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Neuropsycholo`ia\ Vol[ 24\ No[ 0\ pp[ 54Ð69\ 0886


Copyright Þ 0885 Elsevier Science Ltd[ All rights reserved
Pergamon PII] S9917Ð2821"85#99943Ð0 Printed in Great Britain
9917Ð2821:86 ,06[99¦9[99

Asperger|s syndrome and memory] Similarity to


autism but not amnesia
DERMOT M[ BOWLER\ NICOLA J[ MATTHEWS and JOHN M[ GARDINER
Department of Psychology\ City University\ London\ U[K[

"Received 7 January 0885^ accepted 1 May 0885#

Abstract*Two experiments are described in which the memory of adults with Asperger|s syndrome is compared with that of verbal
IQ controls[ The results of the _rst experiment showed that the Asperger subjects resembled autistic adults and children in their
failure to use category information to aid their free recall[ In the second experiment\ both groups of subjects showed similar priming
e}ects in an implicit stem completion task and similar performance on an explicit cued recall task[ Moreover\ both groups also
showed more priming for items that they had read at study and better recall for items that they had to generate at study\ suggesting
that the cued recall of the Asperger subjects did not result from contamination by automatic or involuntary processes[ Copyright Þ
0885 Elsevier Science Ltd[

Key Words] Asperger|s syndrome^ memory^ autism[

Introduction short!term and serial memory tasks ð10Ł\ they are imp!
aired in their longer!term memory\ especially in free recall
There has been much debate on whether Asperger|s tasks ð4\ 5\ 6Ł[ Such observations have led Boucher and
syndrome ð0\ 1Ł and autism ð03Ł constitute distinct dis! Warrington to draw comparisons between autism and
orders or are situated on a continuum ð04Ł[ Whereas the amnesic syndrome\ which is partly characterized by
classically autistic children are frequently mentally a de_cit in long!term memory and in the ability to form
retarded\ show motor stereotypies and delayed and devi! new associations "see ð19Ł#[ Autistic children\ unlike con!
ant language\ people with Asperger|s syndrome are of trols\ have also been found to be unable to use category
normal intelligence\ show more abstract stereotypies\ information to help their free recall ð15Ł\ thereby re_ning
such as specialized interests in radio transmitters or bus an earlier observation\ made by Hermelin and O|Connor
timetables\ and show no abnormalities of language apart ð09Ł\ that autism involves a basic cognitive de_cit in the
from either ~at or exaggerated intonation patterns[ The ability to process stimuli in an elaborative\ meaningful way[
current consensus is that\ although there are di}erences However\ several studies have failed to _nd evidence
in some areas of psychological functioning\ there are also of any impairment in cued recall\ either with perceptual
many areas of similarity\ most notably in the area of cues\ such as FR for FRUIT or CHA for CHAIR ð6Ł\
social impairment[ rhyme cues or category name cues ð15Ł\ or other con!
Clinical accounts of children with Kanner!type autism ceptual cues such as leading questions ð5Ł[ Here\ the par!
describe them as having a good rote memory ð05Ł\ and allel between autism and amnesia breaks down\ since
such accounts of higher!functioning children and adults amnesics are typically impaired in cued recall too\ as
with Asperger|s syndrome document prodigious mem! they are in all explicit memory tasks*those that require
ories for information centred on highly specialized inter! conscious recollection of previous experiences ð7Ł[ The
ests such as bus timetables or dinosaurs ð16Ł[ idea that the memory impairments of people with autism
Experimental studies of children with Kanner!type are less evident when cues are provided than when free
autism show that\ while they appear to be unimpaired on recall is required is further supported by studies by Min!
shew and her colleagues ð06\ 07Ł[ They found no di}er!
ences between high!functioning adults with autism
 Address for correspondence] Department of Psychology\ "people who _t current diagnostic criteria for Kanner!
City University\ Northampton Square\ London EC0V 9HB\ type autism but who are of normal IQ# and controls on
U[K[^ e!mail] d[m[bowlerÝcity[ac[uk[ rote and associative memory but marked di}erences on

