A Note on Language Choice
In the preparation of this manuscript, careful consideration was given to the terminology used to describe autism. The choice between person-first language (“person with autism”) and identity-first language (“autistic person”) is a nuanced one, influenced by individual preferences and community norms. We have chosen to use identity-first language in this manuscript, respecting the preferences of a significant portion of the autistic community and of the lead researcher who is autistic and prefers this terminology. This choice aligns with a perspective that views autism as an integral part of an individual’s identity. However, we acknowledge and respect the diversity of opinions on this matter and understand that some individuals prefer person-first language. We intend no disrespect and aim to honor the complexity of individual and community preferences through our choice of words.
Autism
Globally, 1 in 100 children are autistic (Zeidan et al., 2022). Autistic people experience challenges interpreting body language and facial expressions, as well as identifying emotions, which play a pivotal role in facilitating positive social interactions (Gallup et al., 2016). They may also demonstrate unique approaches to verbal, written, and gestured social initiations that diverse from those of their neurotypical peers, potentially affecting social play experiences (Jiménez-Muñoz et al., 2021; Stone et al., 2019). Consequently, autistic people experience social rejection up to four times more than their neurotypical peers (Craig et al., 2021), which can lead to higher levels of loneliness and depression (Finke et al., 2018).
Many autistic adolescents experience social and emotional challenges, and challenges relating to communication and making and maintaining friendships. Building quality relationships is essential to wellbeing and protects against negative outcomes such as underachieving academically and occupationally, loneliness, social isolation, depression, anxiety, peer rejection, and bullying (Beaumont et al., 2021; Finke et al., 2018). This is particularly important during the adolescent phase of development as accelerated biological growth and major social role transitions are experienced during this stage in life. Adolescence is therefore a critical period of life to focus on within the autistic population (Sawyer et al., 2018).
Recently, studies have focused on gaming as a tool to improve socialization of autistic adolescents (Jiménez-Muñoz et al., 2021). Games are accessible and a popular activity among adolescents. Adolescents are therefore likely to engage in and maintain engagement in game-based activities to improve their socialization (Moreno & Hoopes, 2020). Additionally, autistic individuals tend to focus on particular interests, so their interest in gaming can be utilized to support their social development (Stone et al., 2019).
Massive Multiplayer Online Role-Playing Games (MMORPGs)
MMORPGs are commercial online games where multiple players navigate a common virtual environment that requires players to communicate and collaborate with others to complete tasks and missions in order to progress to higher levels (Gallup et al., 2016). Engagement with MMORPGs have been found to positively impact adolescent identity, self-esteem, socialization, learning and development due to their collaborative nature (Moreno & Hoopes, 2020; Visser et al., 2013). Studies have also suggested that MMORPGs provide a platform for autistic adolescents to socialize with less risk and challenges compared to real life (Gallup et al., 2016) by allowing them to use different modes of communication including speech, writing, image and gesture in writing chat boxes, voice chats and video chats (Stone et al., 2019). MMORPGs provide opportunities for autistic adolescents to develop social confidence as they are required to communicate with others through problem solving and strategizing and this collaboration results in building social connections (Gallup et al., 2016). These potential gains in social confidence through gaming have the potential to generalize to real-world situations and help reduce experiences of social isolation (Beaumont et al., 2021; Finke et al., 2018; Gallup et al., 2016).
Social Benefits of Gaming
MMORPGs may be useful in improving social relationships for autistic adolescents due to the nature of the gameplay as they are required to engage in conversations with other players to problem solve and strategize to work towards shared goals resulting in social connections and friendships which may generalize to real-world social contexts (Finke et al., 2018; Gallup et al., 2016; Sundberg, 2018; Visser et al., 2013).
An online questionnaire-based quantitative study indicated that there are social gains for autistic people who play video games, such as increased feelings of connection to friends, decreased feelings of loneliness, expansion and maintenance of social relationships with others, and more friendships; however, friendship quality and having close friendships was not investigated (Sundberg, 2018). To supplement these findings, qualitative studies have reported that autistic people who play video games perceive that gaming positively impacts their lives as they are able to use video games as stress relief, they are able to increase their socialization through connection with others online when they are not able to in-person, and that they are able to self-reflect and generalize social activities in MMORPGs to comparable social situations in real life (Finke et al., 2018; Gallup & Serianni, 2017).
Moreover, studies have also used experimental methods to demonstrate the benefits of gaming on socialization in autistic people (Chung et al., 2016; Ferguson et al., 2013; Wang et al., 2018). Overall, these studies suggested that gaming can be beneficial for increasing compliment use, turn-taking, providing positive post-game comments (Ferguson et al., 2013), improving sense of commitment to collaboration, ability to value peers (Wang et al., 2018) and increasing social arousal and recognition of emotions (Chung et al., 2016) in autistic adolescents. Whilst there is a multitude of quantitative studies demonstrating the effectiveness of gaming on social outcomes, there are limited qualitative studies on this topic. Further qualitative research is warranted as it is important to understand the experiences of autistic adolescents in order to better understand what aspect of gaming can foster communication and socialization, as well as the enablers and barriers of gaming to socialize and build friendships.
Two notable qualitative studies have been conducted, both indicating perceived social benefits of gaming. Finke et al. (2018) studied autistic adolescents and young adults who played video games through semi-structured interviews to examine their perceptions, experiences, and motivations of gameplay. However, this study focused on video games and experiences broadly (which could include single-player games), rather than focusing on MMORPGs and social experiences (the focus of the current study). Despite the broad nature of the games investigated, participants indicated that they were able to interact with new and established friends through their common interest of gaming. Furthermore, Gallup & Serianni (2017) studied autistic young adults who played MMORPGs with a focus on socialization within gameplay. Data were collected through interviews, scheduled observations, and document analysis of online blogs, forums, and chat boxes. Their findings revealed that participants were comfortable socializing online as it mitigated challenges they faced with in-person socialization, which led to increased socialization, friendships, emotional awareness and reciprocation.
Whilst these studies have elucidated why gaming can help benefit socialization, the mechanisms of how autistic adolescents socialize with others through gaming and how they develop friendships through this medium is still unclear (Sundberg, 2018). Furthermore, these studies have solely focused on the perspectives of the adolescents themselves and have not considered parents’ perceptions of gaming and socialization.
