Bradshaw Jessica, Platt Emma, Yurkovic-Harding Julia, Harding Samuel, Fu Xiaoxue
University of South Carolina, Columbia, SC, USA; Carolina Autism and Neurodevelopment Research Center, Columbia, SC, USA.
University of South Carolina, Columbia, SC, USA; Carolina Autism and Neurodevelopment Research Center, Columbia, SC, USA.
Adv Child Dev Behav. 2025;69:99-133. doi: 10.1016/bs.acdb.2025.07.006. Epub 2025 Jul 28.
Autism spectrum disorder (ASD) unfolds over the first two years of life through complex interactions among developmental systems. Attention and autonomic nervous system (ANS) regulation represent foundational processes critical for adaptive engagement with the environment. Disruptions in these systems during early infancy may initiate developmental cascades that contribute to core ASD features, including social-communication challenges and restricted and repetitive behaviors, as well as the vast heterogeneity found within ASD. This chapter reviews our approach to integrating mechanistic research and real-world methodologies to explore autonomic and attentional pathways in the early development of ASD. We conduct prospective, longitudinal studies to track how ANS regulation and attention unfold in infancy in infants at elevated and low familial likelihood for ASD. By integrating multimethod approaches to study these functions in naturalistic contexts, we demonstrate that autonomically regulated attention mechanisms support key developmental milestones and may play an important role in the emergence of ASD. Findings presented provide preliminary support for the theory that infants later diagnosed with ASD exhibit early disruptions in parasympathetic modulation of arousal and attention across responses to social and nonsocial contexts. This work emphasizes the value of leveraging portable, non-invasive technologies to study early autonomic and attention processes in naturalistic contexts. By using this approach to uncover formative mechanisms underlying ASD, we enhance the translational potential of this research while addressing critical gaps in inclusivity and representation. Understanding autonomic and attentional systems in infancy provides an opportunity to identify cascading developmental divergences and promote adaptive developmental trajectories in ASD.
自闭症谱系障碍（ASD）在生命的头两年通过发育系统之间的复杂相互作用逐渐显现。注意力和自主神经系统（ANS）调节是与环境进行适应性互动的关键基础过程。婴儿早期这些系统的紊乱可能引发发育连锁反应，导致ASD的核心特征，包括社交沟通挑战、受限和重复行为，以及ASD中存在的巨大异质性。本章回顾了我们整合机制研究和现实世界方法以探索ASD早期发育中自主神经和注意力通路的方法。我们进行前瞻性纵向研究，以追踪高家族ASD患病可能性和低家族ASD患病可能性婴儿在婴儿期ANS调节和注意力的发展情况。通过整合多方法途径在自然情境中研究这些功能，我们证明自主调节的注意力机制支持关键的发育里程碑，并且可能在ASD的出现中发挥重要作用。所呈现的研究结果为以下理论提供了初步支持：后来被诊断为ASD的婴儿在对社交和非社交情境的反应中，副交感神经对唤醒和注意力的调节存在早期紊乱。这项工作强调了利用便携式、非侵入性技术在自然情境中研究早期自主神经和注意力过程的价值。通过使用这种方法来揭示ASD潜在的形成机制，我们提高了这项研究的转化潜力，同时解决了包容性和代表性方面的关键差距。了解婴儿期的自主神经和注意力系统为识别级联发育差异以及促进ASD中的适应性发育轨迹提供了机会。
