Directed forgetting in high-functioning adults with autism spectrum disorders

Are autistic traits associated with a social-emotional memory bias?

Autistic traits are associated with differential processing of emotional and social cues. By contrast little is known about the relationship of autistic traits to socio-emotional memory, though research suggests an integral relationship between episodic memory processes and psychosocial well-being. Using an experimental paradigm, we tested if autistic traits moderate the effects of negative emotion and social cues on episodic memory (i.e. memory for past events). Young adults (N = 706) with varied levels of self-reported autistic traits (24% in clinical range) encoded images stratified by emotion (negative, neutral) and social cues (social, non-social) alongside a neutral object. After 24 h, item memory for images and associative memory for objects was tested. For item memory, after controlling for anxiety, a small effect emerged whereby a memory-enhancing effect of social cues was reduced as autistic traits increased. For associative memory, memory for pairings between neutral, but not negative, images reduced as autistic traits increased. Results suggest autistic traits are associated with reduced ability to bind neutral items together in memory, potentially impeding nuanced appraisals of past experience. This bias toward more negative, less nuanced memories of past experience may represent a cognitive vulnerability to social and mental health challenges commonly associated with autistic traits and a potential intervention target.

The Distinctive Pattern of Declarative Memories in Autism Spectrum Disorder: Further Evidence of Episodic Memory Constraints

This study examines declarative memory retrieval in ASD depending on the availability and access to stored conceptual knowledge. Fifteen autistic participants and a matched control group of 18 typically-developed (TD) volunteers completed a Remember-Know paradigm manipulated by encoding-type (categorical, perceptual) and item-typicality (high-typical, low-typical). The autistic group showed worse and slower recognition and less recollection but equivalent familiarity-based memories compared to TDs. Notably, low-typical items did not improve their memories as they did for TDs, likely due to difficulties in matching low-fit information to the stored schema. Results suggest that memory decline in ASD may derive from the episodic system and its dynamics with the semantic system. These findings may inform interventional strategies for enhancing learning abilities in ASD.

The Episodic Memory Profile in Autism Spectrum Disorder: A Bayesian Meta-Analysis

Although autism spectrum disorders (ASD) are commonly characterized by diminished episodic memory, the literature in this area is mixed. We address these inconsistent findings by employing multilevel Bayesian meta-analysis to quantify episodic memory differences between individuals with ASD and typically developing (TD) controls. We used meta-regression to evaluate the effects of test modality (e.g., word list, story recall), delay interval (immediate vs. delayed), retrieval demands (recognition vs. recall), and sensory modality (auditory vs. visual) on episodic memory in ASD. A total of 338 effect sizes from 113 empirical articles, including 5,632 unique participants (ASD = 2,777, TD = 2,855), were included. Results show that the memory deficits associated with ASD were larger for recall (g = -0.52, se = 0.04, 95% CrI [-0.60, -0.43]) compared to recognition (g = -0.25, se = 0.05, 95% CrI [-0.35, -0.14]) and differed based on the testing modality. For example, effect sizes were smallest for words (g = -0.28, se = 0.05, 95% CrI [-0.38, -0.18]), pictures (g = -0.38, se = 0.07, 95% CrI [-0.52, -0.24]), and figure reproduction (g = -0.49, se = 0.11, 95% CrI [-0.70, -0.27]). However, effect sizes for sentences (g = -0.59, se = 0.20, 95% CrI [-1.00, -0.21]), stories (Hedges' g = -0.54, se = 0.08, 95% CrI [-0.69, -0.38]) and staged events (g = -0.75, se = 0.10, 95% CrI [-0.95, -0.55]) were much larger. These findings suggest that ASD is associated with a small to medium reduction in scores on episodic memory tests relative to TD controls.

