Do adults with autism spectrum disorders compensate in naturalistic prospective memory tasks?

Remembering the future; prospective memory across the autistic adult's life span

LAY ABSTRACT

What is already known: Prospective memory is an important function for daily living. It is the cognitive function that helps you remember that you are meeting your friend for coffee at 2 pm tomorrow, or that you need to take your vitamins after breakfast. This cognitive function is particularly important in autistic adults, but how prospective memory is associated with increasing age, we currently do not know.What this paper adds: Although performance on experimental tasks that measure prospective memory decreases with age, this pattern is similar in autistic and non-autistic adults. No age effects were found for tasks that were performed outside the lab. Autistic adults and non-autistic adults perform similarly on prospective memory, and this performance remains similar when autistic and non-autistic adults age.Implications for practice, research, or policy: While our results show that prospective memory decreased with increasing age, our results do point to parallel development of prospective memory in autistic and non-autistic adults. This finding serves as a reassurance for those individuals concerned that older autistic individuals might show quicker cognitive decline.

Practice is the best of all instructors-Effects of enactment encoding and episodic future thinking on prospective memory performance in high-functioning adults with autism spectrum disorder

Prospective memory (PM) is the ability to remember to carry out intended actions in the future. The present study investigated the effects of episodic future thinking (EFT) and enactment encoding (EE) on PM performance in autistic adults (ASD). A total of 72 autistic individuals and 70 controls matched for age, gender, and cognitive abilities completed a computerized version of the Dresden breakfast Task, which required participants to prepare breakfast following a set of rules and time restrictions. A two (group: ASD vs. controls) by three (encoding condition: EFT vs. EE vs. standard) between-subjects design was applied. Participants were either instructed to engage in EFT or EE to prepare to the different tasks prior to performing the Dresden breakfast or received standard instructions. Analyses of variance were conducted. Autism-spectrum-disorders (ASD) participants did not differ from control participants in their PM performance, regardless of which strategy they used. Compared to the standard condition, EE but not EFT improved time-based PM performance in all participants. This is the first study to find spared time-based PM performance in autistic individuals. The results confirm earlier results of beneficial effects of EE on PM performance. Findings are discussed with regards to the methodology used, sample composition as well as autistic characteristics.

Time-Based and Event-Based Prospective Memory in Adults with Autism Spectrum Disorder: A Virtual Week Investigation

PURPOSE

Autism spectrum disorder (ASD) is a complex developmental condition including persistent challenges with social communication, restricted interests, and repetitive behavior. Though prospective memory failures are commonly observed in ASD population it has been less studied among adults with ASD. Prospective memory (PM) refers to the execution of delayed intentions. There are contradictory findings of regular and irregular prospective memory task among autistic adults. The present study is an attempt to investigate prospective memory performance among adults with autism spectrum disorder using the Virtual Week board game.

METHOD

Virtual Week (Rendell & Craik, 2000) (3-day Version) is a computerized board game in which participants after rolling a die move token clockwise around the board. Each round of the board represents one virtual "day." Adults between 16 and 25 years of age who were diagnosed with ASD (N = 23) were compared with non-ASD (N = 26) adults.

RESULTS

Analyses of variance were used to analyze the data. Results revealed that autistic adults as compared to normal adults showed poorer performance on time-based task than on event-based task. A significant difference was evident between regular and irregular prospective memory tasks across both tasks among autistic adults. Results also revealed that ASD difficulties are associated with the prospective component of the irregular task.

CONCLUSIONS

Prospective memory failures are widely observed in ASD group, and have important implications for functional independence. The findings of this study provide insight into prospective memory challenges that adults with autism spectrum disorder face in a daily basis.

Self-reported Prospective and Retrospective Memory Among Middle Aged and Older Autistic and Non-autistic People

OBJECTIVE

Self-reported memory difficulties are common among older adults, but few studies have examined memory problems among autistic middle-aged and older people. The current study examines self-rated prospective (PM) and retrospective (RM) memory difficulties and their associations with age in middle-aged and older autistic and non-autistic people.

METHODS

350 autistic people (58% assigned-female-at-birth; age-range: 40-83 years) and 350 non-autistic adults matched on age, birth-sex and education level were included in the analysis. Participants completed the Prospective and Retrospective Memory Questionnaire (PRMQ) which includes questions about PM vs. RM (memory type), environment-cued vs. self-cued (cue), and short vs. long delay (delay).

