Background and Rationale
Autism spectrum disorder ASD is a lifelong neurodevelopmental condition affecting quality of life. In China, ASD prevalence is rising, underscoring the need for scalable, early, evidence‑based interventions. Digital health technologies offer potential to accelerate screening, streamline diagnostics, and deliver home based and clinic based rehabilitation. However, adoption varies by region and professional role, highlighting a digital divide that may limit access for underserved families.
Study Design and What Was Measured
This cross sectional study compared two Chinese provinces, Heilongjiang in the north and Fujian in the south, to examine how digital health services are used and how much they are desired by parents of children with ASD and by rehabilitation professionals.
Researchers surveyed 780 parents and 745 therapists using web based questionnaires covering six domains: current use, perceived benefits, barriers, preferred devices, technologies, and content needs. The study also explored demographic and professional factors linked to use and demand for digital health services.
Main Findings
Use versus Demand
Overall digital health use was low but demand was high. Among parents, usage was 5.9 percent (46 of 780), with Heilongjiang at 6.1 percent and Fujian at 4.5 percent. Among therapists, use was 21.6 percent (161 of 745), similar across provinces. By contrast, parental demand for digital health services reached 79.6 percent (621 of 780), and therapist demand reached 90.0 percent (671 of 745). These results reveal a persistent gap between interest and actual uptake.
Regional Disparities
Demand was consistently higher in Fujian than in Heilongjiang for both groups. Parental demand in Fujian reached 90.9 percent versus 77.8 percent in Heilongjiang, while therapist demand was 93.9 percent in Fujian compared with 88.3 percent in Heilongjiang. These regional differences align with broader economic and digital infrastructure disparities and point to the need for localized policy and investment strategies.
Determinants of Use
For parents, younger age, employment, and higher family income influenced use, with younger parents more likely to engage digital tools. Surprisingly, lower monthly income (≤ CNY 3000) was associated with greater use, suggesting affordability of smartphones and low cost digital options may enable access for lower income families. Children diagnosed later, between 7 and 12 years old, were also linked to higher parental use, possibly reflecting accumulated caregiving burden and seek for flexible information sources.
For therapists, being male, having special education training, and possessing autism specific skills training markedly increased use. Education level and regional location also mattered, with Fujian therapists showing higher demand, a pattern echoing the parental results.
Benefits, Barriers, and Preferences
Both groups identified improved understanding of child behavior, easier access to data, and remote guidance as key benefits. However, barriers included high costs, need for extra equipment, and usability challenges. Smartphone access dominated device preferences, and WeChat mini programs and mobile apps were the preferred platforms, while tablets and laptops followed. Content priorities differed: parents sought rehabilitation courses, policy information, and remote home guidance, whereas therapists wanted personalized rehabilitation plans, policy updates, and ongoing professional training.
Implications for Policy and Practice
The study highlights a clear need to bridge the gap between demand and use through targeted investments in digital health infrastructure, training, and affordability. Local policies should prioritize user centered designs, reduce hardware barriers, and expand evidence based digital rehabilitation tools. Strengthening digital health literacy among therapists could indirectly boost parental engagement and practice benefits for children with ASD.
Limitations and Future Research
The study is limited by its two province sample and urban recruitment, potentially limiting generalizability to rural or private sector settings. Future work should include diverse regions, qualitative methods to explore nuanced barriers, and policy maker perspectives to inform scalable solutions.
Conclusion
Digital health offers promise for ASD care in China, but regional inequities, cost, and capacity constraints hinder uptake. By aligning digital health design with stakeholder needs and local contexts, China can move toward equitable, high quality autism care that leverages the benefits of digital health technologies for all families.
