Design and application of emotion-oriented play-learning tools for children with autism: a cross-cultural qualitative study of parents and teachers in China and Malaysia
Year: 2026
Type: article
Abstract: Background: Autistic children experience enduring difficulties with emotion regulation and daily participation. Emotion-oriented play-learning tools (EPLTs, sensory play-learning tools for supporting emotion and self-regulation) are recognized as low-threshold supports across home-school-community settings; however, robust real-world evidence (RWE) on their use, design requirements, and cross-cultural variation remains limited. Purpose: The purpose of this study is to examine the meanings, applications, and design requirements of emotion-oriented play-learning tools in China and Malaysia, and to identify system-level enablers and barriers to their development and use from stakeholder perspectives. Methods: Adopting reflexive thematic analysis, we conducted semi-structured interviews with 30 stakeholders (15 in China; 15 in Malaysia)-parents/primary caregivers and frontline teachers. Data were analyzed inductively in NVivo using three-level coding, and the reporting followed the Standards for Reporting Qualitative Research (SRQR). Results: Five overarching themes were identified: (1) driving factors (heightened emotional difficulties and trend-driven impetus); (2) attitudes to advanced technologies [virtual/augmented reality (VR/AR) and artificial intelligence (AI)]; (3) potentials and applications (multimodal sensory feedback, support for emotional expression, and transition support); (4) design and market requirements (safety, affordability, maintainability, collaboration, and data minimization); and (5) socio-environmental issues (stigma and policy accessibility). Coding frequencies indicated Theme 4 was the most salient, with stronger emphasis among parents than teachers. Attitudes to technology diverged by country-Malaysian participants were generally more open, whereas Chinese participants were more cautious-while socio-environmental constraints were common to both. Overall, Chinese participants offered denser, institution-focused accounts, whereas Malaysian participants emphasized family- and community-based practical coping. Conclusions: Emotion-oriented play-learning tools may operate as low-threshold, context-adaptable supplement tools in real-world settings. Scalable adoption depends on evidence-informed design; integrated affordability across price, maintenance, and training; and governance frameworks for privacy and explainability. We propose a design paradigm centered on safety, affordability, evidence, and collaboration. This paradigm is intended to guide small-scale RWE pilots, enable home-school data sharing and cross-cultural adaptation, and ultimately enhance quality of life for autistic children-aligning with the Sustainable Development Goals (SDGs) on Good Health and wellbeing, Quality Education, and Reduced Inequality.
Source: Frontiers in Psychology
Authors: Yiming Xing, Nazean Jomhari, Norhanim Zakaria, Xizhen Zhou, Shunfa Lai, Yueting Liu
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7159763986
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