Beyond traditional methods: Augmented reality enhances working memory and emotion recognition in Chinese children with autism—A CANTAB-controlled trial

Children with autism spectrum disorder (ASD) often have difficulties with working memory, attention, inhibitory control, and emotion recognition. These challenges impact daily living and social growth. While computerized cognitive training shows promise, the use of augmented reality (AR) to increase engagement and transfer is not well studied. This randomized controlled trial compared two AR-based interventions—an AR 1-back task and an AR Stroop task—with a traditional 2D Stroop task and a no-training control. Eighty Chinese children with ASD (aged 4–15 years) were randomly placed in one of four groups (n = 20 per group), each completing 10 daily training sessions. Performance was measured before and after the intervention using four CANTAB subtests: Spatial Working Memory (SWM), Delayed Matching to Sample, Multitasking Test, and Emotion Recognition Task. All active training groups showed major within-task improvements and better emotion recognition. Only the two AR-task groups, however, showed notable reductions in SWM between-errors. The 2D Stroop group showed limited transfer, whereas the control group showed no improvement. Between-group analyses showed a significant advantage for the AR-task groups over the no-training control in SWM (ps < .05 after Holm correction). There were no group differences in emotion recognition. These results suggest AR-task-based cognitive training may support broader working memory transfer in children with ASD. However, because no 2D n-back comparison group was included, it's unclear whether the gains stem from the AR format, the task demands, or a combination of both. Replication with fuller designs is needed for definite conclusions.