Memory for actions in autism spectrum disorder

Metacognition facilitates theory of mind through optimal weighting of trait inferences

The ability to represent and infer accurately others' mental states, known as Theory of Mind (ToM), has been theorised to be associated with metacognitive ability. Here, we considered the role of metacognition in mental state inference through the lens of a recent theoretical approach to explaining ToM, the 'Mind-space' framework. The Mind-space framework posits that trait inference, representation of the qualities of the mind giving rise to the mental state, is important in forming accurate mental state inferences. We tested a potential role for metacognition in facilitating optimal weighting of trait inferences, as well as several theoretical predictions regarding factors associated with the accuracy of trait inference and confidence in those trait inferences. Participants completed a judgement-of-confidence task in the trait inference domain alongside the Interview Task, a recently-developed task for assessing the accuracy of trait and mental state inferences. A simple relationship in which increased metacognitive sensitivity is associated with increased accuracy of mental states inferences was not found. However, when predicting trial-level performance, confidence in trait inference was shown to modulate the effect of trait inference accuracy on mental state inference accuracy. This effect was greater in magnitude with lower metacognitive sensitivity, i.e., when confidence is more likely to be misplaced. Furthermore, participants' trait inference ability was associated with the accuracy of their understanding of the average mind. In addition, the accuracy of specific trait inferences was predicted by the participant's similarity to the target, but this similarity benefit was reduced in participants whose self-perception was inaccurate. Reported confidence in a given trait inference was also predicted by participant-target similarity, such that participants showed greater overconfidence in judgements made about similar targets. This overconfidence effect was larger when self-perception was more erroneous. Results support several theoretical claims made by the Mind-space theory, and further elucidate the processes underlying accurate mental state inference.

Episodic memory impairment and its influencing factors in individuals with autism spectrum disorder: systematic review and meta-analysis

Individuals with autism spectrum disorders (ASD) are considered to experience difficulties with episodic memory (EM), while studies on EM in ASD have shown inconsistent results. A meta-analysis of 65 episodic memory studies with a combined sample size of 1652 individuals with ASD and 1626 typically developing individuals was conducted to analyze factors that may affect EM in ASD. The results showed that ASD had a significant medium to large effect size decrease in EM ability. Age period, task type, and reporting method significantly reduced the observed heterogeneity while EM type did not reduce the observed heterogeneity. The results of the meta-regression revealed that it was verbal IQ rather than full-scale IQ that was significantly correlated with EM in individuals with ASD. These findings suggest that individuals with ASD have reduced EM abilities and the potential factors is still needed to be explored.

Self-processing and social functioning in autistic preschoolers

There is evidence of weak self-processing in autism spectrum disorder (ASD), including diminished self-reference effects (SREs) in memory. Because smaller SREs in older ASD children and adults are sometimes associated with worse social functioning, we examined this relation for the first time in ASD preschoolers (n = 21). Following a self-performed task, children completed tests of self/other source memory, verbal ability, imitation and mentalizing. Although the ASD children were outperformed on the socio-cognitive measures by non-autistic preschoolers (n = 20), they still showed a significant SRE. Moreover, the SRE, but not the socio-cognitive variables, was a significant predictor of children's social functioning as rated by parents. Larger SREs were linked with better social functioning, while children with stronger autism traits showed no memory advantage for information encoded self-referentially. These findings support previous research showing that self-processing impairments in ASD are mainly apparent for individuals with greater social difficulties.

Can Enactment and Motor Imagery Improve Working Memory for Instructions in Children with Autism Spectrum Disorder and Children with Intellectual Disability?

This study explored the impacts of enactment and motor imagery on working memory for instructions in children with autism spectrum disorder (ASD), children with intellectual disability (ID) and typically developing (TD) children. The participants were asked to hear (hearing condition), imagine enacting (motor imagery condition) and actually enact (enactment condition) instruction sequences and then recall them orally. Compared with the hearing condition, all groups performed better in the enactment condition, with the greatest advantage exhibited by the TD group; however, only the TD children performed better in the motor imagery condition. In summary, enactment has a weaker facilitating effect on ASD children and ID children than on TD children, and motor imagery is ineffective in the former two groups.

Exploring techniques for encoding spoken instructions in working memory: a comparison of verbal rehearsal, motor imagery, self-enactment and action observation

Encoding and recalling spoken instructions is subject to working memory capacity limits. Previous research suggests action-based encoding facilitates instruction recall, but has not directly compared benefits across different types of action-based techniques. The current study addressed this in two experiments with young adults. In Experiment 1, participants listened to instructional sequences containing four action-object pairs, and encoded these instructions using either a motor imagery or verbal rehearsal technique, followed by recall via oral repetition or enactment. Memory for instructions was better when participants used a motor imagery technique during encoding, and when recalling the instructions by enactment. The advantage of using a motor imagery technique was present in both verbal and enacted recall. In Experiment 2, participants encoded spoken instructions whilst implementing one of four techniques (verbal rehearsal, motor imagery, observation of others' actions or self-enactment), and then recalled the instructions by oral repetition or enactment. For both verbal and enacted recall, memory for instructions was least accurate in the rehearsal condition, while the other encoding conditions did not differ from each other. These novel findings indicate similar benefits of imagining, observation and execution of actions in encoding spoken instructions, and enrich current understanding of action-based benefits in working memory.

