journal article·2026-04-25Open access

Human Factors in Technology-Mediated Autism Intervention: A Caregiver-Centered Framework

Ohoud Mosa Alharbi

Applied Sciences· Volume 16· Issue 9

Abstract

Access to autism intervention services is shaped by persistent structural constraints, including limited availability, cost, and service continuity, which often require caregivers to assume expanded roles in supporting their children’s development. This study examines how such constraints contribute to the emergence and persistence of caregivers as proxy interventionists and how technology-mediated systems support or partially support these roles from a human factors perspective. A sequential mixed-methods design was employed across two phases. The first phase integrated quantitative caregiver and service provider surveys with qualitative interviews to examine service access, early technology adoption, and satisfaction patterns during periods of disrupted service delivery. The second phase examined post-adoption contexts through caregiver and service provider qualitative interviews to understand sustained caregiver-mediated practices, technology use, and associated cognitive, emotional, and coordination demands. An empirically grounded conceptual framework was derived to organize relationships among structural access constraints, role redistribution, technology-mediated interaction mechanisms, and human factors demands. The findings highlight the need for human-centered digital systems that provide structured guidance, coordination support, and accessible intervention resources. This work contributes to the design of scalable, technology-mediated support systems for autism care and offers practical implications for user-centered digital health interventions.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Autism Spectrum Disorder Research · Family and Disability Support Research · Assistive Technology in Communication and Mobility

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Software Engineering, College of Computer and Information Sciences, King Saud University, Riyadh 11451, Saudi Arabia

References (48)