Parents’ Attitudes Toward Gaming
Parents are integral in shaping autistic adolescents’ engagement in video games as the gatekeepers of gaming devices, so their (dis)approval can impact the amount of time spent gaming and, consequently, socialization (Craig et al., 2021). Previous research has indicated that parents of autistic children generally have positive attitudes towards their children engaging in gaming, want to support their gameplay, and believe that there are positive physiological and cognitive outcomes for their children playing games including increased fine motor skills, language skills, proficiency with reading and writing, learning, academic achievement, and critical thinking (Finke et al., 2015). However, the main challenge for parents in managing their autistic child’s gaming is potential negative emotional responses when asked to stop playing (Craig et al., 2021; Schneider et al., 2017). These negative responses may be mediated by the quality of the parent-child relationship as studies have found that poorer quality relationships are associated with increased severity of problem gaming (Schneider et al., 2017). For instance, Kuo et al. (2015) indicated that when parents played video games with their autistic child, their child had fewer issues with anxiety, depression, and social withdrawal. Thus, the interaction between quality of the parent-child relationship and the perspectives of both the parent and their autistic child regarding the benefits of gaming warrants further exploration.
The Current Investigation
Whilst research has focused on the cognitive benefits of gameplay, particularly in relation to educational games, the social benefits of entertainment games, such as MMORPGs, have been overlooked. This is important to address as previous quantitative studies have reported that autistic people who play video games have more friends and experience less loneliness (Finke et al., 2018). To supplement these findings, further qualitative research is warranted to provide insight into how autistic adolescents socialize with others via gaming, how this impacts socialization in the real-world, and to investigate how friendships are developed in-game (Sundberg, 2018). The current study will therefore qualitatively explore this to provide more in-depth insight into the mechanisms of socialization while engaging with multiplayer games among autistic adolescents.
Moreover, there is a lack of qualitative research on parents’ attitudes regarding social outcomes of gaming. These attitudes are crucial as parents’ beliefs about the positive outcomes and social norms of playing video games are the greatest predictors of parental intention to support their child’s engagement with video gaming (Finke et al., 2015). Therefore, the current study will investigate parents’ perceptions of online gameplay to understand their involvement, attitudes and barriers to supporting their autistic child’s gameplay.
MMORPGs provide a safer place for autistic adolescents to engage in social interactions and to develop socially, which may generalize to real-world social contexts (Gallup et al., 2016). Understanding the mechanisms by which autistic adolescents socialize and make friends online is important as this process is critical in reducing social isolation and can positively impact the wellbeing of autistic adolescents (Beaumont et al., 2021; Sundberg, 2018). Furthermore, understanding the perspectives of adolescents and their parents on socialization in online games may not only assist researchers and clinicians in developing educational and therapeutic interventions to support socialization in autistic adolescents, but also aid educators in developing school curricula that integrate MMORPG elements to foster ways to connect with others and inclusivity. Such initiatives could substantially enhance the quality of life for autistic adolescents, promoting more meaningful social interactions and richer educational experiences. MMORPGs are widely and easily accessible, and can serve to bridge a gap to overcome existing barriers, offering a virtual environment where individuals can develop ways to socialize and communicate with others. Leveraging MMORPGs have the potential to enhance the affordability and accessibility of therapeutic interventions, providing clinicians, teachers, and families with a versatile tool that complements traditional therapeutic methods (Beaumont et al., 2021; Ferguson et al., 2013; Malinverni et al., 2017).
To date, no study has simultaneously examined both the views of autistic adolescents and their parents’ experiences of socializing via online games. The current study therefore aims to address this gap by investigating whether engaging in MMORPGs fosters socialization by examining autistic adolescents’ experiences of engaging with MMORPGs as well as their parents’ perceptions of their child’s engagement in these games. Thus, the study sought to address the following research question: “From the perspectives of both autistic adolescents and their parents, how does playing MMORPGs impact upon social development and communication?” It was hypothesized that autistic adolescents would perceive MMORPGs as beneficial for their own social development. Similarly, it was expected that parents would also view MMORPGs as being beneficial for their child’s development.
Method
Participants
A combination of convenience and purposive, criterion-based sampling was used to recruit participants through social media posts in autism and gaming pages/groups and forums. Due to the qualitative nature of the research and the specific eligibility criteria required for participation (autistic adolescent who plays MMORPGs and has a parent/caregiver also willing to participate in the study), a relatively small sample size was obtained. Ten participants (5 pairs of adolescents and one of their parents/caregivers) were involved in this study. Of the five adolescents, four identified as male and one as female (Mage = 16.20 years, SD = 2.77). Five parents were involved in the study, three of whom identified as male and 2 identified as female (Mage = 38.40 years, SD = 3.85). This sample size is similar to past qualitative research involving autistic adolescents and parents of autistic adolescents (e.g., Cohen et al., 2022; Wright Stein et al., 2022). Table 1 presents information about the demographics of the five pairs of autistic adolescents and their parents. Participants received a $25 (AUD) gift card as remuneration for their time associated with the study.