Eye Movements of Spatial Working Memory Encoding in Children with and without Autism: Chunking Processing and Reference Preference

Individuals with autism spectrum disorder (ASD) experience spatial working memory deficits and show different encoding mechanisms from typical developing (TD) peers. To effectively describe the encoding strategies of those with ASD and highlight their characteristics in cognitive processing, we adopted improved change detection tasks and added eye-movement indicators to investigate the chunking function and reference preference of children with and without ASD. The current study included 20 participants with ASD aged 8-16 and 20 TD children matched for age, gender, and intelligence. Experiment 1 used high/low-structured change detection tasks, and eye-movement indexes were recorded as they memorized the locations of the items to investigate spatial chunking strategies. In Experiment 2, changes in eye movement patterns were observed by adding a frame of reference. The results suggested different encoding strategies in ASD and TD individuals. The ASD group showed local processing bias and had difficulty adopting chunking strategies in spatial working memory. Eye-movement analysis suggested that they rarely showed integrated information processing tendency observed in TD children. Moreover, as a compensatory processing, they were more likely to use the frame of reference. In this study, we compared the spatial chunking strategies and reference preference of children with and without ASD, and eye-movement analysis was used to investigate the processing mechanism. These findings are significant for research on cognitive characteristics of ASD and provide a new focus for working memory training in children with ASD. LAY SUMMARY: The current study suggests that children with autism spectrum disorder are poorer at organizing items into chunks in spatial working memory, but rely more on reference frames. If the purpose of location memory is to strengthen the adaptability of children with autism, it should provide them with more clues or references. If it is for the purpose of intervention such as cognitive training, it should guide them to integrate information to improve the basic cognitive processing efficiency. Autism Res 2021, 14: 897-910. © 2020 International Society for Autism Research and Wiley Periodicals LLC.

The Witness-Aimed First Account (WAFA): A new technique for interviewing autistic witnesses and victims

LAY ABSTRACT

Autistic people may be more likely to be interviewed by police as a victim/witness, yet they experience social communication difficulties alongside specific memory difficulties that can impact their ability to recall information from memory. Police interviewing techniques do not take account of these differences, and so are often ineffective. We developed a new technique for interviewing autistic witnesses, referred to a Witness-Aimed First Account, which was designed to better support differences in the way that autistic witnesses process information in memory. The Witness-Aimed First Account technique encourages witnesses to first segment the witnessed event into discrete, parameter-bound event topics, which are then displayed on post-it notes while the witness goes onto freely recall as much information as they can from within each parameter-bound topic in turn. Since witnessed events are rarely cohesive stories with a logical chain of events, we also explored autistic and non-autistic witnesses' recall when the events were witnessed in a random (nonsensical) order. Thirty-three autistic and 30 typically developing participants were interviewed about their memory for two videos depicting criminal events. Clip segments of one video were 'scrambled', disrupting the event's narrative structure; the other video was watched intact. Although both autistic and non-autistic witnesses recalled fewer details with less accuracy from the scrambled video, Witness-Aimed First Account interviews resulted in more detailed and accurate recall from both autistic and non-autistic witnesses, for both scrambled and unscrambled videos. The Witness-Aimed First Account technique may be a useful tool to improve witnesses' accounts within a legally appropriate, non-leading framework.

Frequency-specific neural synchrony in autism during memory encoding, maintenance and recognition

Working memory impairment is associated with symptom severity and poor functional outcome in autistic individuals, and yet the neurobiology underlying such deficits is poorly understood. Neural oscillations are an area of investigation that can shed light on this issue. Theta and alpha oscillations have been found consistently to support working memory in typically developing individuals and have also been shown to be functionally altered in people with autism. While there is evidence, largely from functional magnetic resonance imaging studies, that neural processing underlying working memory is altered in autism, there remains a dearth of information concerning how sub-processes supporting working memory (namely encoding, maintenance and recognition) are impacted. In this study, we used magnetoencephalography to investigate inter-regional theta and alpha brain synchronization elicited during the widely used one-back task across encoding, maintenance and recognition in 24 adults with autism and 30 controls. While both groups performed comparably on the working-memory task, we found process- and frequency-specific differences in networks recruited between groups. In the theta frequency band, both groups used similar networks during encoding and recognition, but different networks specifically during maintenance. In comparison, the two groups recruited distinct networks across encoding, maintenance and recognition in alpha that showed little overlap. These differences may reflect a breakdown of coherent theta and alpha synchronization that supports mnemonic functioning, or in the case of alpha, impaired inhibition of task-irrelevant neural processing. Thus, these data provide evidence for specific theta and widespread alpha synchrony alterations in autism, and underscore that a detailed examination of the sub-processes that comprise working memory is warranted for a complete understanding of cognitive impairment in this population.

