How Do Parents and Clinicians View XR for Neurodivergent Children?

“Parents were much more pragmatic than I expected in terms of saying, this would be really helpful, this would be really beneficial.”

Eileen McGivney, Assistant Professor at Northeastern University

Extended reality (XR) technologies are arriving in homes and classrooms without clear guidelines for use by certain users. Parents and clinicians working with neurodivergent children face decisions about when, how, and whether to introduce VR headsets as tools for learning, therapy, or social connection. These adults navigate questions about appropriate use, developmental impacts, and safety largely on their own, drawing on individual judgment rather than established frameworks.

For children with autism or ADHD, XR presents distinct opportunities and risks. Controlled virtual environments can reduce sensory overload and provide new modes of engagement. The same technologies raise concerns about isolation, dependency, behavioral conditioning, and unknown long-term effects. Parents and clinicians assess these trade-offs in real time as they determine whether XR meets their children’s needs.

Understanding how these stakeholders interpret ethical use matters because their lived experience shapes what responsible XR adoption looks like in practice. Their perspectives reveal the considerations that emerge when adults mediate immersive technologies for vulnerable populations.

A recent study examines how parents of neurodivergent children and clinicians view XR’s ethical dimensions. Rather than measuring learning or psychological outcomes, the research explores what these adults consider right or wrong about XR use and how they think about benefits and harms.

To examine how parents and clinicians understand XR’s promises and perils for neurodivergent children and what their insights reveal about children’s media, education, and therapeutic technology, we spoke with Eileen McGivney, Assistant Professor of Communication Studies and Art + Design at Northeastern University, who conducts design-based research on learning with immersive technologies like virtual reality.

Dr. Eileen McGivney conducts design-based research on how people learn with immersive technologies like virtual reality (VR). In her work, she draws on learning sciences, educational psychology, and media studies to investigate the affordances and limitations of VR to situate learning in environments that are difficult or impossible in traditional classrooms.

In particular, she is interested in the process of learning with VR, how the design of virtual environments and activities affects how learners use and experience them, and ultimately how that affects their learning. In her current work, she is studying processes related to learners’ sense of agency, emotions, self-beliefs, and identities, and how these are affected by design features such as varied types of interactivity. Her work crosses many different populations and contexts, including university health profession students, high school STEM education, workforce development training, and game-based learning to teach problem-solving skills.

Dr. McGivney completed her PhD in education at Harvard University, where she also served as an instructor and a researcher in Project Zero’s Next Level Lab and the NSF-funded EcoLearn projects. Prior to Harvard, she researched technology and innovation in education systems around the globe at the Brookings Institution in Washington, DC, and the Education Reform Initiative in Istanbul, Turkey. She holds an MA in public policy analysis from Sabanci University and a BS in media studies from the University of Illinois Urbana-Champaign.

What parents and clinicians consider “right or wrong” about XR use emerged through their assessments of concrete benefits and risks. The study draws from a larger research collaboration led by Dr. Meryl Alper at Northeastern University, focusing on technology use by neurodivergent children. McGivney and her team conducted qualitative focus groups with parents of children diagnosed with ADHD or autism and clinicians who work with these populations. Participants watched videos highlighting different VR use cases—in health settings, education, and at home—then discussed their perspectives.

Dr. McGivney expected skepticism. Instead, parents demonstrated pragmatic willingness to consider how VR could help their children.

“One of the things that was very striking to me in these focus groups and meeting these parents, it was actually the positives that they identified and how some of them were quite readily willing to look at how these technologies could benefit their children,” McGivney says.

“I guess my expectation had been that parents would be very skeptical and see these technologies as really a negative impact on children because that’s something I hear a lot about. I think when I talked to many parents about virtual reality, they kind of get an image in their mind of a sci-fi movie where everyone is living in an apocalyptic world and using virtual reality as an escape, and these parents were much more pragmatic than I expected in terms of saying, this would be really helpful, this would be really beneficial.”

