Boulton Kelsie Ann, Hilton Makana, Sutton Emilia, Guastella Adam John
Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, Australia.
J Med Internet Res. 2025 Jan 1;27:e58693. doi: 10.2196/58693.
An increase in the prevalence of neurodevelopmental conditions worldwide, alongside resource constraints within clinical services, has led to increased interest in health information technologies, such as apps and digital resources. Digital tools are often viewed as a solution to bridge this divide and to increase supports for families. There is, however, a paucity of research that has evaluated digital health tools, their potential benefits for child neurodevelopment and associated concerns (eg, mental health, well-being), and their benefit for families.
This study conducted the first review of existing mobile apps and digital resources targeted at supporting the needs of children with developmental concerns or neurodevelopmental conditions.
We identified 3435 separate resources, of which 112 (43 apps and 69 digital resources) met the criteria. These resources were categorized according to their purpose or target and were then reviewed based on their engagement, information quality, and evidence base using the Adapted Mobile App Rating Scale.
The most common condition of concern targeted by apps and digital resources was autism (19/112, 17% resources), with retrieved resources focusing on supporting challenging behaviors, promoting speech, language, and social development, and providing options for alternative and assistive communication. Other common areas of concern targeted by apps and digital resources included language and communication (16/112, 14.3%) and attention-deficit/hyperactivity disorder (11/112, 9.8%). Results showed that reviewed resources were engaging, with high levels of accessibility and functionality. Resources had various functions, including developmental or behavioral tasks targeted at children, assistive communication support, scheduling support, journaling, and advice, activities, and strategies for parents. The information quality of resources, such as credibility of source and evidence base was, however, mostly low. Apps and digital resources with good credibility and an existing evidence base were largely developed in partnership with research, health, or government institutions, and were rated significantly higher on overall quality compared with apps and digital resources not developed in partnership with such institutions (apps; t=-4.35, P<.001; digital resources; t=-4.95, P<.001).
The lack of evidence base across resources means that it is extremely difficult to provide recommendations to families with respect to apps or digital resources that may support their needs. Frameworks for the development of new tools are discussed, highlighting the novel approaches required to demonstrate the efficacy of tools for improving outcomes for children and families. Such a framework requires collaboration with multiple stakeholders (software developers, researchers, regulatory bodies, clinicians, children, and families) and engagement across multiple levels of expertise (app development, implementation, and dissemination within services, policy, and clinical regulations), to harness the potential of digital health for improving outcomes and promoting support in child neurodevelopment, which at this juncture remains largely underdeveloped.
全球范围内神经发育障碍患病率上升，加之临床服务资源有限，人们对健康信息技术（如应用程序和数字资源）的兴趣日益浓厚。数字工具常被视为弥合这一差距、增加对家庭支持的解决方案。然而，评估数字健康工具、其对儿童神经发育的潜在益处及相关问题（如心理健康、幸福感）以及对家庭的益处的研究却很匮乏。
本研究首次对旨在满足发育问题或神经发育障碍儿童需求的现有移动应用程序和数字资源进行综述。
我们识别出3435个独立资源，其中112个（43个应用程序和69个数字资源）符合标准。这些资源根据其目的或目标进行分类，然后使用改编后的移动应用程序评分量表，基于其参与度、信息质量和证据基础进行综述。
应用程序和数字资源最常关注的疾病是自闭症（19/112，占资源的17%），检索到的资源主要集中在支持具有挑战性的行为、促进言语、语言和社交发展以及提供替代和辅助沟通选项。应用程序和数字资源关注的其他常见领域包括语言和沟通（16/112，14.3%）以及注意力缺陷多动障碍（11/112，9.8%）。结果表明，所综述的资源具有吸引力，具有较高的可及性和功能性。资源具有多种功能，包括针对儿童的发育或行为任务、辅助沟通支持、日程安排支持、日志记录以及为家长提供的建议、活动和策略。然而，资源的信息质量，如来源的可信度和证据基础，大多较低。具有良好可信度和现有证据基础的应用程序和数字资源大多是与研究、健康或政府机构合作开发的，与未与此类机构合作开发的应用程序和数字资源相比，其整体质量评分显著更高（应用程序：t=-4.35，P<.001；数字资源：t=-4.95，P<.001）。
各类资源缺乏证据基础意味着极难就可能满足家庭需求的应用程序或数字资源向家庭提供建议。讨论了新工具开发的框架，强调了证明工具对改善儿童和家庭结局有效性所需的新方法。这样一个框架需要与多个利益相关者（软件开发人员、研究人员、监管机构、临床医生、儿童和家庭）合作，并在多个专业层面（应用程序开发、服务内的实施和传播、政策和临床法规）进行参与，以利用数字健康的潜力来改善结局并促进对儿童神经发育的支持，而目前这方面在很大程度上仍未得到充分发展。
