Background: Digital Health as a Pathway for ASD Care
Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition with rising prevalence worldwide. In China, early screening and intervention face challenges related to accessibility, time requirements, and disparities between urban and rural regions. Digital health technologies—ranging from mobile screening tools to home-based rehabilitation platforms—offer a scalable approach to improve early detection, optimize therapy, and reduce the burden on families and clinical services. The COVID-19 era further accelerated the adoption of remote and digitally powered care, underscoring the potential of China’s health system to leverage technology for ASD.
What the Study Examined
This cross-sectional survey explored how parents of children with ASD and rehabilitation therapists in two economically and geographically distinct Chinese provinces—Heilongjiang (northern) and Fujian (southern)—perceive and use digital health services. Participants included 780 parents and 745 therapists, recruited from designated institutions and surveyed via a web platform. The study assessed current use, perceived benefits, barriers, preferred devices, and content needs related to digital health in ASD care.
Key Findings: Use versus Demand
Use vs Demand
Overall, use of digital health services was modest: 5.9% among parents (46 of 780) and 21.6% among therapists (161 of 745). In contrast, demand was high: 79.6% of parents and 90.0% of therapists expressed a need for digital health solutions. These patterns point to a gap between awareness and actual practice, likely driven by cost, infrastructure, and training barriers rather than perceived usefulness.
Regional Differences
Demand for digital health services was significantly higher in Fujian than in Heilongjiang for both groups, highlighting regional inequities in economic development, digital infrastructure, and local policy support. Usage rates did not show the same clear regional split, suggesting that awareness and readiness to adopt digital tools may be more sensitive to local capacity than to immediate access alone.
Who Uses and Who Demands
Among parents, younger age, active employment, and higher education predicted greater use, while higher demand correlated with Fujian residence and higher education. For therapists, male gender, specialization in special education, and prior autism-specific training increased both use and demand. These patterns reflect broader digital literacy dynamics and professional confidence with technology.
Preferences and Barriers
Devices and Platforms
Smartphones were the dominant device for both groups, followed by tablet PCs. WeChat mini-programs and other mobile apps emerged as the preferred platforms, aligning with China’s high smartphone penetration and ubiquitous social media ecosystem. Yet advanced technologies such as VR/AR and robotics remained relatively unfamiliar or inaccessible, likely due to limited exposure and training.
Content Needs
Parents prioritized rehabilitation content, policy information, and remote guidance for home-based care. Therapists emphasized personalized rehabilitation plans, policy updates, and ongoing professional development. The data suggest a need for user-centered digital health tools that balance information access with practical, clinically meaningful applications.
Barriers
Cost, the requirement for additional equipment, and usability challenges were repeatedly cited as major obstacles. The findings underscore the digital divide and the risk that digital health tools, if not designed with affordability and ease of use in mind, may inadvertently widen gaps in ASD care.
Implications for Policy and Practice
To turn high demand into widespread use, policymakers and health system leaders should focus on: (1) expanding affordable digital health options tailored to ASD, (2) investing in training for therapists to build confidence in digital modalities, (3) leveraging widely used platforms like WeChat to deliver scalable, home-based interventions, and (4) deploying region-specific strategies that address local infrastructure and economic realities. Local pilots, subsidies, and capacity-building programs could help bridge the urban–rural divide and ensure equitable access to evidence-based digital ASD care.
Limitations and Future Research
The study’s external validity is limited to two provinces and urban institutions, which may not capture rural or private-sector dynamics. Future work should adopt mixed methods to explore experiences of policymakers, developers, and health administrators, and to test targeted digital health interventions across diverse Chinese settings.
Conclusion
Digital health holds promise for transforming ASD care in China by enabling early detection, personalized intervention, and greater family engagement. Yet regional disparities and practical barriers threaten to limit its impact. By aligning technology design with regional realities and investing in training and affordable access, China can move toward more equitable, effective ASD care powered by digital health.
