Effects of augmented and virtual reality-based interventions on social behaviors in children with ADHD: a narrative systematic review

Difficulties in social skills and social behavior are among the core functional impairments experienced by children with Attention Deficit Hyperactivity Disorder (ADHD). Augmented Reality (AR) and Virtual Reality (VR) technologies have gained increasing attention as innovative intervention tools to support social development in this population. However, evidence regarding their effectiveness remains fragmented and methodologically heterogeneous. This narrative systematic review synthesized empirical evidence on AR- and VR-based interventions for social skills and behaviors in children and adolescents with ADHD. Following PRISMA 2020 guidelines, a comprehensive literature search was conducted across Web of Science, Scopus, ERIC, PsycINFO, and Google Scholar for studies published between 2015 and 2025. Studies were screened using predefined inclusion and exclusion criteria based on the PICO framework. Eligible studies included quantitative experimental or quasi-experimental designs with standardized quantitative measures of social outcomes. Risk of bias was assessed using appropriate methodological appraisal tools, and findings were synthesized narratively due to heterogeneity. A total of 148 records were identified, of which 28 studies met the inclusion criteria. The studies demonstrated considerable variability in sample characteristics, intervention duration, technological modality (AR, VR, or hybrid systems), and outcome measures. VR interventions were more frequently studied and showed consistent short-term benefits, while AR approaches demonstrated contextualized and ecologically valid applications. Hybrid AR-VR interventions appeared promising for engagement and skill generalization, but evidence remains limited due to small sample sizes and heterogeneous designs. Findings suggest that AR and VR technologies may provide beneficial and engaging tools for supporting social development in children with ADHD. Nevertheless, conclusions regarding the relative effectiveness of specific modalities should be interpreted cautiously. Future research should prioritize well-designed randomized controlled trials, standardized outcome measures, and direct comparisons between AR, VR, and hybrid interventions to strengthen the evidence base and inform clinical practice.