54
55 D[ M[ Bowler:Asperger|s syndrome and memory

memory tasks that require comprehension and recall of intentionality criterion|\ was suggested by Schacter et al[
complex visual and auditory material[ Minshew suggests ð13Ł who suggested that\ in addition to keeping all test
that the patterns of strengths and weaknesses seen in the conditions constant\ except the retrieval instructions\ one
memory of high!functioning adults with autism may be should also include some variable known to dissociate
the result not of a memory de_cit per se but of an impair! explicit from implicit performance[ The level of pro!
ment in the application of general strategies\ such as cessing has proved a popular choice\ since it is well estab!
the organization of information into categories\ to the lished that\ although this variable strongly in~uences
information to be remembered[ This pattern resembles explicit performance\ it has little e}ect on performance
the memory impairments reported by Baddeley and Wil! in perceptual priming tasks like word!stem completion
son ð2Ł and Stuss et al[ ð14Ł in patients with frontal lobe "e[g[ ð12Ł#[ If the level of processing were to be shown to
damage\ and underpins other work such as that by Ozon! have a strong e}ect on performance in such an implicit
o} et al[ ð08Ł\ who demonstrated impairments in frontal task\ it could be concluded that subjects must have been
lobe functioning in Asperger and high!functioning autis! responding on an explicit basis[ A particularly powerful
tic subjects[ demonstration of this logic was reported by Java ð01Ł\
Although memory in both high!functioning children who used word stem cues for both explicit and implicit
and adults with Kanner!type autism has been extensively tests following a generate vs read manipulation at study
researched\ as far as we are aware\ there has been little "cf[ ð3\ 00Ł#[ Java found that generating words at study
or no previous experimental investigation of possible led to superior recall in the explicit test\ but reading words
memory impairment in adults with an Asperger diag! at study led to superior completion in the implicit test[
nosis[ The major purpose of this article is to describe such Obviously\ if subjects had been responding in the same
an investigation[ In the light of the recent debate over way in each test\ such a crossover interaction could not
whether or not Asperger|s syndrome and autism are sep! have occurred[ Though this interaction replicated Blax!
arate disorders\ the _rst experiment was a replication on ton ð3Ł and Jacoby|s ð00Ł _ndings\ only the study by Java
adults with Asperger|s syndrome of Tager!Flusberg|s ð15Ł meets the criteria suggested by Schacter et al[ ð13Ł by
study of autistic children and Minshew et al[|s ð07Ł study having identical cues in each kind of test[
of autistic adults\ in order to ascertain if Asperger adults A further aim of our second experiment was to rep!
resemble the other two groups by producing similar licate Java|s ð01Ł study[ Accordingly\ subjects in both
results in their free recall of related and unrelated words[ groups either generated or read the words in a study list\
If they do\ then performance across Asperger and control and were then given implicit and explicit memory with
groups should be similar for an unrelated word list\ and word stem cues[ Both groups should show superior recall
the Asperger group should show signi_cantly lower per! of generated words in the explicit test\ and superior com!
formance for a related word list[ pletion of read words in the implicit test[ The question
The second experiment was designed to investigate the then is whether the Asperger group and the control group
performance of Asperger and control groups in explicit perform similarly in the implicit test\ but di}erently in
compared with implicit memory tasks[ If there is any the explicit test[
parallel between Asperger|s syndrome and the amnesic
syndrome\ then any impairment in the Asperger group
should be evident in the explicit test\ and not in the Experiment 0
Method
implicit test[ This outcome should be obtained even when
the two tests involve identical test cues\ such as word Subjects
stems\ and di}er only with respect to whether subjects
are instructed to use these cues to recall words from the The Asperger group consisted of 05 adults "09 men\ 1
study list\ or to complete them with the _rst words that women#[ They all had a diagnosis of Asperger|s syndrome
come to mind "e[g[ ð8Ł^ see ð11Ł for a general review#[ according to draft ICD09 research criteria but excluding the
In addition\ although some of the earlier _ndings with requirement for absence of delay or deviance in language devel!
opment[ None showed any obvious present state abnormalities
autistic children showed no impairment in cued recall\ at in the structural or semantic aspects of their language[ In
least some of these cued recall tasks might actually have addition\ on the basis of parental interviews\ all were reported
allowed subjects to perform the task as if it were an as not having engaged in symbolic play or joint attention behav!
implicit task "e[g[ ð6Ł#\ that is\ responding with words that iours as children\ and all had Wechsler verbal IQs above 69[
{came to mind| rather than trying consciously to recollect All diagnoses were made by clinicians experienced in the diag!
nosis of autism and were con_rmed by the _rst author[ The
the study list[ The present study would allow us to deter! control group consisted of 05 volunteers recruited from a local
mine whether impaired cued recall resulted from the oper! Job Centre "7 male\ 7 female#[ The control subjects were mat!
ation of automatic or involuntary processes[ ched to the Asperger subjects on both chronological age and
That subjects may not always obey the instructions verbal IQ as measured by the WAIS[ Table 0 summarizes the
they are given in explicit compared with implicit tests\ age and IQ means for both groups[ All subjects were tested
individually and were paid for participating[ The present experi!
and hence that performance might be {contaminated|\ is ments formed part of a larger test battery taken by the subjects\
a problem that has greatly exercised memory theorists in all of whom participated in Experiment 1 followed by Experi!
recent years[ One solution to this problem\ {the retrieval ment 0[
D[ M[ Bowler:Asperger|s syndrome and memory 56

