关键词: 孤独症谱系障碍儿童, 瞳孔测量, 筛查诊断, 早期预测, 自主神经系统

Abstract: Autism spectrum disorder (ASD) is a common neurodevelopmental disorder, and early diagnosis is crucial for intervention and prognosis. Pupillometry is an objective, non-invasive, and rapid assessment technique that can evaluate abnormal neural responses in children before behavioral characteristics appear. Existing research confirms that children with autism exhibit atypical pupillary response patterns: in the pupillary light reflex, these manifest as prolonged contraction latency and reduced relative contraction amplitude, suggesting weakened parasympathetic regulation; In complex visual stimulation tasks, this is manifested as smaller pupil dilation in response to social stimuli, while greater pupil dilation or no significant difference compared to typical developing children is observed for non-social stimuli; furthermore, in the attention orientation task, greater pupil dilation is noted, suggesting a dysfunction in the dynamic coupling between the tension and phase components of the locus coeruleus-norepinephrine system. Pupillary parameters not only effectively distinguish between children with diagnosed autism and typically developing children, but some of these parameters are also associated with the core symptom dimensions of autism. More importantly, pupillary parameters collected during infancy and early childhood have predictive value for the severity of symptoms at the time of subsequent diagnosis. Future research should focus on longitudinal follow-up of high-risk infant and toddler cohorts and the establishment of a standardized multimodal assessment system, with a view to clarifying the early predictive efficacy of pupillometry prior to the manifestation of behavioural symptoms of autism, and to facilitate its translation into a clinical screening aid.

Key words: children with autism spectrum disorder, pupillometry, screening and diagnosis, early prediction, autonomic nervous system