Neurodevelopmental conditions such as attention deficit hyperactivity disorder (ADHD) and autism affect about one in ten children. These conditions impact development, behaviour and wellbeing.

But children with these conditions and their caregivers often can’t get the support they need. Families report difficulties accessing health-care providers and experience long wait lists to receive care.

Digital tools, such as apps and websites, are often viewed as a solution to these gaps. With a single click or a download, families might be able to access information to support their child.

There are lots of digital tools available, but it’s hard to know what is and isn’t useful. Our new study evaluated freely available digital resources for child neurodevelopment and mental health to understand their quality and evidence base.

We found many resources were functional and engaging. However, resources often lacked evidence for the information provided and the claimed positive impact on children and families.

This is a common problem in the digital resource field, where the high expectations and claims of impact from digital tools to change health care have not yet been realised.

What type of resources?

Our study identified 3,435 separate resources, of which 112 (43 apps and 69 websites) met our criteria for review. These resources all claimed to provide information or supports for child neurodevelopment, mental health or wellbeing.

Resources had to be freely available, in English and have actionable information for children and families.

The most common focus was on autism, representing 17% of all resources. Resources suggested they provided strategies to promote speech, language and social development, and to support challenging behaviours.

Other common areas included language and communication (14%), and ADHD (10%).

Resources had various purposes, including journalling and providing advice, scheduling support, and delivering activities and strategies for parents. Resources delivered information interactively, with some apps organising content into structured modules.

Resources also provided options for alternative and assistive communication for people with language or communication challenges.

Most apps were functional and accessible

Our first question was about how engaging and accessible the information was. Resources that are hard to use aren’t used frequently, regardless of the information quality.

We evaluated aesthetics, including whether digital tools were easy to use and navigate, stylistically consistent, with clean and appealing graphics for users.

Most resources were rated as highly engaging, with strong accessibility and functionality.

But many lacked quality information

We ranked resources on various features from 1 (inadequate) to 5 (excellent), with a ranking of 3 considered acceptable. These ratings looked at how credible the resource was and whether there was evidence supporting it.

Despite their functionality, 37% of reviewed apps did not meet the minimum acceptable standards for information quality. This means many apps could not be recommended. Most websites fared better than apps.

There also wasn’t a lot of scientific evidence to suggest using either apps or digital resources actually helped families. Studies show long-term engagement with digital tools is rare, and downloads don’t correspond to frequent usage or benefits.

Digital tools are often viewed as a panacea to health-care gaps, but the evidence is yet to show they fill such gaps. Digital health is a fast-moving field and resources are often made available before they have been properly evaluated.

What should you look for in digital resources?

We found the highest quality resources were developed in collaboration with institutions, such as health, university or government groups.

One highly rated resource was the Raising Children’s Network and the associated app, Raising Healthy Minds. These are co-developed with a university and hospital, and by people with appropriate qualifications.

This resource provides information to support children’s overall health, development and wellbeing, with dedicated sections addressing neurodevelopmental needs and concerns.

Our research shows parents can assess whether digital resources are high quality by checking they are:

• factually correct. Look for where the app or resource is getting its information. Does the author have the qualifications and training to provide the information? Are they a registered health expert who is accountable to a regulatory body (such as AHPRA, the Australian Health Practitioners Regulation Agency) for providing information that does not cause harm?
• consistent across multiple credible sources, such as health institutions.
• linked to supporting information. Look for reliable links to reputable institutions. Links to peer-reviewed scientific journals are often helpful as those articles will also usually describe the limitations of the research presented.
• up-to-date. Apps should be frequently updated. For websites, dates of update are usually found on the homepage or at the bottom of individual pages.

Beware of red flags

Some things to watch out for are:

• testimonials and anecdotes without evidence and scientific links to back the anecdotes up. If it sounds too good to be true, it probably is.
• no information provided about conflicts of interest. Organisations gain when you click on their links or take their advice (financial, reputation and brand development). Think about what they gain when you use their information to help keep a balanced perspective.

Remember, the app’s star rating doesn’t mean it will contain factual information from a reliable source or be helpful for you and your child.

The role of digital tools

Digital tools won’t usually replace a health professional, but they can support care in many different ways. They may be used to help to educate and prepare for meetings, and to collaborate with health providers.

They may also be used to collect information about daily needs. Studies show reporting on sleep in children can be notoriously difficult, for example. But tracking sleep behaviour with actigraphy, where movement and activity patterns are measured using a wearable device, can provide information to support clinical care. With the promise of artificial intelligence, there will also be new opportunities to support daily living.

Our findings reflect a broader problem for digital health, however. Much investment is often made in developing products to drive use, with spurious claims of health benefits.

What’s needed is a system that prioritises the funding, implementation and evaluation of tools to demonstrate benefits for families. Only then may we realise the potential of digital tools to benefit those who use them.

