Immediate and Short-Term Effects of Selective Vibrotactile Re-Cueing on Attention Re-Engagement, Gaze Shifting and Response Latency in Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis of Controlled Studies

Attention disengagement, gaze shifting, and delayed response initiation are frequently investigated in children with Autism Spectrum Disorder (ASD), reflecting differences in attentional regulation, sensory processing, and responsiveness to environmental stimuli. Vibrotactile stimulation has emerged as a potential sensory-based approach to facilitate attention re-engagement and behavioral responsiveness. However, evidence regarding the immediate and short-term effects of selective vibrotactile re-cueing on attentional and behavioral outcomes remains fragmented across controlled studies. This systematic review and meta-analysis aims to synthesize available evidence from controlled studies investigating the immediate and short-term effects of selective vibrotactile re-cueing on attention re-engagement, gaze shifting, and response latency in children with ASD. The review will examine whether targeted vibrotactile cues facilitate disengagement from ongoing activities, promote shifts in visual attention toward relevant stimuli, and improve the speed of behavioral responses compared with control conditions, including no stimulation, sham stimulation, alternative sensory cues, or usual conditions. A comprehensive literature search will be conducted across relevant electronic databases to identify eligible randomized and non-randomized controlled studies involving children diagnosed with ASD. Studies evaluating selective vibrotactile stimulation, tactile re-cueing, or vibration-based attentional prompting will be considered. Outcomes of interest will include attention disengagement and re-engagement, gaze-shifting performance, orienting responses, task-switching behavior, and response latency measured through behavioral, psychophysical, or eye-tracking paradigms. Immediate effects will be defined as outcomes measured during stimulation or directly following a single cue or intervention exposure, while short-term effects will include outcomes assessed within a limited period following repeated or brief intervention sessions. Data extraction will include participant characteristics, intervention parameters, stimulation location, frequency, intensity, duration, comparator conditions, outcome measurement methods, and follow-up intervals. Where sufficient methodological and clinical homogeneity exists, quantitative synthesis will be performed using appropriate meta-analytic models. Effect estimates will be calculated using standardized or mean differences, as appropriate, with corresponding 95% confidence intervals. Heterogeneity will be assessed using statistical measures, and subgroup or sensitivity analyses will be conducted where feasible to explore variations according to stimulation characteristics, study design, and outcome measurement approaches. Risk of bias will be assessed using appropriate tools for randomized and non-randomized controlled studies, and the certainty of evidence will be evaluated using the GRADE framework where applicable. The anticipated outcomes include identifying whether selective vibrotactile re-cueing produces measurable improvements in attention re-engagement, gaze shifting, and response latency in children with ASD, determining the magnitude and consistency of these effects, and identifying intervention parameters associated with favorable outcomes. This review may provide an evidence-based foundation for developing individualized sensory-based attentional interventions and inform future experimental research in pediatric neurorehabilitation. The findings may also help identify methodological limitations, evidence gaps, and priorities for future clinical trials examining vibrotactile stimulation as a potential adjunct to attention and behavioral regulation interventions in children with ASD.