en Cognitive Neuroscience Cognitive Neuroscience Original Original <div style="text-align: justify;"><strong>Introduction</strong>: This study looked at the effects of combined transcranial direct current stimulation (tDCS) and exergaming therapy on the balance and cognitive flexibility in children with autism spectrum disorder (ASD).&nbsp;<br> <strong>Methods</strong>: A quasi-experimental randomized controlled trial (RCTs) study was undertaken with 30 children aged 7-10 years, who were randomly allocated to either an experimental group (n=15) getting active tDCS (1.5 mA over the left DLPFC) + Kinect-based exergaming or a control group (n=15) receiving sham tDCS with exergaming. The 4-week intervention (3 sessions per week) was preceded and followed by extensive evaluations using the movement assessment battery for children-2 (MABC-2) and the Wisconsin card sorting test (WCST).<br> <strong>Results</strong>: Analysis of covariance (ANCOVA) showed significant between-group differences favoring the experimental group for static balance (F=9.537, P<0.001, &eta;p2=0.128) and dynamic balance (F=7.51, P<0.001, &eta;p2=0.158), with medium-to-large effect sizes. The results showed that the combined tDCS and exergame intervention had a stronger effect on improving cognitive flexibility than exergame alone. This improvement was associated with a significant increase in correct and conceptual responses and a decrease in repetitive errors in the combined group (P<0.001).&nbsp;<br> <strong>Conclusion</strong>: The work fills a key gap in neurorehabilitation research by presenting empirical data for combined neuromodulation and digital-motor therapies in ASD. The findings encourage the creation of tailored protocols that target both cognitive and motor networks concurrently. Future studies should look at long-term maintenance effects and the brain processes that underpin these synergistic advantages. This integrated strategy holds promises for improving motor learning and functional results in children with neurodevelopmental problems.</div> Autism spectrum disorder (ASD), Cognitive flexibility, Exergaming, Motor learning, Neurorehabilitation, Transcranial direct current stimulation (tDCS) 113 122 http://bcn.iums.ac.ir/browse.php?a_code=A-10-8350-1&slc_lang=en&sid=1 Sepideh Fallahiyan sepidehfallahian78@gmail.com 13700319475328460057440 13700319475328460057440 No Department of Behavioral and Cognitive Sports Sciences, Faculty of Sports and Health Sciences, University of Tehran, Tehran, Iran. Mahmoud Sheikh M.sheikh@ut.ac.ir 13700319475328460057441 13700319475328460057441 No Department of Behavioral and Cognitive Sports Sciences, Faculty of Sports and Health Sciences, University of Tehran, Tehran, Iran. Seyyed Fardin Qeysari fardin.Qeysari@ut.ac.ir 13700319475328460057442 13700319475328460057442 No Department of Behavioral and Cognitive Sports Sciences, Faculty of Sports and Health Sciences, University of Tehran, Tehran, Iran. Mahboubeh Ghayour Najaf abadi m.ghayournaj@ut.ac.ir 13700319475328460057443 13700319475328460057443 Yes Department of Behavioral and Cognitive Sports Sciences, Faculty of Sports and Health Sciences, University of Tehran, Tehran, Iran.