Using games as part of the intervention and support process (sometimes referred to as 'gaming therapy') is an increasingly popular method of supporting autistic youth to develop social competencies and other skills because they are believed to be inherently motivating and fun for youth. Some emerging research has indicated that intervention programmes using games can be beneficial for autistic youth, but little is currently known about why, how and for whom they work. This study conducted a realist evaluation of a programme using the video game "Minecraft" for autistic youth, comprising interviews and observations with autistic youth (n = 4), facilitators (n = 2) and caregivers (n = 6). Findings from interviews and observations suggest that leveraging strengths, sharing power by placing youth in the 'expert role' and learning in a naturalistic and motivating environment provided youth with the opportunities to develop social competencies in communicating their wants and needs and supported the development of social connections, independence and emotion regulation. The results of this realist evaluation may provide a framework for future intervention and support programmes using video games.Lay abstractUsing games as part of the intervention and support process (sometimes called 'gaming therapy') is increasingly used with autistic youth. Gaming is believed to be fun, motivating, and helpful in supporting autistic youth to develop social connections and skills, but very little research has explored this. In this study, we looked at a gaming-based programme that uses Minecraft. We did interviews and observations with youth, facilitators and caregivers of youth to find out why, how and for whom it works. We found that the gaming-based programme could be particularly motivating for youth interested in video games. Facilitators shared the interests of the youth and shared power by placing youth in the 'expert role', while providing youth with opportunities to learn and develop in their own way. Feedback from youth, their caregivers and facilitators suggests that the gaming-based programme might help youth develop social connections, independence and emotion regulation. The results of this realist evaluation may provide a framework for future gaming-based programmes.

Keywords: autism; social connection; strengths-based; video-games.