Digital interventions for autism spectrum disorders: A systematic review and meta-analysis

ImportanceDigital technology is now widely available for the interventions of autism, but its validity and feasibility remain to be proved.ObjectiveThis study aimed to investigate the effectiveness of digital health interventions (DHIs) in improving core symptoms or intelligence quotient in patients with autism spectrum disorder (ASD).MethodsThree databases including PubMed, Cochrane, and Scopus, were searched on November 15, 2022. Randomized clinical trials that enrolled patients with ASD who received DHIs and a control group without DHI treatment were included. Cochrane risk of bias tool (RoB 2) was applied to assess the risk of bias.ResultsA total of 33 studies, involving 1285 participants (658 [51.2%] in DHI groups and 627 [48.8%] in control groups), were analyzed to investigate the differences between DHI groups and control groups. Significantly greater improvements in the overall performance of ASD were observed in the DHI groups compared to the control groups (including active, waitlist, treatment-as-usual, and no treatment) with an effect size of 1.89 (Cohen's d 95% confidence interval [CI]: 1.26-2.52). Studies with treatment-as-usual, waitlist, and no treatment control demonstrated large effect sizes of Cohen's d 3.41 (95% CI: 0.84-5.97), Cohen's d 4.27 (95% CI: 1.95-6.59), and Cohen's d 4.52 (95% CI: 2.98-6.06) respectively. In contrast, studies with active control revealed insignificant effect sizes (Cohen's d 0.73, 95% CI: 0.12-1.33).InterpretationThis meta-analysis found significantly greater improvements in core symptoms or intelligence quotient in ASD patients receiving DHIs compared to those in control conditions. ASD patients may benefit from the DHIs and reduce the economic burden. This meta-analysis found significantly greater improvements in core symptoms or intelligence quotient in patients with autism spectrum disorder receiving digital health interventions compared to those in control conditions. Patients with autism spectrum disorder may benefit from digital health interventions and reduce the economic burden. * image