Enhanced pupillary light reflex in infancy is associated with autism diagnosis in toddlerhood

Pär Nyström1, Teodora Gliga2, Elisabeth Nilsson Jobs1

  • 1Uppsala Child & Babylab, Department of Psychology, Uppsala University, SE-75142, Uppsala, Sweden.

Insights

Infants later diagnosed with autism spectrum disorder (ASD) show a larger pupillary light reflex. This sensory difference in infancy may aid early ASD risk assessment.

Area of Science:

  • Neurodevelopmental disorders
  • Sensory processing
  • Infant development

Background:

  • Autism spectrum disorder (ASD) affects ~1% of the population.
  • Previous research indicated weaker pupillary light reflexes in children and adults with ASD.
  • Infant siblings of children with ASD previously showed stronger pupillary light reflexes than low-risk infants.

Purpose of the Study:

  • To investigate pupillary light reflex differences in 9-10-month-old high-risk infant siblings.
  • To determine if pupillary light reflex magnitude in infancy predicts later ASD diagnosis and symptom severity.

Main Methods:

  • Pupillometry was used to measure pupillary light reflexes in 9-10-month-old infants.
  • Infants were categorized as high-risk (siblings of children with ASD) or low-risk controls.
  • High-risk infants were followed to 36 months for ASD diagnosis.

Main Results:

  • High-risk infants who later received an ASD diagnosis showed a larger relative pupillary light reflex constriction compared to non-diagnosed high-risk infants and low-risk controls.
  • The magnitude of the pupillary light reflex in infancy correlated with symptom severity at follow-up.

Conclusions:

  • Sensory atypicalities, specifically in pupillary light reflexes, play a role in the etiology of ASD.
  • Pupillometry shows potential as a tool for early ASD risk assessment in infants.
  • Further refinement of pupillometry could enhance early identification and intervention for ASD.

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