Table 1
Demographic Information for Adolescent and Parent Participants
Adolescent Demographics | Parent Demographics | ||
|---|---|---|---|
A1 | P1 | ||
Age | 19 | Age | 35 |
Gender | Female | Gender | Female |
Location | USA | Location | USA |
Weekly MMORPG Play | 4 h | Child’s Weekly MMORPG Play | 5 h |
MMORPGs Played | MMO Collectible Card Games | ||
A2 | P2 | ||
Age | 12 | Age | 37 |
Gender | Male | Gender | Female |
Location | Australia | Location | Australia |
Weekly MMORPG Play | 20 h | Child’s Weekly MMORPG Play | 11 h |
MMORPGs Played | Apex, Call of Duty, Roblox, Fortnite | ||
A3 | P3 | ||
Age | 18 | Age | 35 |
Gender | Male | Gender | Male |
Location | USA | Location | USA |
Weekly MMORPG Play | 15 h | Child’s Weekly MMORPG Play | 15 h |
MMORPGs Played | Lost Ark, Dark Orbit Reloaded, Neverwinter, Swords of Legend. | ||
A4 | P4 | ||
Age | 15 | Age | 42 |
Gender | Male | Gender | Male |
Location | USA | Location | USA |
Weekly MMORPG Play | 4 h | Child’s Weekly MMORPG Play | 4 h |
MMORPGs Played | Mini Militia | ||
A5 | P5 | ||
Age | 17 | Age | 43 |
Gender | Male | Gender | Male |
Location | USA | Location | USA |
Weekly MMORPG Play | 20 h | Child’s Weekly MMORPG Play | 20+ h |
MMORPGs Played | Star Wars, Guild Wars 2 | ||
The protocol for this study was reviewed and approved by the Griffith University Human Research Ethics Committee. Those who expressed interest in participating in the study were contacted by the researchers who explained the study inclusion criteria, protocol, and goals of the research. Adolescent and parent pairs who wished to continue with participation scheduled an appointment to complete an interview. Both the adolescent and parent provided written consent as well as verbal consent (prior to the start of the interview). Participants were also informed of their right to withdraw from the study at any time.
Procedure
Participants were first sent an online survey to complete (prior to the interview). Semi-structured interviews were then conducted online via Microsoft Teams for each adolescent and parent, with each interview lasting approximately 30 min in duration. Participants were offered the choice to have their parent/child next to them in their interview (e.g., for support, comfort, safety). For all pairings, both the adolescent and parent were present at the same time during the interviews. With both participants’ knowledge and consent, all interviews were recorded (video and audio) for the purposes of transcription. Once both interviews had been completed, participants were presented with the opportunity to have any questions answered and were then thanked for their time.
Measures and Instruments
Prior to the interview, both adolescents and parents were sent an online survey which included questions relating to gameplay (hours spent playing games, type of games played), demographic questions (e.g., self-identified gender, age), and the Unidimensional Relationship Closeness Scale (URCS). The URCS is a 12-item self-report scale that assesses the perceived closeness of relationship-pairings. This scale utilizes a 7-point Likert scale ranging from 1 (Strongly Disagree) to 7 (Strongly Agree). All 12 items were averaged to determine a closeness score with low scores representing low relationship closeness and high scores representing high relationship closeness. The URCS was adapted so that the questions were relatable and targeted towards this specific child-parent relationship pairing. The URCS has previously demonstrated sound reliability among family members (α = 0.96; Dibble et al., 2012). This scale was included in the study for three main purposes: (i) to determine the closeness of the parent-child relationship, (ii) to inform whether perceived parent-child closeness was consistent with the qualitative responses provided by the parent and child in the interview, and (iii) to determine whether the closeness of the relationship impacted parents’ support for the adolescent to game online. Of particular interest was whether different themes would emerge for adolescent and parent pairs who reported different levels of relationship closeness.
The lead researcher is autistic and was involved in the study’s conceptualization, development, conduct, and reporting of findings. This researcher conducted the semi-structured interviews and importantly has experience engaging with and supporting autistic people and their families. The researcher therefore served as an instrument in navigating the conversation whilst ensuring that critical themes were explored and that interviews were conducted in a respectful manner. Interviews with adolescents explored motivations to play video games with an emphasis on exploring motivations for socialization including getting to know new and different people, gaming with others, belonging to online groups and communities, having company while gaming, level of enjoyment playing with others and quality of company. The interview also explored their social experience in-game, aspects of MMORPGs they believe are helpful in socializing with others and whether in-game socialization helped with socialization in real-life contexts. Interviews with parents explored their perception of their child using online games to socialize including if they thought their child met people online, gamed with others, belonged to online groups and communities, had company while gaming, enjoyed playing online games with others and the quality of company they thought their child had in-game. It also explored their perceptions of the social benefits of online gaming and their concerns regarding their child’s gaming.
Interview guides were developed by both researchers with consideration of previous gaming experience, experience supporting those with autism (and their families), and previous literature on the topic. Different interview guides were developed for adolescent and parent interviews. These guides included a mix of closed and open-ended questions. Open-ended questions provided participants with opportunities to express their views and experiences whilst keeping with the aims of the research. Prompts were used to elicit further information from responses to both closed- and open-ended questions. Interviews with adolescents included questions such as “Have you made new friends through gaming?” and “Do you think that playing these games has helped you socialize with others in-person?”. The parent interview guide included questions such as, “What do you believe is different between in-game and in-person socialization?” and “Do you think that playing these games has helped your child socialize with others in-person?” See Table 2 for a list of questions and prompts included in the interview guide for both adolescents and parents.
