Design and Evaluation of an Immersive VR Space Based on Pedagogical Agent for Theory of Mind Training in Autistic Children: Insights from Brain Activity and Participatory Study

While virtual reality (VR) offers potential for training children with autism spectrum disorder (ASD), limited evidence guides pedagogical agent (PA) design for immersive theory of mind (ToM) training. This study adopted a sequential multi-method approach to develop and preliminarily evaluate a cave automatic virtual environment (CAVE)-based ToM training space for autistic children. Study 1 used functional near-infrared spectroscopy (fNIRS) with 22 autistic children and found that rich interaction elicited greater neural activation during ToM processing, particularly when anthropomorphic cues were limited. Building on these findings, Study 2 combined interviews with 6 autism education experts and a collage workshop with 8 autistic children. The integrated findings supported cartoon-style human agents with moderate facial expressions, low-saturation and limited colors, diverse movements, expressive speech, simple verbal expressions, stepwise cues, and contingent feedback. These strategies guided development of the CAVE-based training space in Study 3. The preliminary feasibility evaluation indicated satisfactory professional-user usability, with the three participating children showing higher post-training ToM scores and caregiver-reported changes in social functioning. Overall, the study provides design and methodological guidance for immersive learning environments that better align with autistic children’s processing characteristics and intervention needs, while suggesting the potential of the CAVE-based environment for ToM training.