ArticleFrontiers in psychology2026
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.
Article in Frontiers in psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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