et al, Caruso et al and Stasolla et al emphasize that tailoring games to the individual needs of children is a key factor in the success of interventions. They propose the integration of neurofeedback technologies and adaptive algorithms so that the content can be adjusted in response to user reactions.^32,41,42 Simulated social interaction scenarios included in serious games enhance emotional intelligence, as highlighted by Hassan et al and Azadboni et al.^43,44 Through these scenarios, children adopt the perspectives of others, thereby increasing their empathy. The ability to take another person’s viewpoint strengthens the understanding of social norms and supports conflict prevention, as noted by Ghanouni et al.⁴⁵ Emotional understanding and self-regulation help children develop functional strategies for initiating and maintaining positive social relationships.^46,47

Finally, the study by Zakari et al examines forty serious games designed for children with ASD. The authors categorize these games based on technological platforms, graphics and methods of user interaction. Their review reports that serious games played on mobile phones and tablets have effectively supported players in expressing their emotions and increasing their engagement with others.⁸

Factors that enhance the effectiveness of serious games

The game mechanics used in serious games are based on interactivity, challenge, and real-time feedback, elements that facilitate learning and enhance children's engagement.²³ A particular advantage is that they provide a controlled environment in which children with ASD can practice social situations without the threat of failure or social rejection. The repeatability of the scenarios allows children to boost their confidence in social interactions and internalize basic social skills in a pleasant and non-threatening way.⁴⁸

The use of technologies such as AR and VR offers enriched learning experiences, reducing cognitive barriers and enhancing concentration.³² Through AR, children can see objects "come to life" in their physical space, which facilitates the generalization of skills. According to Almurashi et al, the integration of AR into serious games creates an interesting context that enhances the participation, attention, and persistence of children with ASD in completing activities. Interactive graphics provide visualised information that helps in understanding abstract concepts. These technologies have the ability to present social scenarios through images, animations and sound, facilitating understanding and interaction.³³ Similarly, Aresti-Bartolome and Garcia-Zapirain developed a cognitive rehabilitation system based on serious games, which focuses on strengthening social skills. The results of their pilot study show significant improvement in understanding social situations and interacting with peers. The game uses narratives and characters to teach the importance of communication, waiting in line, and expressing emotions.⁴⁹

The contribution of VR games to the creation of safe learning environments is also noteworthy. The review by Caruso et al. offers guidelines for designing immersive VR serious games for children with ASD, which allow experimentation with collaborative behaviors. Three-dimensional visualization and the ability to navigate social environments in first person expand opportunities for experiential learning.³²

Flexibility-oriented design includes settings such as game speed, number of stimuli, and mission complexity. Functionality on mobile devices, offline use, and easy access for teachers and parents enhance the sustainability of interventions. Technical support, ease of use, and the ability to integrate games into the child's daily life (school, home) positively influence the maintenance of interest and consistency in use.^22,27

Furthermore, it is important to create games that are accessible regardless of the child's cognitive or verbal level. It is important that serious games are appropriate for the child's chronological and developmental age.^48,50 Games such as "emotiplay" and "ASC-Inclusion" use simple graphics, sounds, and nonverbal cues to serve children with low functionality. On the other hand, the game "ECHOES" can be adapted to low and high functioning profiles through simulated scenarios.²⁵ The integration of alternative input methods (e.g., buttons instead of a mouse) and the use of touch make the experience more user-friendly for a wide range of abilities.^21,35

Games should be predictable, with clear goals, limited stimuli, and positive feedback. The absence of unpredictable or noisy stimuli is particularly important, as children with autism often exhibit hypersensitivity to auditory or visual stimuli. The structure of games should provide stability and security, encouraging repetition without causing confusion or disorientation.⁵¹ The use of incentives such as virtual rewards, badges, or progressive difficulty levels maintains focus and encourages continuous effort.⁵²

The use of mini-games with a clear structure and goal is particularly positive, as they reinforce rewards and offer repeated opportunities for success. These games are short, usually lasting only a few minutes (5-15 minutes), have a simple design without a complex environment and graphics, and aim to teach a single concept or skill.⁶