Table 0[ Mean chronological age and psychometric scores for vation that the memory problems of high!functioning
the two experimental groups individuals with autism centre on organizational and con!
Asperger subjects Control subjects trol processes can be extended to individuals with
Asperger|s syndrome[
Chronological age "in years#
Mean 20[1 22[2
S[D[ 00[9 00[3
Mean VIQ 88[33 85[14
Experiment 1
S[D[ 05[61 02[11
Mean PIQ 75[20 85[01 Subjects with Asperger syndrome and IQ!matched
S[D[ 08[11 09[20 controls studied a list of words\ half of which were gen!
Mean IQ 83[95 84[83 erated and half read[ During the generate condition\ all
S[D[ 07[19 00[84
subjects were asked to produce the target word from a
semantic clue and the initial letter of the word "e[g[ red!
dish yellow citrus fruit] O******<#[ The majority
Design and materials of the clues were descriptive phrases but some consisted
of the opposites of the relevant words "e[g[ the opposite
This experiment consisted of two word lists consisting of of enemy] F*******#\ and all were designed to
twelve concrete nouns each as used by Tager!Flusberg ð15Ł[ One ensure that the target words would be generated by all
list contained twelve words drawn from the same category\ i[e[
animals\ and the second list consisted of twelve words taken
the subjects[ In the read task\ subjects simply read the
from di}erent unrelated categories[ In designing these lists target word o} the card[ On completion of the study lists\
Tager!Flusberg had ensured that all the words were approxi! all subjects were given a _ller task followed by a word
mately matched for frequency of use[ stem completion task\ also presented as a _ller task\ and
then a cued recall test with word stem cues[
Procedure

The order of presentation of related and unrelated word lists Method


was counterbalanced across subjects[ Words were presented
verbally at a rate of one word per second[ Subjects were asked Subjects
to listen carefully and to repeat as many of the words as they
could recall as soon as the experimenter had indicated she had The same subjects were used as in Experiment 0[
_nished reading the list by means of a nonverbal signal "looking
up at the subject[ Subjects were allowed as much time as they
required to recall as many words from the list as possible[
Design and materials

