Supporting self-determination in ageing adults with mild-to-moderate intellectual disabilities through virtual...

Background: The increasing longevity of people with intellectual disabilities has intensified the need to promote participation, autonomy and quality of life in later adulthood. However, ageing often occurs in contexts with limited opportunities for decision-making and personal agency. Virtual reality offers psychologically safe environments to rehearse complex actions and strengthen beliefs in capability.

Methods: A qualitative, theory-informed design was conducted with 45 adults aged 50-78 years with mild-to-moderate intellectual disability who completed a 12-week immersive virtual reality programme based on Causal Agency Theory. The intervention included familiarisation and structured domestic scenarios of increasing complexity targeting volitional action, self-regulated action and action-control beliefs. Semi-structured post-intervention interviews were analysed using reflexive thematic analysis, combining inductive coding with deductive mapping.

Results: Five themes were identified. Participants experienced virtual reality as a space for genuine choice with visible consequences; they described planning, anticipation, emotional monitoring and learning through consequences. The experience strengthened competence and confidence, often perceived as transferable. Immersive environments enabled engagement with challenging situations in psychologically safe conditions when carefully calibrated, and participation was seen as meaningful preparation for everyday life and ageing.

Conclusions: Virtual reality may support self-determination in later life by enabling authentic decision-making, structured self-regulation and emotionally secure engagement with challenge.