Parents drew on existing experience with how other technologies already help their children. They described children playing Roblox with friends online because visiting a friend’s house feels overwhelming. They recognized how certain sensory needs make traditional activities difficult.

The VR field trip example resonated strongly. School trips to museums can overwhelm children who lack space to decompress when stimulation becomes too intense. Parents saw VR field trips as offering the same educational content with critical differences: children could remove the headset when needed, remain in familiar environments like classrooms or homes, and participate without the social and sensory demands of all-day excursions with peers.

“One of the examples that we showed them was the class taking a kind of virtual reality field trip to observe dinosaurs, and they talked about how something like a school field trip to a museum can be a real almost nightmare for certain children who when they get overwhelmed there isn’t necessarily a place for them to go to unwind or remove themselves from the stimulation,” McGivney explains. “They talked about how it would be so great because if there is any kind of issue with the virtual reality field trip, they can take the headset off and kind of have time to themselves and be in a familiar environment like a classroom or home setting.”

For children who traditional field trips exclude entirely due to sensory or social challenges, VR offered participation in controlled conditions adapted to individual needs.

Parents identify risks alongside benefits. They express concerns about isolation, safety, and what children lose when spending extended time in virtual environments. These worries mirror what parents generally share about VR, but parents of neurodivergent children frame them through their children’s specific needs and vulnerabilities.

The critical finding centers on individualization. What works for one child fails for another, even among children with the same diagnosis. Some children thrive in traditional school field trips, while others find them unbearable. Some benefit from remote schooling using VR, while others need an in-person structure. The ethical question becomes less about whether XR is appropriate and more about whether it fits the individual child.

“It’s not necessarily a benefit or a risk, but what we identified as a key factor is having a very individualized approach because some children would do much better in the in-person field trip. Some would do better in virtual reality. Some would need either activity kind of scaffolded differently by their adults, counselors, teachers, and parents,” McGivney says. “Making sure that whatever the approach is fits for the child is the big priority.”

Parents discussed how remote school using VR could benefit children who struggle in traditional classroom environments. The social dynamics, physical structures, and sensory demands of school buildings overwhelm certain children. VR learning from home with opportunities for immersion in different places appeals to parents whose children learn better outside conventional settings.

“They talked about how for some kids that would be great, they also talked about how for other kids it would really not work,” McGivney notes.

The individualized lens extends to social applications. Parents see potential for children to connect with grandparents during holidays when travel disrupts routines. Routine changes can derail neurodivergent children, and VR offers a way to maintain family connections without the stress of travel.

“We have one example in the study of a family using virtual reality to connect with grandparents over the holidays when they’re not able to actually go visit them and how some things that actually can really affect their children, such as not having a routine, not being able to do something that was expected, can really derail them,” McGivney says. “Using something like this technology to still allow more casual interactions, like let’s hop in VR and play a game and you feel as though you’re actually sitting next to grandma and catching up with her, those are the types of things I think could be really beneficial given what the needs of the child are.”

Parents also see value in children finding community. In small towns or rural areas, neurodivergent children may feel isolated as the only ones with their diagnosis. VR could connect them with other children facing similar challenges, fostering natural peer relationships in immersive environments. Remote access to clinicians becomes another possibility for families in areas lacking specialized services.

The individualized approach reveals a core ethical principle: XR’s appropriateness depends entirely on context, child, and implementation, not on the technology itself.

The enthusiasm parents express confronts a significant obstacle: limited research on XR use in everyday contexts with neurodivergent children. Most existing studies treat VR as a medical device or clinical treatment rather than as a tool families use at home or educators integrate into classrooms.

“A lot of studies have been done as kind of using these as more like medical devices or clinical treatments for people with ADHD or on the autism spectrum,” McGivney says. “I think about how to manage these at home or in a classroom, I don’t think we have a lot of good evidence quite yet.”