Adapting games to the cultural identity of the player, as demonstrated by the research of Fridenson-Hayo et al is important in order to enhance the acceptance of the content and the relevance of the scenarios.²¹ The use of characters, costumes, languages, and behaviors familiar to the child enhances identification and assimilation of information. In addition, environments such as virtual classrooms, virtual homes, or playgrounds help transfer the experience to real social situations.⁴²

The majority of serious games for people with ASD focus on developing social skills and emotion recognition.^7,21 Games that promote the learning of basic emotional concepts (such as “Emotiplay”, “ASC-Inclusion”) through experiential experiences and multimodal stimuli (sound, image, video) show increased success rates.³⁵ The use of facial and emotion recognition technologies, as reported by Garcia et al enhances interactivity and personalized learning. The ability for children to see their expressions reflected in characters or receive feedback on their understanding of an emotion increases awareness and promotes empathy.⁴⁰

According to Whyte et al, teachers contribute significantly to the design of appropriate learning environments through serious games, taking into account the specific needs of each child with ASD.⁵¹ Teacher training is also essential. Almurashi et al emphasize that professionals' skills in technology enhance the proper use of these games.³³ In addition, educators can act as mentors for parents, teaching them how to use the appropriate games and suggesting strategies for continuing the intervention at home, thereby reinforcing the role of serious games as intervention tools rather than mere entertainment.⁶

Finally, Kirst et al presented a game that involves parents in the cultivation of social and emotional skills. The results of their study show that parental involvement enhances the transfer of skills from the virtual to the real environment. Parent-child collaboration creates opportunities for real-time guidance and reinforcement, enhancing the sense of security. Thus, adults act as a bridge between the experiences the child gains from play and the application of these in real environments, such as school or family.⁵³

However, choosing the right game is crucial to the success of the intervention, as, the appropriate game is crucial to the success of the intervention, as it should respond to the specific needs of the children, be based on scientifically proven methods, and facilitate the development of social, emotional, and cognitive skills.⁴¹ The heterogeneity that characterizes ASD requires the personalization of serious games. The adaptability of the game to different levels of functionality and the possibility of personalized intervention are fundamental selection criteria.³³ It is particularly beneficial for games to incorporate behavior recording and analysis capabilities, providing the desired information to specialists and parents.⁵³ Interdisciplinary collaborations between educational specialists, designers, and psychologists will also ensure that games are based on/framed by educational principles, enhancing their effectiveness and availability in various environments, such as school and home.⁵⁴

In conclusion, the integration of serious games into the therapeutic and educational approach for children with ASD has shown particularly encouraging results. They improve social understanding, enhance emotional recognition, and promote active interaction. Despite differences in technologies and methods, the common denominator is the ability of serious games to provide safe, controlled, and engaging environments where children can learn and practice critical social skills.

Limitations in the application of games

Despite their benefits, researchers have identified several limitations and challenges that affect the effective integration of these tools into educational and therapeutic practice. One of the main limitations is the low degree of individualization in serious games. Many of these games do not account for the high heterogeneity that characterizes children with ASD, which means they may not address the specific needs or functional levels of users.^7,41,55,56

Linguistic and cultural adaptation is another critical factor. Many serious games have been developed in English speaking contexts, with limited availability in other languages or cultural settings, which hinders their use internationally.²¹

Furthermore, in societies where play is regarded as a secondary or non-serious activity, the acceptance and support of serious games may be reduced. Promoting the value of play as an educational tool requires systematic awareness raising among all stakeholders.²⁵

At the same time, ongoing training is necessary for both educators and parents concerning the technological and pedagogical implementation of these tools. Professional development related to their use remains limited, creating barriers to effective application.^50,51

Technical complexity and the need for specialized equipment constitute an additional challenge that may restrict accessibility for schools or families with limited resources. This raises concerns about equal opportunities and social inclusion, particularly in developing countries or rural areas.^32,42

