Mobile device applications and treatment of autism spectrum disorder: a systematic review and meta-analysis of effectiveness

Objective The current study was performed to assess the evidence for effects of therapeutic intervention with mobile device applications (apps) for individuals with autism spectrum disorder (ASD). Design The main methodology of the current study was systematic review with meta-analysis. Setting Only randomised controlled trials (RCTs) for mobile device apps for individuals with ASD were considered for review in the current study. Patients The target population was individuals clinically diagnosed with ASD. Interventions Applications that are operable on a smart (mobile) device and interactive with users. Main outcome measures The main outcomes were based on standardised mean differences in pretrial and post-trial scales in each control and intervention group. Results Out of a total of 1100 studies (after duplicate removal), 7 RCTs were selected for final analysis. Of the seven studies, two RCTs were further analysed for effects based on the visual and fine motor subscales of the Mullen Scales of Early Learning, which favoured the intervention groups (standardised mean difference (SMD)=0.41, 95% CI 0.03 to 0.80; SMD=0.41, 95% CI 0.03 to 0.80), without either having any heterogeneity (p>0.1) or publication bias. Conclusions Although it is still early to draw a conclusion, available studies are showing promise for use of mobile device apps for treatment of individuals with ASD. More well-designed and large-scale studies focused on improving behavioural symptoms of ASD are warranted. PROSPERO registration number CRD42019128362.