RESULTS

Autistic people reported significantly more PM and RM difficulties than the comparison group. Both groups reported more difficulties with PM (vs. RM), self-cued (vs. environment-cued), and short (vs. long) delay. No significant interactions were observed. Among autistic people, younger age was associated with reporting more PM and RM difficulties, but this pattern was not observed among non-autistic people.

CONCLUSIONS

Autistic people may be at reduced risk for memory problems as they age, compared to their same-age non-autistic peers. Further studies are required to explore the association between self-reported memory challenges and memory task performance among autistic older people.

A review of executive functioning challenges and strengths in autistic adults

Objective: There has been a steady rise in research characterizing executive functioning (EF) impairments in autistic individuals but limited research investigating EF strengths. This review provides a summary of current EF research in autistic adults with a focus on EF challenges and strengths and potential sources of heterogeneity in research findings. New avenues for addressing gaps in our understanding of EF strengths are proposed.Method: A review of the EF literature was conducted. One hundred twenty-four studies of inhibition, working memory, cognitive flexibility, fluency, planning, decision-making, and subjective measures of EF in autistic adults were included.Results: Autistic adults with average intellectual functioning demonstrate difficulties with cognitive flexibility, phonemic fluency, and working memory. Strengths in planning, decision-making, and semantic verbal fluency were evident in some but not all studies. Findings regarding inhibition are inconclusive. Key findings across each EF domain are discussed and sources of potential heterogeneity across studies were evaluated. The type of measure used appears to contribute to heterogeneous findings. Subjective EF measures revealed more consistent findings of deficits in autistic adults than objective EF measures.Conclusions: Research reveals areas of EF weaknesses as well as strengths in autistic adults. Unlike EF challenges, EF strengths are not well understood. Future research identifying EF strengths is needed to improve services and supports for autistic adults. Further investigation of potential factors that interact with or constrain EF such as comorbid disorders, verbal ability, sensory processing, and other factors specific to autism will be critical to move the field forward and increase understanding of how EF is related to everyday functioning in autistic adults.

Did you hear? Auditory prospective memory cues are more beneficial for autistic than for non-autistic children and adolescents

BACKGROUND

The transition from primary to secondary school is particularly difficult for autistic children, a transition underpinned by an increase in prospective memory (PM) demands.

AIMS

To better understand PM in autistic children of the relevant age range and its underlying processes, the current study investigated the impact of cue salience (distinctiveness) on PM in autistic and non-autistic children and adolescents. The study was unique in manipulating the visual and auditory salience of PM cues. Salient cues are assumed to put lower demands on executive control resources as compared to cues that blend in with the ongoing activity.

METHODS AND PROCEDURES

The children completed a computer-based categorisation task in which an event-based PM task was embedded. The salience of PM cues was manipulated (low, high visual and high auditory salience).

OUTCOMES AND RESULTS

Results revealed that both groups benefitted from an increase in visual and auditory salience, but only autistic participants were faster to respond to auditory cues.

CONCLUSIONS AND IMPLICATIONS

Increased cue salience improved PM performance for all children. Positive effects of auditory cues were especially evident in autistic children.

Ageing and heterogeneity regarding autism spectrum conditions: a protocol paper of an accelerated longitudinal study

INTRODUCTION

Autism spectrum conditions (ASC) develop early in life and are thought to last a lifetime. However, ASC research has two major knowledge gaps that hinder progression in understanding the concept of ASC and in providing proper support for autistic adults: (1) the majority of knowledge about ASC mainly stems from childhood studies so little is known about older autistic adults and (2) while it is broadly recognised that ASC is a heterogeneous condition, we do not yet understand the differences in trajectories leading to their future outcome. We aim to fill both knowledge gaps.

METHODS AND ANALYSIS

A multistage overlapping cohort design assessing (cognitive) ageing in ASC is designed to obtain an accelerated longitudinal data set. Data, including a multitude of questionnaires, diagnostics and cognitive tests, are collected over four waves within a 10-year time frame. This will provide information regarding actual changes in quality of life, co-occurring health conditions and cognition as well as the possibility to test external validity and temporal stability in newly formed behavioural subtypes. Participants consist of three groups of adults aged 20-90 years: (1) with a clinical diagnosis of ASC, (2) with a clinical diagnosis of attention deficit hyperactivity disorder (ADHD) but no ASC, (3) no ASC/ADHD (ie, comparison group). The sample size differs between waves and instruments. Detailed analysis plans will be preregistered in AsPredicted or at the Open Science Framework.