Is visual metacognition associated with autistic traits? A regression analysis shows no link between visual metacognition and Autism-Spectrum Quotient scores

Metacognition -the human ability to recognize correct decisions- is a key cognitive process linked to learning and development. Several recent studies investigated the relationship between metacognition and autism. However, the evidence is still inconsistent. While some studies reported autistic people having lower levels of metacognitive sensitivity, others did not. Leveraging the fact that autistic traits are present in the general population, our study investigated the relationship between visual metacognition and autistic traits in a sample of 360 neurotypical participants. We measured metacognition as the correspondence between confidence and accuracy in a visual two alternative forced choice task. Autistic-traits were assessed through the Autism-spectrum Quotient (AQ) score. A regression analysis revealed no statistically significant association between autistic traits and metacognition or confidence. Furthermore, we found no link between AQ sub-scales and metacognition. We do not find support for the hypothesis that autistic traits are associated with metacognition in the general population.

A meta-analysis and critical review of metacognitive accuracy in autism

LAY ABSTRACT

The ability to make accurate judgements about our own and others' mental states has been widely researched; however, it is unclear how these two abilities relate to each other. This is important given that there is evidence that autistic individuals can have difficulty with accurately judging others' mental states. Recent evidence suggests that some autistic individuals may also have difficulty accurately judging their own mental states. This may have an impact on various aspects of everyday life but particularly academic success, and therefore it is important that this skill is not overlooked when exploring areas of individual support. The aim of this article is to bring together the research examining autistic individual's ability of making accurate judgements about their own mental states and to establish whether this is an area that warrants further investigation. The results from this article show that autistic individuals may have difficulty making accurate judgements about their own mental states, although this depends on the type of judgement being made. It also highlighted that while autistic children may have difficulties in some areas, these may improve by adulthood. Overall, this article shows that more research is needed to fully understand where specific difficulties lie and how they may be overcome.

A review of procedural and declarative metamemory development across childhood

Metamemory is a component of metacognition that includes both the knowledge of factors that affect memory (i.e. declarative metamemory) and knowledge and application of factors in one's own learning and recall performance (i.e. procedural metamemory). The current paper aims to provide a comprehensive review of studies examining metamemory ability development from preschool into adolescence in order to improve the understanding of metamemory, its developmental course, and the available assessment methods. We examined the developmental trajectory of procedural and declarative metamemory abilities for both typically developing children and clinical populations. We found procedural metamemory abilities emerge around 4 to 5 years old, and significantly improve across childhood and into adulthood, although less is known about metamemory development across adolescence in typically developing children. Additionally, metamemory abilities vary significantly based on clinical pathology, although relatively fewer studies have examined these abilities in children with neurodevelopmental disorders or other neurologic conditions, such as acquired brain injury. The methods of metamemory assessment varied significantly across studies as well, indicating a need for a standardized metamemory measure, which would have high utility for clinical care.

Memory for actions and reality monitoring in adults with autism spectrum disorder

Reality monitoring is the cognitive process of distinguishing between internally and externally generated information sources such as imagined and performed actions. The purpose of this study was to examine self-self-monitoring with action in people with autism, which has not been examined previously, using subject performed tasks along with free recall and recognition. Twenty adults with ASD and 20 adults with typical development (TD) participated in this study. Participants memorized action sentences such as "write in pencil" and "under imagined, pantomime, or enacted conditions." Free recall, yes/no recognition, and reality monitoring tests were conducted immediately after and one week later. There was no difference in reality monitoring between the ASD and TD groups. The free recall and recognition performance of the ASD group was lower than that of the TD group. The results of the present study support the previously reported finding of unimpaired retrospective mechanisms of sense of agency related to reality monitoring in people with ASD. Moreover, low levels of free recall and recognition were discussed regarding difficulties in memory reconstruction and consolidation.

Investigating socioecological obesogenic factors in children with Autism Spectrum Disorder

Obesity-related information in children with Autism Spectrum Disorder (ASD) is limited, and research findings are contradictory. Thus, this study aimed to use a nationwide non-clinical sample to examine the association of sociological factors with overweight status in children with ASD and reveal the degree of differences in the risk factors for overweight in children with and without ASD. The data for this cross-sectional study, based on the modified ecological system theory model, were obtained from the 2019 National Survey of Children's Health. The weighted logistic regressions were performed to determine the factors associated with overweight status in children with ASD, controlling for demographics, physical activity-related behaviors, and family and environmental conditions. A total of 529 children were identified (mean age 13.78 years, 83.21% boys). Two-parent households, less healthy parents and households, households with smokers, poor sleep quality, and greater participation in organized activities were associated with a higher likelihood of overweight in children with ASD (all P < 0.05). The determinants of obesity among children with ASD go beyond the individual level; family and community support are important. Therefore, greater attention should be directed toward the families of children with ASD and community-level administrative policies to improve quality of life by preventing or reducing obesity in children with ASD.

