Effectiveness of Digital Health Technologies in the Management of Autism Spectrum Disorder in Children and Adolescents: A Systematic Review.

Limited access to specialist services, driven by workforce shortages and increasing demand, has constrained timely face-to-face management of autism spectrum disorder (ASD). Children and adolescents with ASD frequently engage with digital technologies, prompting growing interest in digital health interventions as potential adjuncts to traditional care; however, their effectiveness remains uncertain. This systematic review aimed to evaluate the evidence from randomised controlled trials assessing digital health interventions for the management of ASD-related symptoms in children and adolescents. Embase, MEDLINE, and Web of Science were searched in March 2023, and findings were synthesised narratively. Twelve randomised controlled trials comprising 622 participants met inclusion criteria, evaluating heterogeneous interventions including tablet- and computer-based applications, web-delivered video-modelling programmes, mobile health interventions, and wearable augmented-reality systems. While results for primary outcomes were mixed, with several trials reporting null findings for core social communication deficits, consistent positive effects were observed for functional and additional outcomes. Specifically, interventions grounded in established behavioural principles demonstrated benefits for receptive language, emotional comprehension, and adolescent vocational skills (e.g. employment interview performance and conflict negotiation). However, few studies directly compared digital interventions with active face-to-face therapies, and the overall risk of bias was mixed largely due to concerns regarding the randomisation process and high risk of bias in outcome measurement stemming from the use of unblinded, subjective parent-reported measures. Digital health interventions, therefore, show promise as adjunctive tools for supporting ASD management in children and adolescents, but larger, longer-term randomised trials across more diverse populations are required to establish their effectiveness, durability, and role alongside conventional ASD services.