ETHICS AND DISSEMINATION

Ethical approval for this study was obtained from the ethical review board of the Department of Psychology of the University of Amsterdam (wave 1 2011-PN-1952 and 2013-PN-2668, wave 2 2015-BC-4270, waves 3 and 4 2018-BC-9285). In line with the funding policies of the grant organisation funding this study, future papers will be published open access.

Transdiagnostic validity of the MATRICS Consensus Cognitive Battery across the autism-schizophrenia spectrum

BACKGROUND

Autism Spectrum Disorder (ASD) and schizophrenia are neurodevelopmental disorders which share substantial overlap in cognitive deficits during adulthood. However, treatment evaluation in ASD and treatment comparisons across ASD and schizophrenia are limited by a dearth of empirical work establishing the validity of a standard cognitive battery across ASD and schizophrenia. Promisingly, the MATRICS Consensus Cognitive Battery (MCCB) has been validated in schizophrenia and encompasses cognitive domains that are impacted in ASD. Thus, this study aimed to establish MCCB's generalizability from schizophrenia to ASD.

METHODS

Community-residing adults with schizophrenia (N = 100) and ASD (N = 113) underwent MCCB assessment. Using multigroup confirmatory factor analysis, MCCB's transdiagnostic validity was evaluated by examining whether schizophrenia and ASD demonstrate the same configuration, magnitude, and directionality of relationships within and among measures and their underlying cognitive domains.

RESULTS

Across schizophrenia and ASD, the same subsets of MCCB measures inform three cognitive domains: processing speed, attention/working memory, and learning. Except for group means in category fluency, continuous performance, and spatial span, both groups show vastly comparable factor structures and characteristics.

CONCLUSIONS

To our knowledge, this study is the first to establish the validity of a standard cognitive battery in adults with ASD and furthermore the first to establish a cognitive battery's comparability across ASD and schizophrenia. Cognitive domain scores can be compared across new samples using weighted sums of MCCB scores resulting from this study. These findings highlight MCCB's applicability to ASD and support its utility for standardizing treatment evaluation of cognitive outcomes across the autism-schizophrenia spectrum.

Increasing Extrinsic Motivation Improves Time-Based Prospective Memory in Adults with Autism: Relations with Executive Functioning and Mentalizing

Time-based prospective memory (PM) is diminished under various task demands in individuals with autism spectrum disorder (ASD). However, it is still unclear what underpins their impairment or how it could be remediated. This study explored whether instructions to prioritise one element of a PM task over another improved performance in adults with ASD (compared to a group of matched neurotypical adults), and how that is related to cognitive abilities. Results indicated that importance instructions significantly improved the PM performance of participants with ASD. Moreover, the extent of the benefit was associated significantly with objectively-measured executive set-shifting ability and self-reported inhibitory control ability (the poorer the set-shifting/inhibitory control, the greater the benefit). Implications for future research and clinical practice are discussed.

Prospective Memory in Adolescents with Autism: A Preliminary Study of the Impact of Memory Load

We evaluated event-based prospective memory (EBPM) in adolescents with Autism, varying the load of the to-be-performed intentions. We included measures of inhibition, working memory and binding. Results showed that increasing the retrospective memory load reduced performance in controls. In Autism, adolescents were impaired in the low load condition with normal performance for the ongoing task, with the reverse pattern in the high load condition. EBPM may be impacted in Autism due to difficulty to process ongoing and EBPM tasks simultaneously possibly because of restricted inhibitory control.

A Systematic Review of What Barriers and Facilitators Prevent and Enable Physical Healthcare Services Access for Autistic Adults

Autistic people are more likely to: be diagnosed with a range of physical health conditions (i.e. cardio-vascular disease); experience premature mortality (for most disease categories); and experience barriers to effectively accessing healthcare. This systematic review sought to identify studies that report on barriers and facilitators to physical healthcare access for autistic people. A total of 3111 records were screened and six studies were included: two quantitative, two qualitative, and two mixed-methodology studies. Patient-provider communication, sensory sensitivities, and executive functioning/planning issues emerged as important barriers to healthcare. Recommendations for clinicians and those planning services are discussed.