The experiment used a 1 "Asperger vs control# ×1 "implicit


Results and discussion vs explicit test# ×1 "generate vs read# mixed repeated measures
design with the order of conditions counterbalanced across
The results of this experiment are outlined in Table 1[ subjects[ Stimuli consisted of 79 di}erent six!letter words taken
Analyses of the data using a repeated measures from a previous study list designed by Java and Gardiner ð02Ł
and listed in the appendix[ Study list words were hand!printed
ANOVA showed signi_cant main e}ects for Group ðF on index cards with the generate cards showing the initial letter
"0\29#  5[03\ P ³ 9[91# and Related:Unrelated lists "F of the target word and either a descriptive phrase or the opposite
"0\29#  16[35\ P ³ 9[990Ł and a Group by Related: of the target word[ These words were randomly divided into
Unrelated lists interaction ðF "0\29#3[36\ P ³ 9[94Ł[ two sets of 39 words each to produce study lists A and B[ Half
Inspection of means shows that the di}erence between the subjects in both experimental groups studied list A and
half studied list B[ Within each study list\ the 39 words were
related and unrelated lists was greater for the control randomly divided into half again\ 19 being presented using the
than for the Asperger subjects[ generate task and 19 using the read task[ Within each study list\
These results demonstrate that the Asperger subjects generate and read words were counterbalanced across subjects[
used here\ like Tager!Flusberg|s ð15Ł autistic children and The two methods of presentation were blocked so that half the
Minshew et al[|s ð06Ł high!functioning adults\ are imp! subjects in each group received the generate task _rst and half
received the read task _rst[
aired in using semantic information in free recall[ The Two test lists were devised\ consisting of 39 word stems each
_ndings thus suggest that Minshew et al[|s ð06\ 07Ł obser! three letters long[ Within each test list\ half of the word stems
were from study list A and half were from study list B\ so that
for each subject\ the test lists were divided equally into studied
Table 1[ Mean number of words recalled in Experiment 0 and novel items[ The novel items that had not previously been
presented to that subject for study provided the baseline mea!
Asperger subjects Control subjects sures of priming and intrusion rates in cued recall[ Of the 19
word stems that had previously been studied by the subjects\
Unrelated word list 4[95 "1[07# 4[45 "0[26# half of these were taken from the generated list and half from
Related word list 5[02 "0[87# 7[95 "0[95# the read list[ The test list that was used to examine implicit
memory for half the subjects in each group was used to test
57 D[ M[ Bowler:Asperger|s syndrome and memory

