A Systematic Review on the Development of High-Tech Mobile Applications in Urdu, Punjabi, and Sindhi for Children with Autism Spectrum Disorder and Social Communication Disorder

Abstract

Background: Children with Autism Spectrum Disorder (ASD) and Social Communication Disorder (SCD) face persistent impairments in language acquisition, social communication, and daily functioning. High-technology mobile applications have demonstrated efficacy in supporting communication and language development in these populations; however, the overwhelming majority of validated applications are developed in English and culturally oriented toward Western contexts. No prior systematic review has examined the development or effectiveness of mobile applications specifically designed in Urdu, Punjabi, or Sindhi — the three primary regional languages of Pakistan and South Asia — for children with ASD or SCD. Objective: To systematically identify, characterise, and appraise the methodological quality and effectiveness of high-technology mobile applications incorporating Urdu, Punjabi, or Sindhi language support for children (aged 0–18 years) with ASD or SCD. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. Five electronic databases — PubMed/MEDLINE, IEEE Xplore, Scopus, Web of Science, and Google Scholar — were searched in January 2025 from inception to search date. Two independent reviewers conducted dual screening at title/abstract and full-text stages; disagreements were resolved by consensus. Methodological quality was assessed using the Mixed-Methods Appraisal Tool (MMAT), JBI Quasi-Experimental Checklist, and CASP Quantitative Checklist, as appropriate to study design. Narrative synthesis was conducted using the SWiM framework. Results: Of 847 records identified, 28 studies met eligibility criteria after removal of 156 duplicates and staged screening. Seven studies constituted the core evidence base directly aligned with the review's South Asian regional language focus. Five studies incorporated Urdu as a primary application language; one study addressed Sindhi-language digital learning; no standalone study was identified for Punjabi. The only study covering all three target languages simultaneously (Hassan et al., 2025) demonstrated measurable speech production gains and significantly improved compliance. Quality scores ranged from 5 to 9 out of 10; three studies were rated High quality, one Moderate–High, two Moderate, and one Moderate–Low. The direction of reported effect was uniformly positive across all core studies, though only two employed validated, standardised outcome instruments in controlled designs. Conclusion: Urdu-language mobile applications for ASD and SCD children in Pakistan demonstrate feasibility and positive usability but lack controlled efficacy evidence. Punjabi represents a critical and entirely unaddressed evidence gap despite representing the primary language of Pakistan's largest population. Prioritised development and rigorous evaluation of Punjabi- and Sindhi-language mobile ASD applications are urgently needed to meet international inclusive education mandates and ensure linguistically equitable intervention access.