Objective:To explore the correlation between neurodevelopmental levels and core symptoms in children with autism spectrum disorder(ASD)at different developmental levels.Methods:A retrospective analysis was conducted on 346 children diagnosed with ASD for the first time at the Department of Child Developmental and Behavioral, Women and Children’s Hospital, School of Medicine, Xiamen University from January 2021 to October 2023. The developmental quotient (DQ) of ASD children was assessed using the 0-6 years old children's neurodevelopmental assessment. A total DQ score less than 70 was classified as the low-functioning ASD group( n=285)and total DQ score more than 70 was classified as high-functioning ASD group( n=61). The core symptoms of ASD children were evaluated using the autism behavior checklist (ABC) and childhood autism rating scale (CARS). The analysis focused on comparing the core symptoms among different developmental levels and examining the impact of developmental quotient in various areas on these core symptoms. SPSS 21.0 statistical software was used for t-test and multiple linear regression analysis. Results:(1)The total score of ABC((60.71±22.61) vs(53.23±24.18), t=2.316, P=0.021), sensory factor((7.96±5.18) vs(6.36±4.60), t=2.233, P=0.026), language factor((13.44±5.86) vs(10.46±5.52), t=3.641, P<0.001), the total score of CARS((34.59±5.18) vs(31.07±5.72), t=4.731, P<0.001), relationship to people((2.82±0.66) vs(2.57±0.67), t=2.604, P=0.01), imitation((3.01±0.76) vs(2.61±0.88), t=3.646, P<0.001), emotional response((2.33±0.77) vs(1.97±0.73), t=3.41, P<0.001), body((2.01±0.78) vs(1.77±0.72), t=2.249, P=0.025), taste-smell-touch response and use((1.52±0.70) vs(1.31±0.53), t=2.163, P=0.031), verbal communication((3.19±0.64) vs(2.90±0.70), t=3.141, P=0.002), non-verbal communication((2.68±0.62) vs(2.20±0.60), t=5.595, P<0.001), activity level((2.33±0.78) vs(2.10±0.83), t=2.108, P=0.036), level and consistency of intellectual response((2.14±0.76) vs(1.77±0.72), t=3.499, P=0.001), and general impressions of children ((2.36±0.59) vs(2.13±0.50), t=2.891, P=0.004)in the low-functioning ASD group were higher than those in the high-functioning ASD group.(2) Multiple stepwise linear regression analysis showed that children in high-functioning ASD group, language and fine motor domain DQ could negatively predict the total CARS score ( β=-0.383, -0.268; both P<0.05). Children in low-functioning ASD group, language and gross motor domains DQ could negatively predict the total CARS score( β=-0.233, -0.149, both P<0.01). Conclusions:The lower the development level, the more severe the core symptoms of ASD children. Fine motor and language ability have an impact on the core symptoms of ASD children with higher development level, while gross motor and language ability have an impact on the core symptoms of ASD children with low development level. In clinical practice, appropriate motor intervention plans can be formulated according to the development level of ASD children.