Context: Digital Health and Autism Care in China
Autism spectrum disorder (ASD) affects about 0.7% of Chinese children, underscoring the importance of early detection and evidence-based intervention. Digital health—encompassing AI-driven screening, remote rehabilitation, and data-driven care—offers routes to scalable, cost-effective solutions. Yet in China, regional disparities threaten to widen existing gaps in access to timely diagnosis and personalized therapy, particularly between wealthier eastern provinces and more rural northern regions.
Two Provinces, Two Realities: Low Use, High Demand
A cross-sectional survey conducted in Heilongjiang (northern region) and Fujian (southern region) reveals a consistent pattern: digital health services for ASD are widely desired but rarely used. Among parents of children with ASD, only 5.9% reported actual use of digital health tools, with 6.1% in Heilongjiang and 4.5% in Fujian. Rehabilitation therapists showed higher engagement, at 21.6%, with similar levels across provinces (Heilongjiang 21.5%, Fujian 22.1%). Despite these low adoption rates, demand remains robust: about 79.6% of parents and 90.0% of therapists expressed a need for digital health services. The gulf between demand and use points to barriers beyond interest, rooted in cost, access, and capability.
What Drives Use and Demand?
For parents, younger age, employment, and higher education increased the likelihood of using digital health resources. Surprisingly, lower monthly household income was also linked to greater use, suggesting smartphones and free or low-cost online resources help bridge some access gaps. The child’s age at diagnosis mattered: families with children aged 7–12 were more likely to engage with digital health tools, possibly reflecting accumulated caregiving burden and a search for additional support after delayed identification.
Among therapists, male gender, special education specialization, and prior autism-specific training predicted higher use. Therapists in Fujian reported greater demand than those in Heilongjiang, and higher education levels correlated with stronger interest in digital health content, especially for professional development and policy information. These patterns highlight how training, resource availability, and regional economic context shape adoption and expectations for digital health in ASD care.
Preferences: Devices, Platforms, and Content
Smartphones emerged as the favored device for both groups, followed by tablet PCs. Parents leaned toward internet protocol television (IPTV) for accessing information, whereas therapists favored laptops. Platform preferences pointed to WeChat mini-programs and web/mobile apps for parents, with therapists also engaging digital information management systems. In terms of content, parents prioritized rehabilitation courses, policy information, and remote home-based guidance, while therapists trusted individualized rehabilitation plans, policy updates, and ongoing professional training. These differences underscore the need for tailored digital health offerings that align with each stakeholder’s goals and daily workflows.
Perceived Benefits and Barriers
Both groups value digital health for improving understanding of child behavior and development and for easier access to data and information. Therapists also highlighted time savings on clinical visits. However, barriers persist. High costs, the need for additional equipment, and usability challenges (technology complexity) hinder uptake. The so-called digital divide—driven by economic, educational, and geographic factors—appears to limit the equitable spread of digital innovations, despite strong demand.
Regional Disparities and Policy Implications
The study documents clear regional disparities: Fujian shows higher demand compared with Heilongjiang, reflecting differences in income, education, and infrastructure. This pattern suggests that national digital health strategies must be complemented by local investments in broadband, affordable devices, training, and culturally appropriate content. Bridging the digital divide will require coordinated action among policymakers, healthcare providers, educators, and technology developers to ensure scalable solutions reach under-resourced areas without imposing prohibitive costs on families or clinics.
Conclusions and Recommendations
Digital health holds promise for ASD care in China, offering scalable screening, home-based rehabilitation, and data-driven care pathways. Yet the observed high demand and low use signal structural barriers rather than a lack of interest. To translate potential into real gains, policymakers should expand affordable digital health options, promote user-friendly platforms, and invest in targeted training for clinicians. Localized programs that address regional disparities—especially in rural and economically disadvantaged areas—are essential. A collaborative, equity-focused approach will help ensure digital health advances improve outcomes for all children with ASD and their families across China.
