Pictogram room augmented reality technology games improve body knowledge, imitation, and joint attention skills in autistic children with intellectual disability

Abstract Body knowledge, imitation, and joint attention are foundational for child development, yet many autistic children with intellectual disability struggle to acquire these skills. This study evaluated the effects of an educational intervention using Pictogram Room (PR), an open-access augmented reality (AR) technology program with games targeting these abilities. Twenty-three autistic children with intellectual disability (ages 7–14) from Spain, Bulgaria, and Türkiye participated. A stepped wedge randomized design was implemented across two groups. Over 27 sessions, delivered in their usual educational settings by their regular staff, participants showed significant and sustained improvements in body knowledge, imitation, and joint attention. This is the first AR-based intervention shown to simultaneously enhance these three core skills in this population. The program is brief, socially valid, and requires no specialized training, making it a promising tool for inclusive educational practice.