The research gap creates a problem. Parents and clinicians make decisions without evidence-based guidance about what works, what harms, and what factors predict success or failure for different children.

Dr. McGivney identifies simple design improvements that could immediately help parents. During focus groups, she discovers that some parents who own Meta Quest headsets and use them with their children don’t know they can cast what the child sees to a television screen. This monitoring feature exists but remains invisible to users who need it most.

“There were actually were parents participating who own VR headsets like the MetaQuest and who have used them with their children but didn’t know that you could cast what the child is seeing in their headset to the television and it made me realize there’s a real gap there in terms of how people are educated to use these because that’s a really simple fix,” she explains. “If you can observe everything your child is doing because it’s on the TV screen in the middle of the living room and there isn’t any possibility for them to kind of hide away from it, then that kind of opens up this area where parents safeguards can come in. Who are you talking to in there? Who is that? OK, it’s time to take it off because you’ve gotten kind of too far into this.”

She suggests designers could automatically enable casting when headsets operate in child mode, making parental monitoring the default rather than a hidden option.

Beyond visibility fixes, Dr. McGivney recommends design variations that accommodate different needs. Applications should allow parents and children to toggle social interaction on or off. A virtual museum visit might include other people for children who benefit from social presence, or function as a solitary experience for children who find social interaction overwhelming or unsafe.

“Have different levels and variations of applications and experiences that parents can choose. Parents and children can choose what works for them, right? So maybe for some children social interaction in VR is really beneficial and for others it’s very overwhelming or dangerous and so can you kind of turn on and off whether there are other people in the environment, let’s say on like in a virtual museum,” McGivney says.

Co-design with neurodivergent communities represents another priority. Rather than adapting mainstream applications, developers should work directly with these populations to create experiences that address their specific interests and needs.

“We should invest in a pretty robust research basis so that we can make good evidence based recommendations,” she adds. “How can we work with these communities and populations to design things that they really want to use and that are going to kind of work for them as well.”

The path forward requires both immediate practical improvements and long-term research investment to build the evidence base that parents, clinicians, and designers currently lack.

Building that evidence base requires funding that is currently under threat. Dr. McGivney emphasizes the importance of federal support through agencies like the National Science Foundation, which funds STEM education research, and the National Institutes of Health, which supports studies on children with autism and ADHD. Current federal funding cuts threaten this research pipeline.

“I would love to see more support for research. I think we’re also in a very challenging time right now where we’re actually losing a lot of research funding at the especially at the federal level so that would be one thing I would say everyone should support funding for through the National Science Foundation which works on STEM education as well through the National Institutes of Health which does a lot fund a lot of research on children with autism and ADHD,” McGivney says. “The better funding we have for research, the better development we’re going to be able to recommend.”

Industry shifts create additional uncertainty. Meta’s decision to shutter its metaverse division, which includes significant VR development, might suggest the technology faces decline. Dr. McGivney sees the opposite: an opportunity for diversification.

“I would say to anybody who’s really interested in or using these technologies don’t let that discourage them because I think that only gives us an opportunity for more smaller players to get in on the market so I see in the future maybe we’ll have more a network of lots of smaller companies instead of kind of one company dominating the space so not to get discouraged I don’t think that these types of devices or immersive experiences are going away but I do think they may look different in the future,” she says.

Smaller companies entering the market could mean more specialized applications designed for specific populations rather than one-size-fits-all platforms. This aligns with the individualized approach parents identify as essential.

Ethical XR use for neurodivergent children depends on closing the gap between rapid technology adoption and the knowledge needed to guide that adoption responsibly. Parents and clinicians make consequential decisions about when children use headsets, what content they access, and how long they stay immersed. These adults need research-backed guidance, design features that enable effective monitoring and customization, and recognition that what works varies dramatically from child to child.

As XR becomes more embedded in education and therapeutic contexts, the question is whether the systems supporting these technologies—research funding, evidence-based design, and individualized implementation—can keep pace with the pace at which families and clinicians adopt them.