For children with autism spectrum disorder, the intersection of physical engagement and cognitive challenge may represent an underutilized therapeutic avenue. Inhibitory control and motor coordination — two domains frequently compromised in ASD — are notoriously difficult to address simultaneously through conventional interventions. A systematic review now synthesizes the emerging evidence on whether interactive video game exercise, or exergaming, can move the needle on both fronts at once.
Drawing on six studies identified across PubMed, Scopus, Web of Science, and ERIC — and screened against PRISMA and PROSPERO standards — the review assessed exergame interventions targeting executive function components and motor skill outcomes in pediatric ASD populations. Inhibitory control, measured via Stroop and Flanker paradigms, improved in two studies, while cognitive flexibility — evaluated using the Wisconsin Card Sorting Test — showed gains in two others. A timing-dependent pattern emerged: single-session acute interventions tended to influence inhibitory control specifically, while multi-session programs produced broader adaptation across both cognitive and gross motor domains.
The finding that a single exergame session can transiently sharpen inhibitory control is consistent with the broader acute exercise cognition literature, where brief aerobic bouts reliably boost prefrontal-dependent functions through catecholamine release and increased cerebral blood flow. What makes exergames potentially distinctive for ASD populations is the added motivational layer — structured interactive feedback may reduce the social friction that often limits participation in conventional exercise or therapies. However, this review's conclusions rest on a strikingly small evidence base: only six qualifying studies, with heterogeneous designs, variable session lengths, and small sample sizes. No meta-analysis was performed, limiting quantitative precision. The field also lacks consensus on optimal exergame type, session frequency, or duration thresholds for clinically meaningful change. This is an early-stage literature with promising directional signals, but it remains far from practice-ready guidance. Larger, randomized controlled trials with standardized outcome measures are essential before exergaming can be confidently recommended as an adjunct therapy in ASD clinical or educational settings.
