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NCT Number: NCT07322952

Gamified Tai Chi for Cognitive Control and Behavioral Symptoms in Children With Autism Spectrum Disorder: An Assessor-Blinded Randomized Controlled Trial

This randomized controlled trial evaluates the effectiveness of a "Gamified Tai Chi" intervention on improving executive functions (such as inhibitory control, working memory, and cognitive flexibility) in children with Autism Spectrum Disorder (ASD).

The study aims to determine whether integrating game mechanics (based on the Mechanics, Dynamics, and Aesthetics framework) into Tai Chi training offers superior benefits compared to traditional Tai Chi training or routine care.

Approximately 200 children aged 8-15 years will be randomly assigned to one of three groups for a 12 months period:

Gamified Tai Chi Group: Participants will attend sessions combining simplified Tai Chi forms with interactive tasks, such as digital chasing games and cooperative challenges, using a point-based reward system to enhance engagement.

Traditional Tai Chi Group: Participants will learn the same Tai Chi movements but via standard instruction methods without gamification elements.

Control Group: Participants will continue their routine rehabilitation or physical education classes (Waitlist design).

Assessors who are blinded to group allocation will evaluate outcomes at baseline and post-intervention using standardized cognitive tasks (e.g., Flanker task, 1-back task) and behavioral questionnaires regarding social functioning and daily living skills.

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Key information

Conditions

Autism Spectrum Disorder (ASD Autism Spectrum Disorder Child Development Disorders, Pervasive Mental Disorders Neurodevelopmental Disorders

Age range

9 year–12 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Chaozhou Special Education School

Chaozhou, Gaungdong, China

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Children aged 9 to 12 years at enrollment.
  • Clinical diagnosis of autism spectrum disorder based on DSM-5 criteria, confirmed by a qualified clinician.
  • Full-scale or equivalent IQ of at least 80.
  • Able to understand basic instructions, imitate movements, and take part in group activities.
  • Able to tolerate low- to moderate-intensity exercise.
  • Educational, rehabilitation, and medication plans expected to remain stable during the study.
  • Written informed consent provided by a legal guardian, with child assent obtained when developmentally appropriate.

Exclusion criteria

  • IQ below 80.
  • Unable to complete basic cognitive or motor assessments.
  • Severe psychiatric or neurological conditions.
  • Exercise contraindications or severe sensory impairments.
  • Safety risks during group activities.
  • Systematic executive-function training, cognitive training, Tai Chi, martial arts, or other structured exercise within the previous 3 months.
  • Medication or rehabilitation plan expected to change during the study.

Treatment and study plan

Gamified Tai Chi Program

Behavioral

Participants will receive a 12 months Gamified Tai Chi intervention (3 sessions/week, 45 mins/session). The intervention integrates the MDA (Mechanics, Dynamics, Aesthetics) framework and exergaming elements into traditional Tai Chi movements to target executive functions.

Traditional Tai Chi Group

Behavioral

Participants will receive a 12 months standard Traditional Tai Chi training (3 sessions/week, 45 mins/session). This group performs the same physical movements as the experimental group but without any gamification, scoring systems, or interactive game scenarios.

Primary outcomes

  1. Change in working memory measured by the 1-back task

    Time frame: Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)

    Working memory is assessed with a computerized 1-back task. Outcomes are mean accuracy and mean reaction time, together with d' as an index of perceptual sensitivity; the 1-back d' is the principal working-memory index. Higher accuracy and higher d' indicate better working-memory performance.

  2. Change in inhibitory control measured by the Flanker task

    Time frame: Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)

    Inhibitory control is assessed with a child-adapted computerized Flanker task. Outcomes are mean accuracy and mean reaction time in each condition and the Flanker conflict effect (the incongruent-minus-congruent difference in reaction time or error rate). Higher accuracy and a smaller conflict effect indicate better inhibitory control.

  3. Change in cognitive flexibility measured by the Dimensional Change Card Sort (DCCS) task

    Time frame: Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)

    Cognitive flexibility is assessed with a computerized Dimensional Change Card Sort (DCCS) task in which children first sort cards by color and then by shape after the rule changes. Outcomes are mean accuracy and mean reaction time and the switch cost (the change in performance after the rule switch). Higher accuracy and a smaller switch cost indicate better cognitive flexibility.

Secondary outcomes

  1. Change in restricted and repetitive behaviors measured by the Repetitive Behavior Scale-Revised (RBS-R)

    Time frame: Time Frame: Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)

    Description: Restricted and repetitive behaviors are assessed with the caregiver-rated Repetitive Behavior Scale-Revised (RBS-R), covering stereotyped, self-injurious, compulsive, ritualistic, and sameness behavior and restricted interests. Each item is scored 0-3, and subscale scores and a total score are derived; the RBS-R total score is the main outcome. Higher scores indicate more prominent restricted and repetitive behaviors.

  2. Change in aberrant behaviors measured by the Aberrant Behavior Checklist (ABC)

    Time frame: Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)

    Autism-related problem behaviors are assessed with the caregiver-rated Aberrant Behavior Checklist (ABC), comprising five subscales: irritability, social withdrawal, stereotyped behavior, hyperactivity and noncompliance, and inappropriate speech. Each item is scored 0-3, and subscale scores and a total score are derived; the ABC total score is the main outcome. Higher scores indicate more severe problem behaviors.

  3. Change in emotion regulation difficulties measured by the Difficulties in Emotion Regulation Scale (DERS)

    Time frame: Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)

    Description: Difficulties in emotion recognition, acceptance, and regulation are assessed with the caregiver-rated Difficulties in Emotion Regulation Scale (DERS), with subscales for nonacceptance, goal-directed behavior, impulse control, emotional awareness, access to regulation strategies, and emotional clarity. Subscale scores and a total score are derived; the DERS total score is the main outcome. Higher total scores indicate greater difficulties in emotion regulation.

  4. Change in overall strengths and difficulties measured by the Strengths and Difficulties Questionnaire (SDQ)

    Time frame: Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)

    Psychological and behavioral problems are assessed with the caregiver-rated Strengths and Difficulties Questionnaire (SDQ), comprising emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behavior subscales. The total difficulties score (sum of the emotional symptoms, conduct problems, hyperactivity, and peer problems subscales) is the main outcome. Higher total difficulties scores indicate greater difficulties, whereas higher prosocial behavior scores indicate more positive social behavior.

Sponsors and collaborators

Lead sponsor

Jinan University Guangzhou

Other

Collaborators

  • Chaozhou Special Education School

Registry information

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jan 7, 2026
Registry last updated
Jun 4, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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