Background: Autism spectrum disorder (ASD) is characterized by deficits in executive functions, such as inhibitory control, which affect behavior and social adaptation. Although physical activity-based interventions, such as exergames, have shown potential to improve these functions, their comparative effects with active traditional games remain underexplored, particularly regarding inhibitory control in children with ASD.

Objective: We aim to analyze the effects of a session of exergames and active traditional games on inhibitory control in children with ASD.

Methods: This randomized controlled crossover trial included 9 male children with ASD (mean age 8.6, SD 1.4 y). Participants completed three 20-minute experimental sessions in random order, with a minimum interval of 48 hours: (1) active traditional games, (2) exergames using Just Dance 2022, and (3) a control session with manual painting activities. Inhibitory control was assessed 5 minutes postsession using a modified flanker task in the E-Prime (version 3.0; Psychological Software Tools Inc) program, recording reaction time (RT) and accuracy in congruent and incongruent phases. Repeated measures ANOVA was used to compare RT and accuracy between experimental and control conditions. Data are presented as means and 95% CIs.

Results: There was a statistically significant effect of condition on RT in the incongruent phase (P=.02). RT in the exergame session (849 ms, 95% CI 642 to 1057) was lower compared to the traditional games (938 ms, 95% CI 684 to 1191; P=.02) and control (969 ms, 95% CI 742, 1196 to P=.01) sessions. No significant differences were observed in RT during the congruent phase or in accuracy across either phase.

Conclusions: A 20-minute session of exergame improved inhibitory control performance in children with ASD compared to active traditional games and painting activities.

Keywords: ASD, autistic; Flanker test; anthropometric; autism; behavior; children; cognition; crossover; exercise; exergame; inhibitory control; pediatric; physical activity; physical education; randomized control trial.

© Juliana Macedo Miranda, Rodrigo Alberto Vieira Browne, Weslley Quirino Alves da Silva, João Paulo Rodrigues dos Santos, Carmen Silvia Grubert Campbell, Isabela Almeida Ramos. Originally published in JMIR Serious Games (https://games.jmir.org).