Memory and metamemory for actions in children with autism: Exploring global metacognitive judgements

BACKGROUND

Standards in education emphasize the role of metacognition in successful academic outcomes for those with and without learning challenges. Research into metamemory in Autism Spectrum Disorder (ASD) has produced mixed outcomes, with some studies finding children with ASD to have spared metacognitive accuracy and others finding it impaired. While most research has used item-by-item metamemory judgements, the novelty of the current study was to use global judgments-of-learning (global JOLs).

METHOD

Twenty-three children with and twenty without ASD were presented with two lists of action words during a learning phase and were asked to either act out the words in a self-performed task or just listen to them being read aloud in a verbal task (control condition). Typically, self-performance produces memory benefits called the enactment effect. For both tasks, children also made pre-learning and post-learning global JOLs, stating how many words they thought they would recall.

RESULTS

Both groups demonstrated the enactment effect, but neither predicted its beneficial effect. Compared to controls, participants with ASD were found to be less accurate in predicting their future memory performance, specifically in the self-performed task. Both groups were comparable in terms of metacognitive monitoring.

CONCLUSIONS

Overall, the findings suggest that success or failure in metacognitive tasks in ASD might depend on task difficulty, and the type of metacognitive judgement used.

Strategic decision making and prediction differences in autism

Background

Several theories in autism posit that common aspects of the autism phenotype may be manifestations of an underlying differentiation in predictive abilities. The present study investigates this hypothesis in the context of strategic decision making in autistic participants compared to a control group.

Method

Autistic individuals (43 adults, 35 male) and a comparison group (42 adults, 35 male) of age and gender matched individuals, played a modified version of the prisoner's dilemma (PD) task where they were asked, if capable, to predict their opponents' move. The predictive performance of the two groups was assessed.

Results

Overall, participants in the autism group had a significantly lower number of correct predictions. Moreover, autistic participants stated, significantly more frequently than the comparison group, that they were unable to make a prediction. When attempting a prediction however, the success ratio did not differ between the two groups.

Conclusions

These findings indicate that there is a difference in prediction performance between the two groups. Although our task design does not allow us to identify whether this difference is due to difficulty to form a prediction or a reluctance in registering one, these findings could justify a role for prediction in strategic decision making during the PD task.

Subject-performed task effect on working memory performance in children with autism spectrum disorder

A previous study found that children with autism spectrum disorder (ASD) have better recall when they perform instructions (subject-performed task [SPT]) than when they passively hear instructions (verbal task [VT]) in a working memory task for instructions, an effect that is called the SPT effect. This study explored whether the SPT effect exhibited by ASD children is caused by the movement component or by processing materials twice. More importantly, this study explored whether intelligence influences the SPT effect exhibited by ASD children. ASD children with three levels of intelligence (N = 56) and a control group, children with intellectual disability (ID) who had low intelligence but did not have ASD (N = 21), were asked to perform working memory tasks for instructions under VT, SPT and repeated (hearing the instruction twice) conditions. No significant difference in performance was observed between the VT and repeated conditions, regardless of the child's level of intelligence. ASD children with lower-middle intelligence exhibited a smaller SPT effect than ASD children with upper-middle intelligence. Critically, while ASD children with low intelligence did not exhibit the SPT effect, an ID group with equivalent low intelligence did show this effect. Therefore, these results show that the SPT effect for ASD children is caused by the movement component and is uniquely associated with a certain level of intelligence, namely, lower middle and higher levels of intelligence. LAY SUMMARY: In ASD children, the benefit of physically performing instructions for working memory performance is uniquely associated with a certain level of intelligence. Only ASD children with lower-middle intelligence (and higher) benefit from physically performing instructions, and higher intelligence increases this benefit; ASD children with low intelligence do not show this benefit. This benefit in ASD children is attributed to the additional motoric code generated by physical performance.

Improving older adults' ability to follow instructions: benefits of actions at encoding and retrieval in working memory

The ability to follow instructions is critical for learning new skills and may support successful aging. Recent evidence indicates a close link between following instructions and working memory, and that action-based processing at encoding and retrieval can improve this ability. In this study, we examined the ability to follow instructions and the benefits of action-based processing in young and older adults. In Experiment 1, participants were presented with spoken or silent demonstrated instructions, then recalled them by oral repetition or physical enactment. Older adults produced fewer correct responses in all conditions. Both age groups were better at recalling demonstrated than spoken instructions in the verbal but not the enacted recall condition. Older adults also benefited from enacted recall relative to verbal recall, but to a smaller extent than younger adults. In Experiment 2, the additional benefit of dual modalities (spoken instructions with simultaneous demonstration) relative to single modality presentation (spoken instructions, or silent demonstration) was examined. Both age groups showed superior performance in dual modality conditions relative to spoken instructions when using verbal recall. These findings suggest that although following instruction ability appears to decline with age, older adults can still benefit from action at encoding and retrieval.

