Content and Quality Analysis of mHealth Apps for Feeding Children with Autism Spectrum Disorder

Background: Approximately 1 in 100 children worldwide are diagnosed with Autism Spectrum Disorder (ASD), and 46% to 89% experience significant feeding difficulties. Mobile health applications (mHealth apps) have emerged as a potential tool for scalable support. However, their quality and relevance in managing ASD-related feeding challenges remain unclear. Objective: To identify and evaluate the quality of mHealth apps available in the Africa region addressing feeding difficulties in children with ASD. Methods: A systematic search was conducted on the Apple App Store and Google Play Store between September and October 2024. Applications were included if they were free, in English, updated within the past year, explicitly focused on feeding in children with autism, available in the Africa region, and had more than 100 downloads. Eligible apps were assessed using the Behavior Change Wheel (BCW) framework and rated with the Mobile App Rating Scale (MARS) across four domains: engagement, functionality, aesthetics, and information quality. Results: Of the 326 applications identified, only two iOS apps met all inclusion criteria. EduKitchen-Toddlers Food Games featured child-centered interactive games and sensory-friendly visuals, while Autism Food Coach 2 provided structured caregiver tools, visual meal plans, and progress tracking. Both apps aligned with multiple BCW intervention functions, including education, training, and enablement. MARS scores of 3.7 and 3.9 indicated acceptable to good usability and content quality. Conclusion: There is a critical shortage of high-quality, evidence-based mHealth applications addressing feeding difficulties in children with ASD. Future development should prioritize clinical validation and the integration of comprehensive, caregiver-centered support features to address this gap.