Trauma and Autism Spectrum Disorder: Review, Proposed Treatment Adaptations and Future Directions

Empirical investigations of trauma and post-traumatic stress disorder (PTSD) in individuals with autism spectrum disorder (ASD) are lacking despite indications of increased risk for exposure to potentially traumatic events in this population. Research on the treatment of traumatic stress psychopathology in ASD is even more limited and suggests a critical need for guidance in the area of ASD-specific treatment adaptations. The current paper provides preliminary recommendations for adapting current evidenced-based, trauma-specific interventions, specifically trauma-focused cognitive behavioral therapy (TF-CBT), for individuals with ASD based on well-established and evidence-based practices for working with this population. These adaptations highlight the need to incorporate treatment goals related to ASD core symptoms and associated characteristics during treatment targeting traumatic stress symptoms. Future directions are discussed, including the development of instruments measuring trauma reactions in ASD, empirical investigations of modified trauma interventions for children with ASD to evaluate effectiveness, and collaboration between professionals specializing in ASD and trauma/PTSD to advance research and facilitate effective care for this community.

Exploring the neurocognitive basis of episodic recollection in autism

Increasing evidence indicates that the subjective experience of recollection is diminished in autism spectrum disorder (ASD) compared to neurotypical individuals. The neurocognitive basis of this difference in how past events are re-experienced has been debated and various theoretical accounts have been proposed to date. Although each existing theory may capture particular features of memory in ASD, recent research questions whether any of these explanations are alone sufficient or indeed fully supported. This review first briefly considers the cognitive neuroscience of how episodic recollection operates in the neurotypical population, informing predictions about the encoding and retrieval mechanisms that might function atypically in ASD. We then review existing research on recollection in ASD, which has often not distinguished between different theoretical explanations. Recent evidence suggests a distinct difficulty engaging recollective retrieval processes, specifically the ability to consciously reconstruct and monitor a past experience, which is likely underpinned by altered functional interactions between neurocognitive systems rather than brain region-specific or process-specific dysfunction. This integrative approach serves to highlight how memory research in ASD may enhance our understanding of memory processes and networks in the typical brain. We make suggestions for future research that are important for further specifying the neurocognitive basis of episodic recollection in ASD and linking such difficulties to social developmental and educational outcomes.

The Influence of task Demands, Verbal Ability and Executive Functions on Item and Source Memory in Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is generally associated with difficulties in contextual source memory but not single item memory. There are surprising inconsistencies in the literature, however, that the current study seeks to address by examining item and source memory in age and ability matched groups of 22 ASD and 21 comparison adults. Results show that group differences in source memory are moderated by task demands but not by individual differences in verbal ability, executive function or item memory. By contrast, unexpected group differences in item memory could largely be explained by individual differences in source memory. These observations shed light on the factors underlying inconsistent findings in the memory literature in ASD, which has important implications for theory and practice.

Reduced Hippocampal Functional Connectivity During Episodic Memory Retrieval in Autism

Increasing recent research has sought to understand the recollection impairments experienced by individuals with autism spectrum disorder (ASD). Here, we tested whether these memory deficits reflect a reduction in the probability of retrieval success or in the precision of memory representations. We also used functional magnetic resonance imaging (fMRI) to study the neural mechanisms underlying memory encoding and retrieval in ASD, focusing particularly on the functional connectivity of core episodic memory networks. Adults with ASD and typical control participants completed a memory task that involved studying visual displays and subsequently using a continuous dial to recreate their appearance. The ASD group exhibited reduced retrieval success, but there was no evidence of a difference in retrieval precision. fMRI data revealed similar patterns of brain activity and functional connectivity during memory encoding in the 2 groups, though encoding-related lateral frontal activity predicted subsequent retrieval success only in the control group. During memory retrieval, the ASD group exhibited attenuated lateral frontal activity and substantially reduced hippocampal connectivity, particularly between hippocampus and regions of the fronto-parietal control network. These findings demonstrate notable differences in brain function during episodic memory retrieval in ASD and highlight the importance of functional connectivity to understanding recollection-related retrieval deficits in this population.