Table 2
Interview Guide for Adolescents and for Parents
Questions for Adolescents | Prompts |
|---|---|
*What are your motivations for playing video games? | |
Do you use video games to socialize? | How do you socialize in-game? |
Do you game with others? | |
Do you prefer gaming on your own or with others? | *Why do you like gaming with others? What do you enjoy about gaming on your own? Are there any aspects of gaming that you think would be more helpful to play with others? |
Have you made new friends through gaming? | How did you become friends with them online? Do you have close friendships in-game? Are you hoping to make new friends online? How could you go about doing this? |
How is socializing in-game different to socializing in-person for you? | How do you socialize in-game? |
*Do you think that socializing in-game or in-person is easier for you? | What aspects of in-person/in-game socialization do you find more difficult? |
Do you think that playing these games has helped you socialize with others in-person? | Why do you think it does/doesn’t? *What aspects of MMORPGs do you think help you socialize with others? |
Would you like to use video games like MMORPGs more to socialize? | |
Questions for Parents | Prompts |
*What do you think motivates your child to play video games? | |
Does your child use video games to socialize? | How does your child use games to socialize? Would you want your child to use video games to socialize? |
Does your child game with others? | |
Does your child prefer gaming on their own or with others? | *Why do you think they like gaming with others? Are there any aspects of gaming that you think would be more helpful if they played with others? |
Has your child gotten to know new and different people through gaming? | *How did they become friends with them online? Do they have close friendships in-game? Do you think they would like to meet new and different people through gaming? What are your thoughts on your child socializing with people through games? |
What do you believe is different between in-game and in-person socialization? | |
Does your child have more difficulties socialising in-game or in-person? | |
Do you think that playing these games has helped your child socialize with others in-person? | How so?/Why not? What aspects of these games do you think might help them socialize with others? |
Do you have any concerns about your child using video games more to socialize? | What are they? Why is this a concern? |
Data Analyses
Transcripts of the recordings were automatically generated by Microsoft Teams. These transcripts were checked and edited by the lead researcher. Any discrepancies or inaudible information were checked and clarified by the participants before the recordings were deleted. The researcher-participant relationship and associated power dynamics were considered throughout the research process using a variety of strategies. In particular, the online nature of the interviews allowed participants to engage in the study within a familiar and comfortable environment. Participants were also provided with the option to have their parent/child next to them during the interview to foster a sense of safety and assurance. Throughout the interview process (before, during, and after the interview), the researcher frequently emphasized participants’ autonomy, reassuring them of their right to prioritize their comfort and choose not to answer any questions that they did not feel comfortable answering. To minimize bias, the autistic researcher engaged in reflexive practices. This was achieved through memo-writing and critically reflecting on all decisions made throughout the research process by considering the researcher’s assumptions and experiences, and their influence on the interpretation of data. To facilitate this, peer-critique was implemented from the conceptualization of the study through to the reporting of findings. The autistic researcher regularly shared memos with the non-autistic researcher to reflect upon and minimize the potential for biases and preconceived notions to “contaminate” the data obtained and analyzed. This diversity in the research team also allowed for a more balanced and comprehensive understanding of findings. Furthermore, participants were invited to check that their data were accurately interpreted. All participants took up this offer and no incongruence was reported.
Braun and Clarke’s (2006) method of inductive thematic analysis was used to analyze qualitative data by identifying common themes and differences that emerged within and across participant interviews. This process was done by both researchers (autistic and non-autistic). Both researchers familiarized themselves with the data by reading (and re-reading) the transcripts thoroughly. Initial codes were then generated independently by the two researchers by highlighting units of meaning that were pertinent to the understanding of the topic and to answering the research question. Strong inter-coder reliability was evident between both researchers (Cohen’s kappa = 0.87). Discrepancies in the coding were resolved through discussion until there was agreement on all initial codes highlighted. The coding process was done manually and facilitated through the use of Microsoft Word. The highlighting tool was used to identify codes, and different colors were used to identify similar codes (which then became themes). All codes identified were listed in a “codebook” which included a table of codes, along with the frequency with which the codes appeared, and examples of each code (excerpts from transcripts). Using this codebook, emerging themes derived from these codes were drawn out and reviewed by exploring common and divergent codes within and across participant transcripts. Emergent themes were identified through use of abstraction (putting similar emergent themes together to develop subthemes), subsumption (deriving super-ordinate themes from emergent themes) and numeration (the frequency in which a theme is presented). This stage was also done independently by both researchers who again compared the higher-order themes identified and discussed discrepancies until agreements were reached for all final themes (Cohen’s kappa = 0.86). The coding and interpretation of data were done manually. Although this can introduce biases due to subjective judgements from researchers, this process was undertaken by two researchers independently (and all discrepancies were resolved through discussion) to minimize the likelihood of introducing bias in the analysis of data. A manual approach was chosen over the use of computer-assisted qualitative data programs to ensure a nuanced understanding of data. This choice was influenced by accessibility of data management programs and the priority to preserve the rich context and creativity inherent in the dataset, which may potentially be overlooked when heavy reliance is placed on automated programs to code data (e.g., Zamawe, 2015). This is particularly pertinent in the current context where some autistic adolescents found it difficult to articulate their experiences to answer the interview questions, particularly at the start of the interviews.
Due to the lead researcher’s own experience of autism, provisions were applied to reduce bias. Rigor and transparency in data collection, analysis, and reporting were achieved through independent assessments of transcripts and themes by both researchers, and use of extensive verbatim quotations to support interpretations of common and divergent themes that emerged from the data.
Results
Table 3 provides a summary of the URCS scores for each child-parent pairing. All of the scores were fairly congruent within the pairs. Pair 2 reported slightly lower relationship closeness than the other pairs in this sample. Further, within Pair 2, the adolescent indicated that they played more hours than their parent indicated (P2 indicated 11 h per week and A2 indicated 20 h per week). Pairs reporting higher relationship closeness scores reported consistent levels of gameplay.
Table 3
Unidimensional Relationship Closeness Scale (URSC) Scores for Adolescent and Parent Pairings (Minimum Possible Score = 1, Maximum Possible Score = 7) (Dibble et al., 2012)
Pair | Adolescent | Parent | Closeness |
|---|---|---|---|
1 | 6 | 7 | High |
2 | 4 | 5 | Moderate |
3 | 7 | 7 | High |
4 | 7 | 6 | High |
5 | 6 | 6 | High |
Adolescents’ Perspectives of Playing MMORPGs
The major themes identified across adolescents’ interviews included “Socialization”, “Game Enhancement” and “Friendships”. Of the codes identified (by both researchers) the most prominent theme was friendships (with 41% of codes relating to this theme), followed by socialization (23% of codes), then game enhancement (11% of codes). The remaining codes did not fit into any common theme.
Socialization
A common theme derived from adolescent interviews was Socialization which described the ease of in-game socialization compared to in-person socialization. All adolescents preferred playing games with others and wanted to use MMORPGs more to socialize. All five adolescents played games with online-only friends, two adolescents also played with in-person friends, and one also played with family members. Additionally, all adolescents reported barriers in socially connecting with others in-person and that they socialized more online than in-person as it allowed them to overcome shyness. For instance, A1 felt more comfortable expressing themselves online, “I feel safer when I’m talking on the chat box and communicating during the video games than meeting in-person”. Similarly, A4 commented that they feel shy when talking to others in-person but enjoy connecting with others online, “It really helps me when I’m trying to control my fears and I won’t be shy and afraid of people”.