Intact context memory performance in adults with autism spectrum disorder

Research on memory in autism spectrum disorder (ASD) finds increased difficulty encoding contextual associations in episodic memory and suggests executive dysfunction (e.g., selective attention, cognitive flexibility) and deficient metacognitive monitoring as potential contributing factors. Findings from our lab suggest that age-related impairments in selective attention contribute to those in context memory accuracy and older adults tended to show dependence in context memory accuracy between relevant and irrelevant context details (i.e., hyper-binding). Using an aging framework, we tested the effects of selective attention on context memory in a sample of 23 adults with ASD and 23 typically developed adults. Participants studied grayscale objects flanked by two types of contexts (color, scene) on opposing sides and were told to attend to only one object-context relationship, ignoring the other context. At test, participants made object and context recognition decisions and judgment of confidence decisions allowing for an evaluation of context memory performance, hyper-binding, and metacognitive performance for context judgments in a single task. Results showed that adults with ASD performed similarly to typically developed adults on all measures. These findings suggest that context memory performance is not always disrupted in adults with ASD, even when demands on selective attention are high. We discuss the need for continued research to evaluate episodic memory in a wider variety of adults with 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.

Age-related differences in adults' ability to follow spoken instructions

A growing body of research illustrates that working memory capacity is a crucial limiting factor in our ability to follow spoken instructions. Despite the ubiquitous nature of instruction following throughout the lifespan, how the natural ageing process affects the ability to do so is not yet fully understood. In this study, we investigated the consequences of action at encoding and recall on the ability to follow spoken instructions. Younger (< 30 y/o) and older (> 65 y/o) adults recalled sequences of spoken action commands under presentation and recall conditions that either did or did not involve their physical performance. Both groups showed an enacted-recall advantage, with superior recall by physical performance than oral repetition. When both encoding and recall were purely verbal, older adults' recall accuracy was comparable to that of their younger counterparts. When action was involved at either encoding or recall, however, the difference in performance between the two age groups became pronounced: enactment-based encoding significantly improved younger adults' ability to follow spoken instructions; there was no such advantage for older adults. These data show that spatial-motoric representations disproportionately benefit younger adults' memory performance. We discuss the practical implications of these findings in the context of lifelong learning.

Comparing motor imagery and verbal rehearsal strategies in children's ability to follow spoken instructions

The ability to follow spoken instructions is critical for children's learning in school and relies on the storage and processing of information in working memory. This study compared the effects of two encoding strategies (motor imagery and verbal rehearsal) on children's ability to follow spoken instructions in a working memory paradigm. A total of 146 children aged 7-12 years completed an instruction span task. In this task, children listened to a series of action-object commands and encoded them by either motor imagery or verbal rehearsal. They then attempted to recall the sequence in serial order by either enacted recall or verbal recall. Overall, children's ability to follow spoken instructions increased with age. In all age groups, children showed superior recall of instructions when they imagined the actions compared with verbal rehearsal of the actions during encoding, and this benefit of motor imagery was similar for verbal recall and enacted recall. Younger children reported motor imagery as more helpful than verbal rehearsal for remembering instructions, whereas older children considered verbal rehearsal as more useful. The study provides novel evidence for motor imagery as a superior strategy (relative to verbal rehearsal) for remembering spoken instructions in school-age children.

Linking metacognition and mindreading: Evidence from autism and dual-task investigations

Questions of how we know our own and other minds, and whether metacognition and mindreading rely on the same processes, are longstanding in psychology and philosophy. In Experiment 1, children/adolescents with autism (who tend to show attenuated mindreading) showed significantly lower accuracy on an explicit metacognition task than neurotypical children/adolescents, but not on an allegedly metacognitive implicit one. In Experiment 2, neurotypical adults completed these tasks in a single-task condition or a dual-task condition that required concurrent completion of a secondary task that tapped mindreading. Metacognitive accuracy was significantly diminished by the dual-mindreading-task on the explicit task but not the implicit task. In Experiment 3, we included additional dual-tasks to rule out the possibility that any secondary task (regardless of whether it required mindreading) would diminish metacognitive accuracy. Finally, in both Experiments 1 and 2, metacognitive accuracy on the explicit task, but not the implicit task, was associated significantly with performance on a measure of mindreading ability. These results suggest that explicit metacognitive tasks (used frequently to measure metacognition in humans) share metarepresentational processing resources with mindreading, whereas implicit tasks (which are claimed by some comparative psychologists to measure metacognition in nonhuman animals) do not. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Memory enhancements from active control of learning in children with autism spectrum disorder

LAY ABSTRACT

Research with adults and typically developing children has shown that being able to actively control their learning experience, that is, to decide what to learn, when, and at what pace, can boost learning in a variety of contexts. In particular, previous research has shown a robust advantage of active control for episodic memory as compared with conditions lacking this control. In this article, we explore the potential of active control to improve learning of 6- to 12-year-old children diagnosed with autism spectrum disorder. We presented them with a simple memory game on a touchscreen tablet, in which children were asked to recall as many of the presented objects as possible. For half of the objects, children could decide the order and pacing of study (active condition); for the other half, they passively observed the study decisions of a previous participant (yoked condition). We found that recognition memory was more accurate when children could actively control the order, pace, and frequency of the study experience, even after a week-long delay. We discuss how teachers and educators might promote active learning approaches in educational and pedagogical applications to support inclusive learning.