Show source-provided references
1. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Publishing. [5th ed.].10.1176/appi.books.9780890425596 ↗
2. Autism spectrum disorder10.1016/S0140-6736(18)31129-2 ↗
3. Early identification of autism spectrum disorder: Recommendations for practice and research10.1542/peds.2014-3667C ↗
4. Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders
5. Rogers, S.J., and Dawson, G. (2010). Early Start Denver Model for Young Children with Autism: Promoting Language, Learning, and Engagement, Guilford Press.
6. Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model10.1542/peds.2009-0958 ↗
7. Behavioral treatment and normal educational and intellectual functioning in young autistic children10.1037/0022-006X.55.1.3 ↗
8. Applied behavior analytic intervention for autism in early childhood10.1016/j.cpr.2010.01.008 ↗
9. Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder10.1007/s10803-015-2407-8 ↗
10. Parent-mediated social communication therapy for young children with autism (PACT): Long-term follow-up of a randomised controlled trial10.1016/S0140-6736(16)31229-6 ↗
11. Parent-mediated early intervention for young children with autism spectrum disorders (ASD)10.1002/ebch.1952 ↗
12. Parent-mediated interventions for children with autism spectrum disorder: A systematic review10.5014/ajot.2019.030015 ↗
13. Parent and family impact of autism spectrum disorders: A review and proposed model for intervention evaluation10.1007/s10567-012-0119-6 ↗
14. Living in a world of our own: The experience of parents who have a child with autism10.1177/1049732308320112 ↗
15. Szlamka, Z., Hanlon, C., Tekola, B., Pacione, L., Salomone, E., WHO CST Team, Servili, C., and Hoekstra, R.A. (2022). Exploring contextual adaptations in caregiver interventions for families raising children with developmental disabilities. PLoS ONE, 17.10.1371/journal.pone.0272077 ↗
16. Racial/ethnic disparities in the identification of children with autism spectrum disorders10.2105/AJPH.2007.131243 ↗
17. Quality versus quantity: The role of socioeconomic status on parent-reported service knowledge, service use, unmet service needs, and barriers to service use10.1177/1362361315569745 ↗
18. Prevalence of parent-reported diagnosis of autism spectrum disorder among children in the US, 200710.1542/peds.2009-1522 ↗
19. Service and treatment use among children diagnosed with autism spectrum disorders10.1097/DBP.0000000000000127 ↗
20. Understanding racial and ethnic disparities in autism-related service use among Medicaid-enrolled children10.1007/s10803-020-04797-6 ↗
21. Costs of autism spectrum disorders in the United Kingdom and the United States10.1001/jamapediatrics.2014.210 ↗
22. Cost offset associated with Early Start Denver Model for children with autism10.1016/j.jaac.2017.06.007 ↗
23. Gentles, S.J., McLaughlin, J., and Schneider, M.A. (2024). Stress among caregivers of autistic children: Conceptual analysis and verification using two qualitative datasets. PLoS ONE, 19.10.1371/journal.pone.0312391 ↗
24. Drmic, I., Brian, J., Roncadin, C., Shaver, C., Pase, M., Rugajs, N., Tofano, K., Dowds, E., Zwaigenbaum, L., and Smith, I.M. (2024). Community implementation of a brief parent mediated intervention for toddlers with probable or confirmed autism spectrum disorder: Feasibility, acceptability, and drivers of success. Front. Pediatr., 11.10.3389/fped.2023.1295294 ↗
25. Project AIM: Autism intervention meta-analysis for studies of young children10.1037/bul0000215 ↗
26. Parent engagement with telehealth-based parent-mediated intervention10.2196/jmir.4913 ↗
27. Telehealth and autism: A systematic search and review of the literature10.1080/17549507.2018.1465123 ↗
28. Parent-mediated intervention training delivered remotely10.2196/jmir.6651 ↗
29. Meta-analysis of effectiveness of parent-mediated telehealth interventions in children with Autism spectrum disorder10.1016/j.rasd.2023.102209 ↗
30. Comparison of a self-directed and therapist-assisted telehealth parent-mediated intervention for children with ASD: A pilot RCT10.1007/s10803-016-2755-z ↗
31. Pediatric telehealth: Opportunities created by the COVID-19 and suggestions to sustain its use to support families of children with disabilities10.1080/01942638.2020.1825032 ↗
32. The digital divide in technologies for autism: Feasibility considerations for low-and middle-income countries10.1007/s10803-021-05084-8 ↗
33. Caregiver perspectives on interventions for behavior challenges in autistic children10.1016/j.rasd.2020.101714 ↗
34. Aithal, S., Karkou, V., Makris, S., Karaminis, T., and Powell, J. (2023). Supporting the wellbeing of caregivers of children on the autism spectrum: A qualitative report on experiences of attending group dance movement psychotherapy. PLoS ONE, 18.10.1371/journal.pone.0288626 ↗
35. Buchwald, K., Shepherd, D., Siegert, R.J., Vignes, M., and Landon, J. (2025). Factors predicting parenting stress in the autism spectrum disorder context: A network analysis approach. PLoS ONE, 20.10.1371/journal.pone.0319036 ↗
36. Human factors systems approach to healthcare quality and patient safety10.1016/j.apergo.2013.04.023 ↗
37. Norman, D.A. (2013). The Design of Everyday Things, Basic Books.
38. Mental health technologies: Designing with consumers10.2196/humanfactors.4336 ↗
39. A randomised controlled trial of an information communication technology delivered intervention for children with autism spectrum disorder living in regional Australia10.1007/s10803-018-3734-3 ↗
40. Human-centered design considered harmful10.1145/1070960.1070976 ↗
41. Courage, C., and Baxter, K. (2005). Understanding Your Users: A Practical Guide to User Requirements Methods, Tools, and Techniques, Morgan Kaufmann.10.1016/B978-155860935-8/50031-2 ↗
42. Creswell, J.W., and Plano Clark, V.L. (2018). Designing and Conducting Mixed Methods Research, SAGE Publications. [3rd ed.].
43. Using thematic analysis in psychology10.1191/1478088706qp063oa ↗
44. ATLAS.ti Scientific Software Development GmbH (2023). ATLAS.ti, ATLAS.ti Scientific Software Development GmbH. Available online: https://atlasti.com.
45. Reflecting on reflexive thematic analysis10.1080/2159676X.2019.1628806 ↗
46. Telehealth and patient satisfaction: A systematic review and narrative analysis10.1136/bmjopen-2017-016242 ↗
47. Development of NASA-TLX (Task Load Index): Results of empirical and theoretical research10.1016/S0166-4115(08)62386-9 ↗
48. (2019). Ergonomics of Human-System Interaction-Part 210: Human-Centred Design for Interactive Systems (Standard No. ISO 9241-210:2019). Available online: https://www.iso.org/standard/77520.html.