cued recall for the other half and vice versa\ so that all the recall of generated words in the explicit test\ and superior
subjects were tested for all 79 words[ completion of read words in the implicit test[
Repeated measures analysis of variance supported this
Procedure
description of the data by showing no signi_cant di}er!
Study list items were hand!printed on index cards and pre! ence in overall performance between the two groups ðF
sented individually[ The presentation rate was approximately "0\29# ³ 0Ł[ Signi_cantly more items were completed
one card every 4 sec[ In the generate condition\ subjects were under the implicit than under the explicit conditions
asked to read the clue silently and then to say the target word
aloud[ In the read condition\ subjects were simply asked to read ðF "0\29#  16[24\ P ³ 9[990Ł[ Neither the group by
the words aloud[ The order of presentation was blocked\ i[e[ generate:read nor the group by implicit:explicit nor the
either all generate followed by all read tasks or vice versa\ but three!way "group by generate:read by implicit:explicit#
within each task\ the target words were presented in a unique interactions were signi_cant[ However\ the inter!
random order for each subject[ Neither group of subjects action between the two within!subject variables
showed any di.culty in reading the test materials[
After the presentation of the study list\ subjects were told "implicit:explicit by generate:read# was signi_cant ðF
that there would be two more tasks before they were given a "0\29#  20[02\ P ³ 9[990Ł[ These results therefore rep!
memory test[ Half the subjects were given the Mill Hill Vocabu! licated those obtained by Java ð10Ł and further showed
lary Test and half the Digit Symbol test from the WAIS as that Asperger subjects do not show any evidence of mem!
_ller tasks[ The _ller task was then followed by a word stem ory impairment in explicit compared with implicit tests
completion task which\ in turn\ was followed by the alternative
test list as a cued recall test "following Java ð01Ł#[ In the word! when the retrieval intentionality criterion is met ð13Ł[
stem completion test\ subjects were given sheets with word Since amnesic subjects do show memory impairment
stems printed in capital letters and asked to complete as many under such conditions "e[g[ ð8Ł#\ our results provide no
as they could with the _rst word "apart from proper nouns# support for a parallel between the amnesic syndrome and
that came into their heads[ They were then told that they would autistic disorders[
take the memory test and were given the same stems to
complete\ but this time\ they were asked to use the stems as
cues to remind them of the words that they had studied General discussion
previously[ They were also told that only half the stems related
to words from the study list and were asked not to guess[ Neither The central aim of this study was to provide a sys!
group of subjects showed any evidence of having di.culty in
completing the generate or read tasks[ tematic investigation into the nature of the memory de_!
cits in Asperger|s syndrome[ The results of Experiment 0
Results and discussion clearly showed that the Asperger subjects resemble classi!
cally autistic individuals in their failure to use semantic
The baseline completion rates for nonstudied words information to aid free recall ð15\ 06Ł\ but that in Experi!
for the implicit test were 9[02 for both groups[ The cor! ment 1\ they did not resemble amnesic subjects in a direct
responding intrusion rates for nonstudied words in the comparison between explicit and implicit tests with word
cued recall test were 9[91 for the Asperger group and 9[92 stem cues[ There is\ therefore\ no support for the parallel
for controls[ As these baseline and intrusion rates are between autism and the amnesic syndrome that was _rst
almost identical\ all further analyses were conducted on proposed by researchers such as Boucher and Warrington
uncorrected study word completion rates[ The principal ð6Ł[ In addition\ by replicating Java|s ð01Ł demonstration
results from the word stem completion and the cued recall of a cross!over interaction between the kind of test and
tests for both experimental groups are outlined in Fig[ 0[ generating vs reading the words at study\ the results of
These results indicate that both groups performed in a the second experiment rule out the possibility that the
similar way in each test[ Both groups showed a superior Asperger subjects were responding to the cued recall test