Four adolescents indicated that online socialization was easier and preferred (over in-person), whereas one adolescent (A2) indicated that in-person socialization was easier. A2 reported that it was easier for him to socialize in-person as his in-person friends help to include him in conversations, whereas barriers to socializing in-game can stem from aggression from other players, “Sometimes people swear and get angry over chat – it’s common, hear it all the time. People can get angry on games”.
Furthermore, four adolescents reported in-game socialization helped them to socialize in-person as socializing in-game can be good practice for talking with others which can be applied in-person, “It does make it easier though…’cause then you probably talked with someone every single day. So then it’s like in your head. Just gonna be like, oh, it’s just gonna be the same thing” (A2). One adolescent (A5) reported that online socialization did not help in-person socialization due to the challenges of meeting online friends in-person (as they live far away). However, A5 commented that socializing via gaming provided a common interest to talk about to connect with others, “Whoever is in the online environment…comes with mindsets to come and meet new people…So it’s easier because there’s already a common ground”.
When considering the forms of communications used, all adolescents reported that they use a combination of written and audio/visual communication in-game, and also use other platforms for communication whilst gaming (e.g., Discord, FaceTime, Facebook, WhatsApp). Three adolescents belonged to gaming-related social media and chat groups outside of the game whereas two did not. For instance, A1 preferred using in-game chat boxes to communicate to reduce distractions to other players and also discussed how they strategized with others via social media. A5 discussed a WhatsApp group where they talked about gaming strategies, “I would go online…and want to play against each other…chat about it and how well you played and how we didn’t play”.
The data that emerged from this theme indicated that autistic adolescents want to play with others and socialize more in-game. Overall, it appears that online gaming (such as through MMORPGs) can facilitate socialization among autistic adolescents by increasing confidence and comfort in communicating with others and reducing barriers such as shyness through a combination of written and audio/visual communication in game and on social media. This may help generalize to in-person socialization by providing practice and familiarity in communicating with others and provide a common interest to facilitate conversations.
Game enhancement
Another theme, Game Enhancement, related to adolescents’ motivations for playing with others including increased enjoyment and improvement of gaming strategies. All adolescents discussed their motivations for playing with others and indicated they preferred to play with others because it was more fun and challenging. A1 commented on playing with others for fun, “Sometimes if you play games on your own, there’s no fun in it. So, I prefer playing with my friends…sometimes if I play video games on my own, I’m kind of bored”. A4 commented on playing with others to challenge themselves, “I really like prefer gaming with other people because it helps me like to challenge myself to do more about the game”. Although, A5 indicated that there can be difficulties with connecting with others in-game when playing in large groups, “You know if I’m playing them against numerous other players you don’t really get the time to talk to someone you know, you just maybe make comments”.
A5 further discussed that during some parts of the game he plays he cannot use the chat box to communicate with other players:
When I’m active in the game that I need to do is go time. And though I did fix my mic and I can interact. But when I’m done with, you know it’s in a game or a mission, I can’t type, so can’t use the chat box
Friendships
“Friendships” was another common theme that encompassed how adolescents met friends online, how their friendships developed and the characteristics of their online friends. All adolescents discussed having close and multiple friendships with people they met online via gaming. Two minor themes emerged, including “Building Friendships” and “Maintaining Friendships”.
Building friendships
A commonality surrounded the building of friendships which described how adolescents met their friends. All adolescents discussed how they met their online friends through player versus player and multiplayer mode where they are randomly matched with other players or choose from a list of players that are available online to play with. They reported that when other players were better at the game, they would continue to engage with these players to improve their gaming skills and question how they play the game to learn how to complete tasks and level up—this then developed into friendships over time. For instance, A1 started friendships while playing against others, “I kind of introduce myself to them. Tell them my location and say a lot of things through the chat box”. A5 stated, “You see a list of available players online…I basically choose who I wanna play with…and then I play and during the course of gaming I try to be friends”. A5 further discussed how they started their online friendships:
Because of playing you exchange…I’m like, how did you manage to…maneuver it this way…people who have gone further in the games than me. So most times…this is what started the interaction likely that this has always been a stumbling block for me…and before you know, we’re talking playing one or two times.
A4 commented how other players seek their friendship, “I’m really good in gaming…So I like defeat a friend and he or she would like, want to know me. So I’ll then give you my contact and then just talk and get to know each other”.
Maintaining friendships
The adolescents also described how they have been able to develop and maintain their online friendships via gaming. All adolescents discussed that they developed their online friendships through sharing game knowledge, strategizing, and working together to progress in the game. When challenges arise with progressing in-game they reach out to their friends for assistance. They will also play against their friends and provide feedback on gameplay. All adolescents discussed that they made friends with people of a similar age. A2 asks friends to help them complete in-game tasks:
So if I’m down at, like, a cornfield… and I finished up with my off my loads…I’ll just ask one of my friends. You got like a trailer or you got like a truck…So it kind of helps you to work with other people, work as a team.
A5 learns from their friends to progress in-game:
I have a couple of friends like that online. People who help me scale through some difficult levels of the game…most of them are people who have played higher levels than I have. And I get to learn from them.
A1, the only female adolescent participant, was the only participant that discussed that they developed close friendships by sharing personal difficulties with their online friends to problem solve solutions to implement into their real life:
You know, actually you can meet someone on a video game and you kind of share your problems with the person apart from you chatting normal and you kind of share your problems with the person…I’m not always close to all of them, but I think out of 100 percent, 50% of them, I can talk to them. And I tell them my issues and kind of give me solutions to them.
Overall, all adolescents reported that they socialize while playing MMORPGs and would like to use MMORPGs to socialize more. Adolescents also indicated that they were motivated to socialize via gaming for fun and to challenge themselves. All adolescents also reported that they had developed friendships online due to the requirements of the game where teamwork is required to progress in the game and to learn from other players to improve their gameplay.
Parents’ perspectives of their child playing MMORPGs
The major themes identified from parents’ interviews included “Benefits”, “Socialization” and “Support”. The most prominent theme elicited in interviews across parents was socialization (with 36% of codes relating to this theme) and benefits (32% of codes), followed by support (28% of codes). The remaining codes did not fit into any common theme.
Benefits
A core theme derived from parents’ interviews involved the Benefits of playing MMORPGs. All parents reported cognitive and social benefits to gaming and that gaming is a good way to socialize and connect with others. Two subthemes were identified including “Cognitive” and “Social” benefits.