Metacognitive Monitoring and Control of Eyewitness Memory Reports in Autism

Providing eyewitness testimony involves monitoring one's memory to provide a detailed and accurate account: reporting details likely to be accurate and withholding potentially inaccurate details. Autistic individuals reportedly experience difficulties in both retrieving episodic memories and monitoring their accuracy, which has important implications for eyewitness testimony. Thirty autistic and 33 IQ‐matched typically developing (TD) participants viewed a video of a mock bank robbery followed by three phases of questions (with judgments of confidence). In Phase 1, participants freely generated the granularity of their responses (i.e., fine‐ or coarse‐grained). In Phase 2, participants answered the same questions but provided both a fine‐ and a coarse‐grained answer. In Phase 3, participants were instructed to maximize accuracy over informativeness by selecting one of their Phase 2 answers as their final answer. They either received the questions socially (from the experimenter) or answered them online. There were no group differences in accuracy or metacognitive monitoring, with both autistic and TD witnesses demonstrating: (a) a strong preference for reporting fine‐grained details at the expense of accuracy; (b) improved though still suboptimal grain size reporting when instructed to maximize accuracy over informativeness; (c) effective accuracy monitoring; and (d) higher overall accuracy when questions were delivered socially. There was, however, a subtle difference in metacognitive control, with autistic witnesses performing more poorly than TD witnesses when questions were delivered socially, but not when they were delivered online. These findings contrast with evidence suggesting that autism is marked by impairments in episodic memory and metacognitive monitoring and control. Autism Res 2020, 13: 2017‐2029. © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc.

Lay Summary

Autistic people have been reported to experience subtle difficulties in monitoring and regulating their information reporting, which has important implications for providing eyewitness testimony. We found that autistic witnesses' testimony comprised a similar level of detail and accuracy as non‐autistic witnesses' accounts. However, autistic people found it difficult to optimize their testimony when the questions were delivered socially—but not when they answered the questions online. © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc.

Putting Your Money Where Your Mouth is: Examining Metacognition in ASD Using Post-decision Wagering

It has been argued that metacognition and mindreading rely on the same cognitive processes (Carruthers in The opacity of mind: an integrative theory of self-knowledge, Oxford University Press, Oxford, 2011). It is widely accepted that mindreading is diminished among individuals diagnosed with autism (Brunsdon and Happé in Autism 18(1):17–30, 2014), however, little is known about metacognition. This study examined metacognition in relation to mindreading and autism using post-decision wagering. Results from a student sample showed negative associations between autism traits and metacognitive accuracy, and metacognitive reaction times and mindreading. These findings were replicated in a general population sample, providing evidence of a reliable association between metacognition, mindreading and autism traits. However, adults diagnosed with autism showed equivalent levels of metacognitive accuracy to age- and IQ-matched comparison participants, albeit only with an overall increase in meta-level processing time.

Exploring the effects of demonstration and enactment in facilitating recall of instructions in working memory

Across the lifespan the ability to follow instructions is essential for the successful completion of a multitude of daily activities. This ability will often rely on the storage and processing of information in working memory, and previous research in this domain has found that self-enactment at encoding or observing other-enactment at encoding (demonstration) improves performance at recall. However, no working memory research has directly compared these manipulations. Experiment 1 explored the effects of both self-enactment and demonstration on young adults’ (N=48) recall of action-object instruction sequences (e.g. ‘spin the circle, tap the square’). Both manipulations improved recall, with demonstration providing relatively larger boosts to performance across conditions. More detailed analyses suggested that this improvement was driven by improving the representations of actions, rather than objects, in these action-object sequences. Experiment 2 (N=24) explored this further, removing the objects from the physical environment and comparing partial demonstration (i.e. action-only or object-only) with no or full demonstration. The results showed that partial demonstration only benefitted features that were demonstrated, while full demonstration improved memory for actions, objects and their pairings. Overall these experiments indicate how self-enactment, and particularly demonstration, can benefit verbal recall of instruction sequences through the engagement of visuo-motor processes that provide additional forms of coding to support working memory performance.

