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Sensitivity and specificity of pupillary light reflex measures for ASD using monocular pupillometry

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Automated hand-held pupillometry demonstrates precision accuracy, offering promise for augmenting ASD screening.


Monocular pupillometry was examined in children and adolescents (36 ASD; 24 TD). Multiple logistic regression and receiver operating characteristic analysis assessed PLR metrics and diagnostic status.


Constriction time (Ct1) (ASD: M = 0.69, SD = 0.21; TD: M = 0.82, SD = 0.18; t(58 = 2.37; p = 0.02) and return to baseline (RTB T75) (ASD: M = 2.93, SD = 1.21; TD: M = 2.32, SD = 1.08; t(58) =  − 2.03; p = 0.04) predicted ASD (β =  − 1.31, OR = 0.27; RTB T75, β = 0.156, OR = 1.162). Sensitivity = 74.8%, when RTB ≥ 1.83 s and 69.4% when Ct1 = 0.785 s.


Findings suggest monocular pupillometry captures differences detecting ASD.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.


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We wish to express our sincere gratitude to study participants and their families.

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Authors and Affiliations



All authors contributed to the study conception and design. Material preparation and data collection were performed by GL, TC, and SJ. Data analysis and manuscript preparation were done by GL and SM. The first draft of the manuscript was written by GL and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Georgina T. F. Lynch.

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Ethics approval and consent to participate

All procedures in this study involving human participants were in accordance with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Study procedures were reviewed and approved by the Washington State University Institutional Review Board, under IRB protocol #15613–002. Informed consent to participate in this study was obtained from all study participants and their legal guardians.

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The authors declare no competing interests.

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Lynch, G.T.F., James, S.M., Cardon, T.A. et al. Sensitivity and specificity of pupillary light reflex measures for ASD using monocular pupillometry. Neurol Sci 43, 4537–4545 (2022).

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