Cognitive benefits
Parents observed cognitive benefits and improvements since their child commenced gaming. Parents reported that gaming is educational, expands their child’s intellectual capacity, improves organizational skills, improves mental health and that gaming provides a sense of accomplishment and tests mental capabilities, determination, and persistence. P1 commented how gaming is a learning experience:
It will help her understand more, learn more to expand her intellectual capacity…Well, I believe that it’s a means to learn and will develop in a digital world. It’s a digital world [that’s] developing gradually as time goes on. So I believe that if she uses this process to learn it’s a good thing.
P4 reported that playing online games with others challenges their child to be better at the game:
He gets to see people who are intellectually capable you know people who are you know majority of people who are very…brilliant. So that’s uh really helps him to, you know, come up and try to be better and try to be good at it.
Social benefits
Parents also discussed social benefits and improvements since their child commenced gaming. Parents identified improved communication skills and ability to connect and relate with others more effectively.
P4 described how through gaming his child has developed socially, “It helps him improve his talking skills, as in relating and associating with people online”. P4 further discussed that playing games has improved his child’s communication with family members and it gives his child something to talk about with family members:
When he started playing games…I start to see changes…because he couldn’t really talk to me. Really talk to his mother…But when playing video game, after playing video games, he could go about this…He wasn’t able to talk to his siblings…now he could play video games and call them and then…his sister come and watch. You know ‘come and see this oh this is what I’m doing’…that’s helping me…helping my family as a whole…he could, you know, relate, and interact with people with our, with everybody in the house…You know, he could ask for things. He could seek opinions…I really see the usefulness of video games.
Socialization
Parents also detailed their child’s socialization with others online and in-person. All parents reported that their child plays games with others online, that social interaction was facilitated through competitive gameplay, and that their child played with others for fun.
Four adolescent and parent pairs had consistent reports of the adolescent’s socialization in-game and in-person whereas Pair 2 (P2 and A2) displayed some inconsistencies. P2 and A2 had the lowest URCS score which indicted moderate closeness (compared to high levels of closeness reported by the other four pairs in the study). A2 reported that they enjoyed playing with others and developed friendships online whereas their parent, P2, reported that they were only interested in playing with their best friend that they know in-person.
All parents reported that their child had social difficulties in-person. Four parents reported that their child had more difficulties with in-person socialization because they are shy and have been unable to make friends in-person but were motivated to play games to socialize and make friends. The other parent, P2, reported that their child had more difficulty with in-game socialization, had not maintained online friendships, and was not motivated to play games to socialize because, “Quite often when I am viewing it, he’s trying to take charge of a situation and trying to control it…if there’s a game, it’s gotta be his game and his way. Compromising is quite difficult for him”, which contrasted with what A2 reported. P2 also suggested that non-competitive games and games that encourage a shared role might help to foster more compromise and positive socialization in-game.
Three parents reported that online and in-person socialization is different because in-person communication involves recognizing body language and emotions. However, two parents reported that there was no difference. Despite this, three parents (P1, P3, P4) believed that their child’s socialization via gaming improved in-person socialization and wanted them to use games more to socialize. P3 further suggested that if there was a video chat component in-game it could help to improve in-person communication. In contrast, P2 and P5 did not think that gaming improved in-person socialization and did not want their child to use games more to socialize. Notably, these two parents did not play games themselves and their children spent the most time playing games (approximately 20 hours a week). In discussing whether online socialization can improve their child’s in-person communication, P2 indicated:
I can’t say I’ve really seen a difference in his ability to socialize in-person…particularly…his best friend…I just find that their relationship in-person is much better…It’s something that they’ve bonded over. I think that’s where it’s potentially helped…They’ve had a common interest.
Overall, whilst parents of autistic adolescents reported that their child experienced difficulties communicating with others in-person, some perceived that in-game socialization could improve in-person socialization. Interestingly, parents who did not play games themselves did not believe that games could facilitate socialization in-person. There was also more inconsistency in responses relating to social engagement and difficulties for the parent-child pair who reported lower relationship closeness.
Support
Parents also discussed their support for their child’s gaming. Specifically, they brought up their oversight of adolescent gaming, their own gaming experience, perceptions of online socialization compared to in-person socialization, and concerns about their child’s gaming. Two subthemes that were identified include “Involvement” and “Concerns”.
Involvement
“Involvement” described the oversight parents had over their child’s gaming, their own gaming experience and perceptions of online socialization compared to in-person socialization.
All parents reported that they had oversight of their child’s gaming. This was achieved through use of the parent’s device and parental controls on the device. P1 reported that they restrict access to games with a chat feature to prevent cyberbullying, which their child, A1, reported was their main mode of communication with others online.
Two parents, P1 and P3, played online games and three parents did not. P1 reported that they would initiate gameplay with their child. Two parents, P2 and P5, who did not play online games devalued online socialization compared to in-person socialization and although they were happy with the increased socialization online, they wanted that to translate into more socialization in-person and did not want their children to use games more to socialize. P1 described their views of in-game versus in-person socialization, “I think it would be socially isolating if I didn’t let him do it.” P5 described how they wanted their child to apply what they do during in-game socialization to real life:
I encourage him to play games anyways because I’ve noticed he cannot really make friends in-person, but he kinda makes friends online… I just tell him to just try to do whatever he does online to also do that offline.
The parents who played online games were content that their child was able to connect with others even if it was only in-game. P3 commented about how they tried to encourage socialization by purchasing video games for their child to socialize with others, “I had to buy something that could keep him company…to try to meet people…also try to relate with people.”
Concerns
Concerns were brought up by four parents, though one parent did not report any concerns. Concerns included bullying, gaming addiction, length of time playing games, impact on mental health, behavior and studies, risk of social isolation in-person, and losing confidence in interpersonal skills in-person.
P1 was concerned about cyberbullying although her child had not experienced cyberbullying due to her oversight and restrictions on using the chat function. P5 wanted his child to spend less time gaming and balance it with other things such as schoolwork and other recreational activities. Furthermore, gaming addiction was discussed by three parents (P1, P2, P5) with concerns about the length of time that their child spends gaming because of the potential impact on their child’s health, behavior, and studies. To combat this, P1 set time limits on gaming to mitigate their concern.