Fig[ 0[ Cued recall and word stem completion in Experiment 1[


D[ M[ Bowler:Asperger|s syndrome and memory 58

in an implicit manner[ This last point is further supported U[ Frith "Editor#\ Cambridge University Press\ Cam!
by the observation that on the cued recall test admin! bridge\ 0880[
istered here\ implicit responses on the explicit test would 2[ Baddeley\ A[ and Wilson\ B[ Frontal amnesia and
probably have led to in~ated intrusion rates for the the dysexecutive syndrome[ Brain and Co`nition 6\
Asperger group had they been responding implicitly[ 101Ð129\ 0877[
3[ Blaxton\ T[ A[ Investigating dissociations among
However\ the comparable baseline and intrusion rates
memory measures] Support for a transfer!appro!
found for both groups suggest that this did not happen[ priate processing framework[ Journal of Exper!
We can\ therefore\ conclude with con_dence that unim! imental Psycholo`y] Learnin` Memory and Co`nition
paired cued recall in people with Asperger|s syndrome 04\ 546Ð557\ 0878[
does not result from the operation of automatic processes 4[ Boucher\ J[ Immediate free recall in early childhood
on an explicit test[ autism] Another point of similarity with the amnesic
The most obvious explanation of the di}erence syndrome[ British Journal of Psycholo`y 61\ 100Ð104\
between the impaired performance in Experiment 0 and 0870[
unimpaired performance in Experiment 1 centres on the 5[ Boucher\ J[ and Lewis\ V[ Memory impairments and
degree of conscious control that subjects had to exercise communication in relatively able autistic children[
over their memory in the two situations[ In the _rst Journal of Child Psycholo`y and Psychiatry 29\ 88Ð
011\ 0878[
experiment\ subjects were given a general instruction to
6[ Boucher\ J[ and Warrington\ E[ Memory de_cits in
learn the word lists and to remember as many of the lists early infantile autism] Some similarities to the am!
as they could[ By contrast\ in the second experiment\ nesic syndrome[ British Journal of Psycholo`y 56\ 62Ð
both the encoding and the retrieval strategies were tightly 76\ 0865[
constrained by the demands of the task[ At the study 7[ Graf\ P[ and Schacter\ D[ Implicit and explicit mem!
phase\ subjects had to read or to generate words\ and ory for new associations in normal and amnesic sub!
at recall\ had to complete word stems[ The _nding in jects[ Journal of Experimental Psycholo`y] Learnin`
Experiment 0 of impairment under unconstrained con! Memory and Co`nition 00\ 490Ð497\ 0874[
ditions coupled with unimpaired performance in Experi! 8[ Graf\ P[\ Squire\ L[ R[ and Mandler\ G[ The infor!
ment 1\ where constraints were strong\ is in line with mation that amnesic patients do not forget[ Journal
Minshew et al[|s ð06\ 07Ł conclusion that people with of Experimental Psycholo`y] Learnin` Memory and
autism perform poorly when they have to develop com! Co`nition 09\ 053Ð067\ 0873[
09[ Hermelin\ B[ and O|Connor\ N[ Psycholo`ical
plex organizing strategies to help in their recall of infor!
Experiments with Autistic Children\ Pergamon\
mation[ Further tests of this account of autistic memory Oxford\ 0869[
de_cits should be aimed at devising a series of experi! 00[ Jacoby\ L[ Remembering the data] Analysing inter!
ments that systematically manipulate the degree of con! active processes in reading[ Journal of Verbal Learn!
trol required of the subject both at study and at recall[ It in` and Verbal Behaviour 11\ 374Ð497\ 0872[
remains possible that the Asperger subjects| performance 01[ Java\ R[ I[ States of awareness following word stem
on the cued recall task remained unimpaired because\ completion[ European Journal of Co`nitive Psy!
being a recognition task\ it was easier than free recall cholo`y 5\ 66Ð81\ 0883[
tasks[ With this argument\ there could still be a similarity 02[ Java\ R[ and Gardiner\ J[ Priming and aging] further
between Asperger|s syndrome and amnesia with the two evidence of preserved memory function[ American
conditions di}ering only in the degree of impairment[ Journal of Psycholo`y 093\ 78Ð099\ 0880[
03[ Kanner\ L[ Autistic disturbances of a}ective contact[
However\ this question cannot be settled by the results
Nervous Child 1\ 106Ð149\ 0832[
of the present study[
04[ Klin\ A[ Asperger syndrome[ Psychiatric Clinics of
North America 2\ 020Ð037\ 0883[
05[ Lockyer\ L[ and Rutter\ M[ A _ve! to _fteen!year
Acknowled`ements*The work reported here formed part of a follow!up study of infantile psychosis] IV[ Patterns of
dissertation by the second author for the degree of B[Sc[ of cognitive ability[ British Journal of Social and Clinical
City University[ The _rst and last authors would also like to Psycholo`y 8\ 041Ð052\ 0869[
acknowledge the support of the Wellcome Trust and the ESRC\ 06[ Minshew\ N[\ Goldstein\ G[\ Muenz\ L[ R[ and
respectively[ Sincere thanks are also due to the Centre for Social Payton\ J[ Neuropsychological functioning in non!
and Communication Disorders for help in the recruitment of
subjects[
mentally retarded autistic individuals[ Journal of
Clinical and Experimental Neuropsycholo`y 03\ 638Ð
650\ 0881[
07[ Minshew\ N[\ Goldstein\ G[\ Taylor\ H[ and Siegel\
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