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

June 2, 2026 updated by: Ma Ruisi, Jinan University Guangzhou

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.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
100

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Gaungdong
      • Chaozhou, Gaungdong, China
        • Chaozhou Special Education School

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
No Intervention: Control Group
Participants will maintain their routine rehabilitation courses and standard physical education classes as per the school curriculum. No additional Tai Chi training will be provided during the 12 months study period. They may be offered Tai Chi training after the study conclusion (Waitlist design).
Experimental: Gamified Tai Chi Group
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.
Behavioral: Gamified Tai Chi Program
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.
Active Comparator: Traditional Tai Chi Group
Participants in this arm receive regular curriculum activities for 16 weeks at the same frequency and duration as the intervention arm (3 sessions/week, 45 minutes/session; 48 sessions in total), delivered by regular teaching staff. These activities include basic physical activities, simple movement practice, classroom routines, and usual rehabilitation activities. This arm does not include Tai Chi, gamified movement tasks, or structured executive-function training. After the 16-week period, participants enter an 8-week natural follow-up during which they continue their usual school curriculum and daily routines.
Behavioral: Traditional Tai Chi Group
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.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
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.
Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)
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.
Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)
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.
Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
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.
Time Frame: Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)
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.
Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)
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.
Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)
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.
Baseline, week 8, week 16, and week 24 (8 weeks after the end of the 16-week intervention)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Jinan University Guangzhou

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Chaozhou Special Education School

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 1, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
March 1, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 1, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
December 22, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 6, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 7, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 4, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 2, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2025LCLL-141

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared because this trial involves a small sample of children with autism spectrum disorder, who are considered a vulnerable population. Given the risk of re identification in this specific clinical and educational setting, and according to the requirements of the ethics committee and the consent obtained from legal guardians, only de identified aggregate results will be reported and shared.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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