Similarly, P2 was concerned about prolonged exposure to games impacting on the behavior of her child:
My biggest concern is…addictiveness…how I’ve seen that prolonged exposure to video games…Can really escalate aggression…and frustration, because like I said, I think that that that lies hand in hand, that addictiveness and gaming.
Overall, all parents identified that there are social benefits to playing MMORPGs. Besides some inconsistencies with P1 and A1, reports of socialization via gaming were consistent across parent and adolescent interviews. All parents were supportive of their child playing games to socialize with others but the parents of the children who played MMORPGs the most hours per week had more concerns regarding the impacts of their gaming on their real life and wanted them to socialize more in real life.
Discussion
This study investigated whether autistic adolescents are socially motivated to play MMORPGs and sought to explore whether parents’ perceptions of MMORPGs and the closeness of the parent-child relationships’ impact upon gaming habits.
Socialization and gaming experiences of autistic adolescents
Autistic adolescents in the current study reported generalization of socialization in MMORPGs to real life which is consistent with previous studies (Finke et al., 2018; Gallup & Serianni, 2017); however, the current study gained further understanding of the mechanisms underlying this socialization process to develop and maintain quality friendships through online gaming. Gaming provides autistic adolescents with a platform to connect with others over a common interest which may extend to in-person socialization. Socializing via MMORPGs minimizes social challenges experienced by autistic adolescents as they can communicate via the chat box function where the conversation is largely task-focused (Gallup et al., 2016; Jiménez-Muñoz et al., 2021; Stone et al., 2019). Gaming is a medium to start task-focused conversations, which reduces the burden of having to start a conversation or topics to discuss. This discussion can help these adolescents gain familiarity with people online which can then develop into friendships (by asking others how to improve their gameplay or progress in-game). This may lead to conversations with more personal topics and quality friendships.
Contradictory to the current study, previous research has indicated that most autistic people do not play video games with others and tend to prefer single-player games (Craig et al., 2021). All autistic adolescents in the current study indicated a preference for playing games with others. Thus, it may not be that autistic adolescents do not want to play games with others; rather, due to social and communication challenges, they may feel more comfortable playing on their own unless they are particularly motivated to play games that require social interaction, such as MMORPGs.
All adolescents in the current study discussed having close and multiple friendships with people they met online via MMORPGs in player versus player and multiplayer mode. This is consistent with previous studies that have indicated social gains for autistic people who play video games, including expansion and maintenance of social relationships with others, and more friendships resulting in quality-of-life improvements (Sundberg, 2018).
Furthermore, adolescents in the current study described the mechanism by which they built and maintained friendships with other players—other players wanted to learn gaming strategies from them due to their gaming skills, or, they wanted to learn from other players who they believed possessed better gaming skills. autistic adolescents might be admired by other players for their gaming skills, which facilitates development of friendships. Additionally, if autistic adolescents can compliment other players on their skills, it is more likely this will result in a positive social interaction. This is consistent with previous studies that have indicated that gaming is beneficial for increasing compliment use and providing positive post-game comments (e.g., Ferguson et al., 2013) and improving sense of commitment to collaboration and ability to value peers (e.g., Wang et al., 2018). autistic adolescents and parents in the current study reported adolescents reached out to others to compliment them about their gameplay and to help them improve their gameplay.
Overall, consistent with our first hypothesis, autistic adolescents perceived that socializing within MMORPGs enhanced their gaming experience. This heighted enjoyment may motivate them to further interact with other players, thereby fostering a cycle of increased socialization and a greater propensity to form in-game friendships.
Parents’ perceptions of their child’s socialization and gaming
All parents from the current study reported that their child plays with others through competitive gameplay and are motivated to socialize in-game which contrasts with previous research (Craig et al., 2021). Furthermore, all parents from the current study reported that their child had experienced social challenges in-person, consistent with their child’s report, and the literature (Beaumont et al., 2021). Parents from the current study reported that in-game socialization reduced the requirement to interpret body language and recognize emotions which further supports previous research that socializing via MMORPGs can minimize barriers experienced by autistic adolescents such as challenges in interpreting body language, facial expressions, and emotional recognition (Gallup et al., 2016; Jiménez-Muñoz et al., 2021; Stone et al., 2019). Consequently, this may help autistic adolescents feel more at ease to communicate with others online. As these adolescents acquire more practice and exposure with this process of socialization (in doing so, reducing barriers such as shyness), this could provide a means to strengthen in-person communication.
Previous research indicated that parents of autistic children have positive attitudes towards their children engaging in playing video games and desire to support their gameplay (Finke et al., 2015), and the current study has provided mixed results regarding attitudes and support for playing MMORPGs. The parents from the current study who believed that their child’s socialization via gaming improved in-person socialization also played video games themselves and were more supportive of their child using games more to socialize. The parents from the current study who did not believe that their child’s in-game socialization improved their in-person socialization were less supportive of their child using games more to socialize and wanted their child to focus more on in-person socialization. As these parents did not play games themselves, this may have impacted on their perception of the social benefits of gaming due to reduced understanding of their child’s gaming experience, thereby contributing to their devaluation of online socialization compared to in-person socialization.
One parent indicated that they restrict access to games with a chat feature to prevent cyberbullying. This may minimize risk of cyberbullying but may consequently hinder their child being able to socialize in-game. Thus, parental restrictions to minimize negative outcomes for their child may have negative outcomes for their child’s ability to socialize online. The parents who devalued online socialization had children who spent the most time gaming, which suggests that it may not be the gaming itself that has negative impacts, but the amount of time spent gaming which may lead to negative outcomes. It is also important to consider whether the issue is that the child is addicted to the game or perhaps that the parent has not been able to negotiate appropriate limits to gaming with their child. The parent in the current study who had the lowest URCS score (indicating moderate closeness to their child), also had several concerns regarding their child’s gaming which is consistent with previous research indicating that poorer quality relationships are associated with increased severity of problem gaming (Schneider et al., 2017).