Kelsie Boulton, Senior Research Fellow in Child Neurodevelopment, Brain and Mind Centre, University of Sydney and Adam Guastella, Professor and Clinical Psychologist, Michael Crouch Chair in Child and Youth Mental Health, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.

The terms “shyness” and “social anxiety” are often used interchangeably because they both involve feeling uncomfortable in social situations.

However, feeling shy, or having a shy personality, is not the same as experiencing social anxiety (short for “social anxiety disorder”).

Here are some of the similarities and differences, and what the distinction means.

How are they similar?

It can be normal to feel nervous or even stressed in new social situations or when interacting with new people. And everyone differs in how comfortable they feel when interacting with others.

For people who are shy or socially anxious, social situations can be very uncomfortable, stressful or even threatening. There can be a strong desire to avoid these situations.

People who are shy or socially anxious may respond with “flight” (by withdrawing from the situation or avoiding it entirely), “freeze” (by detaching themselves or feeling disconnected from their body), or “fawn” (by trying to appease or placate others).

A complex interaction of biological and environmental factors is also thought to influence the development of shyness and social anxiety.

For example, both shy children and adults with social anxiety have neural circuits that respond strongly to stressful social situations, such as being excluded or left out.

People who are shy or socially anxious commonly report physical symptoms of stress in certain situations, or even when anticipating them. These include sweating, blushing, trembling, an increased heart rate or hyperventilation.

How are they different?

Social anxiety is a diagnosable mental health condition and is an example of an anxiety disorder.

For people who struggle with social anxiety, social situations – including social interactions, being observed and performing in front of others – trigger intense fear or anxiety about being judged, criticised or rejected.

To be diagnosed with social anxiety disorder, social anxiety needs to be persistent (lasting more than six months) and have a significant negative impact on important areas of life such as work, school, relationships, and identity or sense of self.

Many adults with social anxiety report feeling shy, timid and lacking in confidence when they were a child. However, not all shy children go on to develop social anxiety. Also, feeling shy does not necessarily mean a person meets the criteria for social anxiety disorder.

People vary in how shy or outgoing they are, depending on where they are, who they are with and how comfortable they feel in the situation. This is particularly true for children, who sometimes appear reserved and shy with strangers and peers, and outgoing with known and trusted adults.

Individual differences in temperament, personality traits, early childhood experiences, family upbringing and environment, and parenting style, can also influence the extent to which people feel shy across social situations.

However, people with social anxiety have overwhelming fears about embarrassing themselves or being negatively judged by others; they experience these fears consistently and across multiple social situations.

The intensity of this fear or anxiety often leads people to avoid situations. If avoiding a situation is not possible, they may engage in safety behaviours, such as looking at their phone, wearing sunglasses or rehearsing conversation topics.

The effect social anxiety can have on a person’s life can be far-reaching. It may include low self-esteem, breakdown of friendships or romantic relationships, difficulties pursuing and progressing in a career, and dropping out of study.

The impact this has on a person’s ability to lead a meaningful and fulfilling life, and the distress this causes, differentiates social anxiety from shyness.

Children can show similar signs or symptoms of social anxiety to adults. But they may also feel upset and teary, irritable, have temper tantrums, cling to their parents, or refuse to speak in certain situations.

If left untreated, social anxiety can set children and young people up for a future of missed opportunities, so early intervention is key. With professional and parental support, patience and guidance, children can be taught strategies to overcome social anxiety.

Why does the distinction matter?

Social anxiety disorder is a mental health condition that persists for people who do not receive adequate support or treatment.

Without treatment, it can lead to difficulties in education and at work, and in developing meaningful relationships.

Receiving a diagnosis of social anxiety disorder can be validating for some people as it recognises the level of distress and that its impact is more intense than shyness.

A diagnosis can also be an important first step in accessing appropriate, evidence-based treatment.

Different people have different support needs. However, clinical practice guidelines recommend cognitive-behavioural therapy (a kind of psychological therapy that teaches people practical coping skills). This is often used with exposure therapy (a kind of psychological therapy that helps people face their fears by breaking them down into a series of step-by-step activities). This combination is effective in-person, online and in brief treatments.

For more support or further reading

Online resources about social anxiety include:

• This Way Up’s online program for managing excessive shyness and fear of social situations
• Beyond Blue’s resources on social anxiety
• a guide to looking after yourself if you have social anxiety, from the Western Australian health department
• social anxiety online program for children and teens from the University of Queensland
• inroads, a self-guided online program for young adults who drink alcohol to manage their anxiety.

We thank the Black Dog Institute Lived Experience Advisory Network members for providing feedback and input for this article and our research.

Kayla Steele, Postdoctoral research fellow and clinical psychologist, UNSW Sydney and Jill Newby, Professor, NHMRC Emerging Leader & Clinical Psychologist, UNSW Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.