At the cognitive level, the outcomes of using serious games are not always clear. Several studies rely on small samples and short intervention periods, making it difficult to generalize their findings.^37,49 The absence of long-term evaluation of the impact of serious games raises questions regarding the generalization of skills acquired through gameplay.^6,44 The complexity of measuring improvements in social or emotional skills, which often requires qualitative data or long-term monitoring, represents a methodological challenge.^40,53 In addition, evaluation procedures may fail to account for variables such as parental involvement or the broader learning environment, which can affect the validity of results.^30,46

In many cases, serious games are treated as supplementary or recreational tools without a clear orientation toward therapeutic goals, which leads to limited systematic integration into intervention programs.^23,52

Finally, there is also an ethical dimension to the use of serious games. The need to collect personal data, often through technologies involving facial or emotion recognition, raises concerns related to privacy and consent, particularly when minors are involved.^35,48

DISCUSSION

The present study examined the extent to which serious games influence the development of social and emotional skills in children on the autism spectrum. The central research question concerned whether and to what degree this type of game can function effectively within interventions that focus on cultivating social and emotional intelligence.

Across the review of 38 studies, the findings support a positive answer. Serious games appear to be effective learning tools that engage the player and sustain participation in the intervention program.

Despite the heterogeneity that characterizes autism, difficulties in social skills remain a common feature. Individuals on the spectrum often struggle to interact in socially acceptable ways, to maintain a conversation, to express their emotions and to recognize the perspective of others. These challenges contribute to social isolation, increase introversion and negatively affect daily functioning.

Parents, educators and therapists frequently encounter such difficulties. For this reason, they design and implement educational and therapeutic programs aimed at developing social and emotional skills through a variety of techniques and tools. The use of technological means, including serious games, is particularly effective because individuals with ASD often find them both appealing and comfortable to use.

On the social level, improvements are reported in social responsiveness, communication, eye contact, interaction, understanding of social norms and cooperation. In the domain of emotional skills, abilities related to distinguishing, identifying and expressing emotions show notable enhancement. Through perspective taking, the cultivation of empathy and engagement with others becomes more achievable.^21,25,31

Several features of serious games support the development of these skills through their design and play mechanics. Such features include animated virtual characters, playful interactive environments, sensory functions that activate touch, sight and hearing, simulations of social situations, virtual or augmented reality, alternative communication systems such as PECS, biometric facial and vocal recognition signals and multimedia stimuli including movement, sound, color and shape.^33,40

In addition, the effectiveness of serious games is reinforced by their design capabilities such as adaptation to individual characteristics of players including developmental age, character selection, behaviors, clothing, language and environment, immediate feedback, imitation, repetition and ease of use on both portable and non-portable devices. Features such as attractive and controlled environments, multimodal components including narration, text, sound, color, movement, touch and vision, and familiar social situations facilitate the transfer of learned skills to everyday life.

However, the use of serious games also presents challenges. The heterogeneity of the autism spectrum itself, the need for a clear understanding of each child’s individual characteristics, the appropriate design of the intervention and the selection of the game that best suits the context are all important considerations. Moreover, the tendency of some children with autism to become strongly attached to technological media may increase the difficulty of disengaging from the game. Finally, the ethical dimension related to the recording, collection and processing of personal data raises important issues of privacy and consent for a vulnerable population group.^41,44,50

CONCLUSION

In conclusion, serious games represent one of the most promising technological applications for supporting children with autism spectrum disorder. They offer significant benefits for the development of social, emotional and cognitive skills. By combining enjoyment with meaningful learning objectives, serious games introduce innovation to education and transform learning into an accessible and engaging process for all.

Recommendations

The absence of a coordinated policy often leads to the fragmented implementation of these tools, without the necessary evaluation or training of teachers. Therefore, investigating the long-term impact of serious games on the psychosocial development of children with ASD, the sustainability of the skills acquired, and the degree of generalization of these skills are important areas that deserve future research attention.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

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