Consistent with our hypothesis, parents recognized the social advantages of their child playing MMORPG, observing firsthand their child’s engagement in in-game socialization. Their endorsement of this social avenue was influenced by factors including their own engagement in gaming, their comparison of in-game interactions to face-to-face socialization, and the amount of time that their child spends gaming.
Limitations and future directions
The current study comprised a small sample size with no parent-child pairings reporting low closeness URCS scores. This may have arisen due to the recruitment method as it is less likely that parents who are not close with their child, and who are less involved in their children’s gaming habits, would participate in the study; thus, this study was unable to gain the perspectives of parents and adolescents who do not report being close. Parents who do not feel close to their child may be less supportive of, or less attentive to, their child’s gaming habits. The transferability of this study’s findings may therefore be limited to parent-child pairings who feel close to each other. Furthermore, saturation was achieved for many interview questions, but not for all. Whilst this presents a limitation for the comprehensiveness of data obtained for some questions, it reflects the depth and diversity of experiences and perspectives captured in this study. This presents opportunities for future research to further explore the aspects of gaming and socialization that may be quite diverse in the autistic population (e.g., motivations for gaming). Despite the relatively small sample size, the current study provided valuable insights into intergenerational perspectives of socialization via gaming for autistic adolescents. Future research may seek to conduct a larger-scale study, utilizing the URCS to screen for parent-child pairs with varying degrees of closeness.
Moreover, given that the majority of the participants in this study were recruited from the USA, it is unclear whether findings are generalizable to autistic adolescents situated in other countries where the dynamic of parent-child relationships may differ. Further, the study did not consider the broad and varied spectrum of autistic experiences. The current sample may not fully encapsulate the diversity seen in the wider autistic community as individuals across the spectrum can have distinctly different experiences and ways of relating to the world. It is recognized that autistic individuals can vastly differ in terms of their sensory preferences, communication styles, and social comfort levels, all of which can potentially influence their engagement with MMORPGs and their socialization experiences. Including a more diverse set of participants representing a wider range of positions on the autism spectrum and exploring potential cultural differences in the perspectives of games and social development may be a fruitful avenue for future research.
Lastly, the researcher conducting the interviews is autistic, which introduces the possibility of implicit biases and observer-expectancy effects. However, this was largely managed with the use of the interview guide. The autistic researcher strictly adhered to the interview guide and ensured that they did not ask any leading questions. The second researcher is not autistic and although they were not involved in the interviews, they were involved in the development of the interview guide and data analysis, with all codes, themes, and interpretations agreed upon by both researchers. Additionally, participant verification was implemented by inviting the participants to check that data was accurately interpreted.
While previous research has suggested social and communication benefits from MMORPG gameplay, the current study makes a connection between those gains and the parent-adolescent relationship and indicates more positive parent perceptions of social/communication gains when they game with their adolescents. A future study may involve a therapeutic intervention using MMORPGs designed to build/improve parent-adolescent relationships by finding common interests in gameplay.
Future research could also investigate which specific online game functions best support socialization development (e.g., in-game chat box function, video chats, interactions with non-playable characters, etc.) among autistic adolescents. Another avenue of research could investigate whether gaming using Virtual Reality can help strengthen socialization skills by providing opportunities for exposure and practice in communicating with others in a safe environment. These future avenues of research could build upon the findings of the current study to develop an engaging intervention to help foster socialization development.
Conclusion
Autistic adolescents and their parents provided evidence of, and acknowledged, the social benefits of playing MMORPGs. This provided a deeper understanding of the mechanisms underlying the socialization process experienced by autistic adolescents as well as the barriers to parental support of socialization via gameplay. Although playing MMORPGs has social benefits, it is important to acknowledge that parents have concerns relating to excessive gaming which may have negative impacts on their child’s wellbeing. Some parents may not allow their child to play MMORPGs due to these concerns, which for some autistic adolescents, may be the only medium that they feel comfortable with to make friends. Thus, it is critical to set clear arrangements between parents and children regarding daily (or weekly) gaming limits to minimize negative gaming-related outcomes (e.g., gaming addiction). These findings may facilitate the development of resources for both parents and their children in engaging with MMORPGs beneficially (e.g., supporting healthy gameplay). Furthermore, these findings may provide insight for game developers to modify or create MMORPGs that are more inclusive and beneficial for autistic individuals.
This research provides evidence of social benefits to playing MMORPGs, and through parental monitoring and oversight, the risks to their child can be mitigated by placing limits on gaming. Autistic adolescents can reap the social benefits while minimizing the negative aspects of excessive gaming. Although there are negative aspects to excessive gaming there are also negative impacts to autistic adolescent’s wellbeing if they do not have a social outlet or friendships (Beaumont et al., 2021; Finke et al., 2018).
This research suggests that playing MMORPGs can improve quality of life for autistic adolescents due to increased socialization and friendships. This research highlights the importance of the parent-child relationship and how this supports autistic adolescents to develop socially via gaming. Further, parents who play games alongside their autistic child are more likely to be more understanding of and acknowledge the social benefits of gaming in helping their child develop socially.
Considering these findings and the popularity and accessibility of MMORPGs, these types of games could be implemented in school curricula and used as part of therapeutic interventions by leveraging interests to increase social engagement and support social development in autistic adolescents (Beaumont et al., 2021; Finke et al., 2015; Stone et al., 2019). These games may provide an affordable and accessible means for autistic adolescents to strengthen social connections and friendships. Overall, healthy engagement with MMORPGs has the potential to foster social development, communication, and wellbeing for autistic adolescents and help strengthen relationships with both friends and family.
Compliance with Ethical Standards
Conflict of interest
The authors declare no competing interests.
Consent to publish
The authors affirm that participants provided informed consent for publication of deidentified data. Parents signed informed consent regarding publishing their deidentified data and their child’s deidentified data.
Ethics approval
This study was approved by the Griffith University Human Research Ethics Committee (GU Ref No: 2021/897). This study was performed in line with the principles of the Declaration of Helsinki.
Informed consent
Informed consent was obtained from all participants included in the study. Written informed consent was obtained from the parents. Verbal informed consent was obtained from all participants prior to the interview.
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