Forward and backward recall of serial actions: Exploring the temporal dynamics of working memory for instruction

The ability to flexibly retrieve and implement sequences of actions is essential to motor learning and planning. Recent research has indicated that serial memory for instructions is influenced by presentation modality (spoken vs. visual demonstration) and recall modality (verbal vs. enacted recall). The present study extended this work by investigating the impact of recall direction (forward vs. backward), in addition to that of presentation and recall modality, on working memory for instruction sequences in healthy young adults. Experiment 1 (N = 24) showed that adults were more accurate in backward than forward verbal recall following spoken instructions. In contrast, enacted recall was not influenced by recall direction. Experiment 2 (N = 24) used visual demonstration of instruction sequences and found similar performance levels in forward and backward recall. Experiment 3 (N = 24) replicated the findings from Experiment 1 and 2, along with the previous observation of an advantage for demonstrated over spoken presentation. In addition, the beneficial effects of enacted recall and visual demonstration also emerged in an analysis of response times, specifically in reduced preparation and recall duration. Demonstrated instructions improved maintenance of all items while backward recall enhanced memory of later items in the sequence. These findings provide new insights into the cognitive processes and temporal dynamics of working memory for serial actions and instructions.

Brief Report: Memory for Self-Performed Actions in Adults with Autism Spectrum Disorder: Why Does Memory of Self Decline in ASD?

The decline in self-related memory in ASD was investigated by using encoding, forgetting, and source monitoring. Participants memorized action sentences verbally, observationally, or by enacted encoding. Then, they underwent recall, recognition, and source monitoring memory tests immediately and 1 week later. If the information were properly encoded, memory performance in the enacted encoding would be the highest (enactment effect). The result of memory tests in ASD and TD people showed that enacted encoding was superior. However, recall and source monitoring in ASD was significantly lower than in TD, which was not the case for recognition and forgetting. These results suggest that the decline in memory of self in ASD is associated with a deficit in memory reconstruction and source monitoring.

Do actions speak louder than words? Examining children's ability to follow instructions

The ability to encode, retain, and implement instructions within working memory is central to many behaviours, including classroom activities which underpin learning. The three experiments presented here explored how action—planned, enacted, and observed—impacted 6- to 10-year-old’s ability to follow instructions. Experiment 1 (N = 81) found enacted recall was superior to verbal recall, but self-enactment at encoding had a negative effect on enacted recall and verbal recall. In contrast, observation of other-enactment (demonstration) at encoding facilitated both types of recall (Experiment 2a: N = 81). Further, reducing task demands through a reduced set of possible actions (Experiment 2b; N = 64) led to a positive effect of self-enactment at encoding for later recall (both verbal and enacted). Expecting to enact at recall may lead to the creation of an imaginal spatial-motoric plan at encoding that boosts later recall. However, children’s ability to use the additional spatial-motoric codes generated via self-enactment at encoding depends on the demands the task places on central executive resources. Demonstration at encoding appears to reduce executive demands and enable use of these additional forms of coding.

Following Instructions in Patients With Schizophrenia: The Benefits of Actions at Encoding and Recall

The ability to follow spoken instructions is important to everyday functioning but has seldom been studied in patients with schizophrenia (SZ). Recent evidence suggests that action-based processing may facilitate the ability to follow instructions, which relies largely on working memory. In this study, we tested the hypothesis that SZ patients may also benefit from action-based advantages in following instructions. Forty-eight clinically stable SZ patients and 48 demographic- and IQ-matched controls completed a following spoken instruction span task involving varied encoding and recall conditions. While SZ patients were impaired in the overall performance of following spoken instructions, this deficit could be attributed to working memory impairment. More importantly, SZ patients showed action-based advantages both at the encoding and retrieval stage to the same extent as healthy controls. Specifically, both healthy controls and SZ patients showed improved memory performance when they additionally performed the actions, or watched the experimenter carrying out the actions compared with simply listening to spoken instructions during the encoding stage. During the retrieval stage, memory was improved when they recalled the instructions by physical enactment compared with oral repetition. The present study provides the first empirical evidence for the impairment in the ability to follow instructions in SZ. We have shown that involving action-based processing in the encoding and retrieval stage facilitated memory of instructions, indicating that the enactment advantage in working memory also applies to SZ patients. These findings provide useful insights for clinical interventions and cognitive remediation for SZ patients.

Following instructions from working memory: Why does action at encoding and recall help?

Two experiments investigated the consequences of action at encoding and recall on the ability to follow sequences of instructions. Children ages 7–9 years recalled sequences of spoken action commands under presentation and recall conditions that either did or did not involve their physical performance. In both experiments, recall was enhanced by carrying out the instructions as they were being initially presented and also by performing them at recall. In contrast, the accuracy of instruction-following did not improve above spoken presentation alone, either when the instructions were silently read or heard by the child (Experiment 1), or when the child repeated the spoken instructions as they were presented (Experiment 2). These findings suggest that the enactment advantage at presentation does not simply reflect a general benefit of a dual exposure to instructions, and that it is not a result of their self-production at presentation. The benefits of action-based recall were reduced following enactment during presentation, suggesting that the positive effects of action at encoding and recall may have a common origin. It is proposed that the benefits of physical movement arise from the existence of a short-term motor store that maintains the temporal, spatial, and motoric features of either planned or already executed actions.

