The Potential of Virtual Reality for Diagnosing Cognitive Functions in Adolescents with Autism: Empirical Study

Background . Adolescents with autism spectrum disorder often experience significant challenges during traditional cognitive assessments, including social communication difficulties, anxiety in unfamiliar environments, and sensory sensitivities that may compromise diagnostic accuracy. Virtual reality offers a promising alternative that could reduce stress and provide more precise evaluation of cognitive functions. This study compared performance on cognitive tasks across traditional paper-based, digital, and virtual reality environments. Methods . Twenty-five adolescents with autism spectrum disorder (mean age 15.5 years; 19 males, 6 females) with varying cognitive functioning levels completed five cognitive tasks in three formats: paper-based, digital, and virtual reality. Tasks included Raven's Colored Progressive Matrices, Bourdon attention test, Visual Memory Test, Kohs Block Design Test, and Recognition of Overlapping Figures. Heart rate variability was recorded via electrocardiography during virtual reality immersion to assess psycho-emotional safety. Subjective experiences were evaluated using the Positive and Negative Affect Schedule and Likert-scale questionnaires. Data were analyzed using one-way analysis of variance. Results . Heart rate variability analysis showed no significant differences across measurement phases (rest, passive virtual reality exposure, active roller coaster simulation), confirming that virtual reality immersion did not adversely affect psycho-emotional state. Performance on Raven's Matrices, Visual Memory Test, and Recognition of Overlapping Figures was comparable across all three formats (p > 0.05). However, the Bourdon Test and Kohs Block Test demonstrated significantly longer completion times in virtual reality (p < 0.05), attributed to difficulties with controller manipulation. All participants reported predominantly positive emotions and expressed strong interest in future virtual reality experiences. Conclusions . Virtual reality is a safe and promising tool for cognitive assessment in adolescents with autism spectrum disorder, though tasks requiring precise motor control require adaptation or preliminary training. These findings support the development of virtual reality-based diagnostic models and expand understanding of cognitive processes in varied conditions. The approach shows potential for broader application with other populations with disabilities. Future research should include neurotypical comparison groups and adapt additional assessment tools for virtual reality formats.