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Starmate: A Lightweight AI Assistant for Autism Caregivers Developed and Evaluated Through a User-Centered Mixed-Methods Framework

  • Zhifan Li
  • , Xiaoxia Liu
  • , Tianhao Chen
  • , Yuting Yang
  • , Xiaoyan Liu
  • , Yuanyuan Lv
  • , Zixuan Zhao
  • , Xueying Li
  • , Xiaoqing Yin
  • , Zhongwen Feng
  • , Yue Lan
  • , Yanjie Zhao
  • , Wei Ke
  • , Yong Lin
  • , Kefeng Li
  • Macao Polytechnic University
  • Nanning Ruibao Children’s Rehabilitation Service Center
  • Zhuhai Women and Children’s Hospital
  • Jiangmen Maternity and Child Health Care Hospital
  • Guangdong-Hong Kong-Macao University Joint Laboratory of Interventional Medicine
  • Capital Medical University

Research output: Contribution to journalArticlepeer-review

Abstract

Autism spectrum disorder (ASD) affects tens of millions of families worldwide, yet parents confront abundant but unreliable online advice and limited access to timely, empathetic guidance. To address this critical gap, we developed Starmate (http://kefeng.mpu.edu.mo/starmate), a 1.5B-parameter, domain-tuned AI assistant for ASD caregivers, using a rigorous user-centered mixed-methods framework. Informed by in-depth interviews () and a Kano survey () that identified “Hands-on guidance” as a must-have caregiver requirement, we engineered a novel modular architecture that integrates sentiment analysis, expert-vetted knowledge-graph-augmented retrieval (LightRAG), and a domain-fine-tuned Qwen2.5-1.5B model. In a blinded, side-by-side comparison against leading commercial LLMs, Starmate demonstrated improved performance across key metrics within this evaluation framework (86.76 vs 78.43–83.84;) and showed specific advantages in Empathy, Hands-on guidance, and Logical clarity (all). Automated benchmarking corroborated these results, with top scores for Professional accuracy (86.18), Empathy (86.79), and Hands-on guidance (82.58). These findings demonstrate the technical feasibility of a lightweight, privacy-conscious, domain-specific LLM to generate accurate, empathetic, and actionable responses in benchmarked scenarios, laying the groundwork for future real-world usability and clinical testing.

Original languageEnglish
Article number106
JournalJournal of Medical Systems
Volume50
Issue number1
DOIs
Publication statusPublished - Dec 2026

Keywords

  • Autism spectrum disorder
  • Caregiver support
  • Large language models
  • Retrieval-augmented generation
  • User-centered design

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