Impaired Memory for Instructions in Children with Attention-Deficit Hyperactivity Disorder Is Improved by Action at Presentation and Recall

Children with attention deficit hyperactivity disorder (ADHD) often fail to comply with teacher instructions in the classroom. Using action during presentation or recall can enhance typically developing children's abilities to complete multi-step instruction sequences. In this study, we tested the ability to following instructions in children with ADHD under different conditions to explore whether they show the same beneficial effects of action. A total of 24 children with ADHD and 27 typically developing children either listened to or viewed demonstrations of instructions during encoding, and then either verbally repeated or physically performed the sequences during recall. This resulted in four conditions: spoken-verbal, spoken-enacted, demonstration-verbal, and demonstration-enacted. Children with ADHD were significantly impaired in all conditions of the following instructions task relative to the typically developing group. Both groups showed an enacted-recall advantage, with superior recall by physical performance than oral repetition. Both groups also benefitted from demonstration over spoken presentation, but only when the instructions were recalled verbally. These findings suggest that children with ADHD struggle to complete multi-step instructions, but that they benefit from action-based presentation and recall in the same way as typically developing children. These findings have important implications for educators, suggesting that motor-based methods of instruction-delivery might enhance classroom learning both for children with and without developmental disorders.

Metacognitive monitoring and the hypercorrection effect in autism and the general population: Relation to autism(-like) traits and mindreading

Among neurotypical adults, errors made with high confidence (i.e. errors a person strongly believed they would not make) are corrected more reliably than errors made with low confidence. This 'hypercorrection effect' is thought to result from enhanced attention to information that reflects a 'metacognitive mismatch' between one's beliefs and reality. In Experiment 1, we employed a standard measure of this effect. Participants answered general knowledge questions and provided confidence judgements about how likely each answer was to be correct, after which feedback was given. Finally, participants were retested on all questions answered incorrectly during the initial phase. Mindreading ability and autism spectrum disorder-like traits were measured. We found that a representative sample of ( n = 83) neurotypical participants made accurate confidence judgements (reflecting good metacognition) and showed the hypercorrection effect. Mindreading ability was associated with autism spectrum disorder-like traits and metacognition. However, the hypercorrection effect was non-significantly associated with mindreading or autism spectrum disorder-like traits. In Experiment 2, 11 children with autism spectrum disorder and 11 matched comparison participants completed the hypercorrection task. Although autism spectrum disorder children showed significantly diminished metacognitive ability, they showed an undiminished hypercorrection effect. The evidence in favour of an undiminished hypercorrection effect (null result) was moderate, according to Bayesian analysis (Bayes factor = 0.21).

Metacognitive Awareness of Facial Affect in Higher-Functioning Children and Adolescents with Autism Spectrum Disorder

Higher-functioning participants with and without autism spectrum disorder (ASD) viewed a series of face stimuli, made decisions regarding the affect of each face, and indicated their confidence in each decision. Confidence significantly predicted accuracy across all participants, but this relation was stronger for participants with typical development than participants with ASD. In the hierarchical linear modeling analysis, there were no differences in face processing accuracy between participants with and without ASD, but participants with ASD were more confident in their decisions. These results suggest that individuals with ASD have metacognitive impairments and are overconfident in face processing. Additionally, greater metacognitive awareness was predictive of better face processing accuracy, suggesting that metacognition may be a pivotal skill to teach in interventions.

The influence of input and output modality on following instructions in working memory

Following instructions is an important component of learning and has been shown to rely on working memory. This study examined the ability to follow instructions within working memory under varying input and output modalities. In Experiment 1, participants heard, read, or viewed demonstration of short sequences of instructions, and recalled either by oral repetition or physical enactment. There was a significant main effect of encoding, showing superior recall performance when instructions were demonstrated relative to spoken or written presentation. Experiment 2 examined whether recall is further improved when instructions are presented both in spoken and demonstrated form, relative to single modality presentation. The advantage for demonstration over spoken instructions was replicated, and dual input was superior to spoken instructions. However, dual input did not bring extra benefit compared to demonstration of instructions. We also observed a significant enacted-retrieval recall advantage. These findings suggest effects of both input and output modalities on the ability to remember and follow instructions in working memory. Outcomes substantially inform the underexplored but important new area of action-based working memory and its links to embodied cognition, with implications for pedagogic practice.

Online action monitoring and memory for self-performed actions in autism spectrum disorder

This study explored whether individuals with autism spectrum disorder (ASD) experience difficulties with action monitoring. Two experimental tasks examined whether adults with ASD are able to monitor their own actions online, and whether they also show a typical enactment effects in memory (enhanced memory for actions they have performed compared to actions they have observed being performed). Individuals with ASD and comparison participants showed a similar pattern of performance on both tasks. In a task which required individuals to distinguish person-caused from computer-caused changes in phenomenology both groups found it easier to monitor their own actions compared to those of an experimenter. Both groups also showed typical enactment effects. Despite recent suggestions to the contrary, these results support suggestions that action monitoring is unimpaired in ASD.