Reality Monitoring and Metamemory in Adults with Autism Spectrum Conditions

Studies of reality monitoring (RM) often implicate medial prefrontal cortex (mPFC) in distinguishing internal and external information, a region linked to autism-related deficits in social and self-referential information processing, executive function, and memory. This study used two RM conditions (self-other; perceived-imagined) to investigate RM and metamemory in adults with autism. The autism group showed a deficit in RM, which did not differ across source conditions, and both groups exhibited a self-encoding benefit on recognition and source memory. Metamemory for perceived-imagined information, but not for self-other information, was significantly lower in the autism group. Therefore, reality monitoring and metamemory, sensitive to mPFC function, appear impaired in autism, highlighting a difficulty in remembering and monitoring internal and external details of past events.

Eye movements reveal a dissociation between memory encoding and retrieval in adults with autism

People with Autism Spectrum Disorder (ASD) exhibit subtle deficits in recollection, which have been proposed to arise from encoding impairments, though a direct link has yet to be demonstrated. In the current study, we used eye-tracking to obtain trial-specific measures of encoding (eye movement patterns) during incidental (natural viewing) and intentional (strategic) encoding conditions in adults with ASD and typical controls. Using this approach, we tested the degree to which differences in encoding might contribute to recollection impairments, or whether group differences in memory primarily emerge at retrieval. Following encoding of scenes, participants were asked to distinguish between old and similar lure scenes and provide 'remember'/'familiar' responses. Intentional encoding increased eye movements and subsequent recollection in both groups to a similar degree, but the ASD group were impaired overall at the memory task and used recollection less frequently. In controls, eye movements at encoding predicted subsequent correct responses and subsequent recollection on a trial-by-trial basis, as expected. In contrast, despite a similar pattern of eye movements during encoding in the two groups, eye movements did not predict trial-by-trial subsequent memory in ASD. Furthermore, recollection was associated with lower similarity between encoding- and retrieval-related eye movements in the ASD group compared to the control group. The eye-tracking results therefore provide novel evidence for a dissociation between encoding and recollection-based retrieval in ASD.

A cross-sectional study on oral health and dental care in intellectually able adults with autism spectrum disorder

Background

Autism spectrum disorder (ASD) is characterized by impairments in social interaction and communication, restricted patterns of behaviour, and unusual sensory sensitivities. The hypotheses to be tested were that adult patients with ASD have a higher caries prevalence, have more risk factors for caries development, and utilize dental health care to a lesser extent than people recruited from the normal population.

Methods

Forty-seven adults with ASD, (25 men, 22 women, mean age 33 years) and of normal intelligence and 69 age- and sex-matched typical controls completed a dental examination and questionnaires on oral health, dental hygiene, dietary habits and previous contacts with dental care.

Results

Except for increased number of buccal gingival recessions, the oral health was comparable in adults with ASD and the control group. The group with ASD had less snacking, but also less frequent brushing of teeth in the mornings. The stimulated saliva secretion was lower in the ASD group, regardless of medication. Frequencies of dental care contacts were equal in both groups. The most common reason for missing a dental appointment was forgetfulness in the ASD group.

Conclusions

Adults with ASD exhibited more gingival recessions and considerably lower saliva flow compared to healthy controls. Despite equal caries prevalence, the risk for reduced oral health due to decreased salivary flow should be taken into consideration when planning dental care for patients with ASD. Written reminders of dental appointments and written and verbal report on oral health status and oral hygiene instructions are recommended.