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Digital tools for direct assessment of autism risk during early childhood: A systematic review
Debarati Mukherjee1, Supriya Bhavnani2, Georgia Lockwood Estrin3,4
1Indian Institute of Public Health - Bengaluru, Public Health Foundation of India, India.
Insights
Digital tools show promise for early autism screening, especially in low-resource areas. These technologies can be used by non-specialists to identify autism spectrum disorder risk factors more efficiently.
Area of Science:
- Developmental Pediatrics
- Digital Health
- Autism Spectrum Disorder Research
Background:
- Early identification of autism spectrum disorder (ASD) is crucial for timely intervention and improved outcomes, but resource limitations in many global regions hinder this process.
- Poverty of resources often leads to delayed interventions, negatively impacting the developmental trajectory of autistic children and their families.
- Digital tools offer a potential solution to bridge this gap by enabling accessible, objective, and automated screening methods.
Approach:
- This literature review systematically identified and described existing digital tools designed for screening children at risk for autism.
- The review examined both portable (laptops, mobile phones, smart toys) and fixed (desktop computers, virtual-reality platforms) technologies utilized in these tools.
- Assessment methods included computerized games, behavioral observation, and speech analysis to differentiate between autistic and typically developing children.
Key Points:
- Digital screening tools are largely at the 'proof-of-concept' stage but demonstrate promising results in differentiating children with and without ASD through computerized analysis.
- Tasks focusing on social responses and fine/gross motor movements (hand and body movements) are particularly effective in distinguishing autistic traits.
- These tools can be administered by non-specialists in various settings like homes and schools, reducing reliance on expert personnel and infrastructure.
Conclusions:
- Digital tools hold significant potential for large-scale, early identification of autism spectrum disorder risk, particularly in underserved communities.
- Further validation and evaluation of these tools across diverse settings are essential to ensure their real-world applicability and effectiveness.
- Involving stakeholders from underserved communities globally is critical for developing culturally relevant and impactful screening solutions.
Lay Abstract:
The challenge of finding autistic children, and finding them early enough to make a difference for them and their families, becomes all the greater in parts of the world where human and material resources are in short supply. Poverty of resources delays interventions, translating into a poverty of outcomes. Digital tools carry potential to lessen this delay because they can be administered by non-specialists in children's homes, schools or other everyday environments, they can measure a wide range of autistic behaviours objectively and they can automate analysis without requiring an expert in computers or statistics. This literature review aimed to identify and describe digital tools for screening children who may be at risk for autism. These tools are predominantly at the 'proof-of-concept' stage. Both portable (laptops, mobile phones, smart toys) and fixed (desktop computers, virtual-reality platforms) technologies are used to present computerised games, or to record children's behaviours or speech. Computerised analysis of children's interactions with these technologies differentiates children with and without autism, with promising results. Tasks assessing social responses and hand and body movements are the most reliable in distinguishing autistic from typically developing children. Such digital tools hold immense potential for early identification of autism spectrum disorder risk at a large scale. Next steps should be to further validate these tools and to evaluate their applicability in a variety of settings. Crucially, stakeholders from underserved communities globally must be involved in this research, lest it fail to capture the issues that these stakeholders are facing.
