Examining Pragmatic Communication in Children with Autism Spectrum Disorder: An Observational Study of Social Interactions in Virtual Environments Using Avatars

By
Asmetha Jeyarani R.
Radha Senthilkumar
July 15, 2026

Frontiers In Psychiatry

Objective:

To examine pragmatic social communication behaviors in children with Autism Spectrum Disorder (ASD) during structured social scenarios in virtual reality (VR) environments.

Approach:

Participants: Twenty-five children aged 5 to 12 diagnosed with ASD.
Methodology: Children participated in structured social scenarios presented by a VR system to elicit social communication behaviors, including greeting initiation and response, attention to speakers, turn-taking, and context-appropriate verbal responses.
Assessment Tools: Social communication outcomes were assessed using the Indian Scale for Assessment of Autism (ISAA), the Social Communication Questionnaire (SCQ), and a VR-based Pragmatic Social Communication Observation Checklist (VR-PSCOC).

Key Findings:

Post-VR analysis revealed measurable changes across the assessed pragmatic social communication domains during repeated exposure to the VR scenarios.
Significant variations were observed in ISAA scores related to speech-language, communication, and social relationship and reciprocity (p<0.001).
Repeated VR exposure was associated with higher observational scores, indicating observable changes in social communication behaviors.

Interpretation:

The structured VR-based social scenarios provide a feasible environment for observing and characterizing social communication behaviors in children with ASD.

Limitations:

The study involved a small sample size of 25 children, which may limit the generalizability of the findings.
The findings may not be generalizable beyond the specific VR scenarios used.