Benefit of enactment over oral repetition of verbal instruction does not require additional working memory during encoding

For this research, we used a dual-task approach to investigate the involvement of working memory in following written instructions. In two experiments, participants read instructions to perform a series of actions on objects and then recalled the instructions either by spoken repetition or performance of the action sequence. Participants engaged in concurrent articulatory suppression, backward-counting, and spatial-tapping tasks during the presentation of the instructions, in order to disrupt the phonological-loop, central-executive, and visuospatial-sketchpad components of working memory, respectively. Recall accuracy was substantially disrupted by all three concurrent tasks, indicating that encoding and retaining verbal instructions depends on multiple components of working memory. The accuracy of recalling the instructions was greater when the actions were performed than when the instructions were repeated, and this advantage was unaffected by the concurrent tasks, suggesting that the benefit of enactment over oral repetition does not cost additional working memory resources.

Recall of a live and personally experienced eyewitness event by adults with autism spectrum disorder

The aim of the present study was to (a) extend previous eyewitness research in autism spectrum disorder (ASD) using a live and personally experienced event; (b) examine whether witnesses with ASD demonstrate a facilitative effect in memory for self- over other-performed actions; (c) explore source monitoring abilities by witnesses with ASD in discriminating who performed which actions within the event. Eighteen high-functioning adults with ASD and 18 age- and IQ-matched typical counterparts participated in a live first aid scenario in which they and the experimenter each performed a number of actions. Participants were subsequently interviewed for their memory of the event using a standard interview procedure with free recall followed by questioning. The ASD group recalled just as many correct details as the comparison group from the event overall, however they made more errors. This was the case across both free recall and questioning phases. Both groups showed a self-enactment effect across both interview phases, recalling more actions that they had performed themselves than actions that the experimenter had performed. However, the ASD group were more likely than their typical comparisons to confuse the source of self-performed actions in free recall, but not in questioning, which may indicate executive functioning difficulties with unsupported test procedures. Findings are discussed in terms of their theoretical and practical implications.

Working memory and the enactment effect in early Alzheimer's disease

This study examines the enactment effect in early Alzheimer's disease using a novel working memory task. Free recall of action-object instruction sequences was measured in individuals with Alzheimer's disease (n = 14) and older adult controls (n = 15). Instruction sequences were read out loud by the experimenter (verbal-only task) or read by the experimenter and performed by the participants (subject-performed task). In both groups and for all sequence lengths, recall was superior in the subject-performed condition than the verbal-only condition. Individuals with Alzheimer's disease showed a deficit in free recall of recently learned instruction sequences relative to older adult controls, yet both groups show a significant benefit from performing actions themselves at encoding. The subject-performed task shows promise as a tool to improve working memory in early Alzheimer's disease.

Subjective experience of episodic memory and metacognition: a neurodevelopmental approach

Episodic retrieval is characterized by the subjective experience of remembering. This experience enables the co-ordination of memory retrieval processes and can be acted on metacognitively. In successful retrieval, the feeling of remembering may be accompanied by recall of important contextual information. On the other hand, when people fail (or struggle) to retrieve information, other feelings, thoughts, and information may come to mind. In this review, we examine the subjective and metacognitive basis of episodic memory function from a neurodevelopmental perspective, looking at recollection paradigms (such as source memory, and the report of recollective experience) and metacognitive paradigms such as the feeling of knowing). We start by considering healthy development, and provide a brief review of the development of episodic memory, with a particular focus on the ability of children to report first-person experiences of remembering. We then consider neurodevelopmental disorders (NDDs) such as amnesia acquired in infancy, autism, Williams syndrome, Down syndrome, or 22q11.2 deletion syndrome. This review shows that different episodic processes develop at different rates, and that across a broad set of different NDDs there are various types of episodic memory impairment, each with possibly a different character. This literature is in agreement with the idea that episodic memory is a multifaceted process.

Metacognitive judgments-of-learning in adolescents with autism spectrum disorder

This study investigated metacognitive monitoring abilities in adolescents with autism spectrum disorder in two experiments using the judgment-of-learning paradigm. Participants were asked to predict their future recall of unrelated word pairs during the learning phase. Experiment 1 compared judgments-of-learning made immediately after learning and judgments-of-learning made after a delay. We found that both groups overestimated their memory performance but that overall there were no group differences in judgment-of-learning accuracy. Additionally, both groups displayed the standard delayed judgment-of-learning effect (yielding greater judgment accuracy in delayed compared to immediate judgments), suggesting that both groups were able to use appropriate information in making their judgments-of-learning. Experiment 2 assessed whether adolescents with autism spectrum disorder could regulate their study time according to their judgments-of-learning using a self-paced learning procedure. Results showed that both groups spent more time learning items given lower judgments-of-learning. Finally, Experiment 2 showed that judgments-of-learning and study time varied according to item difficulty in both groups. As a whole, these findings demonstrate that adolescents with autism spectrum disorder can accurately gauge their memory performance while learning new word associations and use these skills to control their study time at learning.