Time perception and autistic spectrum condition: A systematic review

Problems with timing and time perception have been suggested as key characteristics of autism spectrum condition (ASC). Studies and personal accounts from clinicians, parents, caregivers, and self‐reports from autistic people themselves often refer to problems with time. Although a number of empirical studies have examined aspects relating to time in autistic individuals, there remains no clear consensus on whether or how timing mechanisms may be affected in autism. A key reason for this lack of clarity is the wide range of timing processes that exist and subsequently the wide range of methodologies, research paradigms, and samples that time‐based studies have used with autism populations. In order to summarize and organize the available literature on this issue, a systematic review was conducted. Five electronic databases were consulted. From an initial 597 records (after duplicates were removed), 45 papers were selected and reviewed. The studies are reviewed within different sections based on the different types of timing ability that have been explored in the neurotypical (NT) population: time sensitivity, interval timing, and higher‐order time perception. Within each section cognitive models, methodologies, possible clinical implications, and research results are discussed. The results show different consistency across studies between the three types of timing ability. The highest consistency of results showing atypical time perception abilities is found in high‐level time perception studies. It remains unclear if autism is characterized by a fundamental time perception impairment. Suggestions for future research are discussed. Autism Res 2019, 12: 1440–1462. © 2019 International Society for Autism Research, Wiley Periodicals, Inc.

Lay Summary

This systematic review examines the different types of timing and time perception behavior that have been investigated in autism. Overall, there are a number of studies that show differences between autistic and non‐autistic individuals, but some studies do not find such differences. Group differences are more consistent across studies using complex tasks rather than simpler more fundamental timing tasks. We suggest that experiments across a range of timing tasks would be fruitful to address gaps in our knowledge.

Do importance instructions improve time-based prospective remembering in autism spectrum conditions?

This study explored the impact of motivation on the memory for delayed intentions (so-called, prospective memory, PM) in autistic individuals. Specifically, we were interested in the effects of personal (i.e., receiving a reward) as compared to social motivation (i.e., performing a favour for someone). Given the well-established theory of mind deficits in autism, we expected autistic individuals to benefit more strongly from personal than social importance manipulations, whereas the opposite pattern was predicted for controls. Sixty-one adolescents with autism and 61 typically developing adolescents participated, with each group distributed equally to one of the three motivation conditions of standard, social and personal reward. Participants worked on a 2-back picture-based ongoing task in which a time-based PM task was embedded. A mixed 2 (Group) x 3 (Motivation condition) analysis of covariance with age, verbal and non-verbal abilities as covariates and correct PM responses as dependent variable indicated solely a main effect of group, with controls outperforming the autism group. In contrast to our expectations, there was no main effect of condition, no significant interaction, and none of the covariates had any significant impact. However, further planned analyses revealed that controls only outperformed autistic individuals in the personal reward condition. Controls performed significantly best when a personal reward was promised, whereas there were no significant differences between the motivation conditions for autistic individuals. Findings are discussed in terms of underlying processes.

Prospective memory (partially) mediates the link between ADHD symptoms and procrastination

Individuals with attention deficit hyperactivity disorder (ADHD) often show poor planning and poor organization of tasks and activities which has been related to reduced memory for delayed intentions (prospective memory) and procrastination-in addition to other cognitive or motivational factors. This study set out to bring the fields of prospective memory and procrastination research together and to explore possible relations between the two constructs in ADHD. Twenty-nine adults with ADHD and 24 healthy controls performed several laboratory-based and real-life prospective memory tasks and filled in questionnaires measuring their symptom severity and procrastination behaviour. Overall, individuals' with ADHD showed clear deficits in everyday prospective memory performance. Individuals with ADHD recalled and executed less of their own real-life intentions. Moreover, there were clear links between everyday prospective memory performance and reported procrastination behaviour, and everyday prospective memory performance mediated the link between ADHD symptoms and procrastination behaviour.

Patterns of Nonsocial and Social Cognitive Functioning in Adults With Autism Spectrum Disorder: A Systematic Review and Meta-analysis

IMPORTANCE

Many studies have investigated impairments in cognitive domains in adults with autism spectrum disorder (ASD). Yet, to date, a comprehensive overview on the patterns of cognitive functioning is lacking.

OBJECTIVE

To provide an overview of nonsocial and social cognitive functioning in various domains in adults with ASD, allowing for comparison of the severity of deficits between different domains.

DATA SOURCES

A literature search performed in an academic medical setting was conducted using PubMed, PsycINFO, Embase, and Medline databases with the combination of the following free-text and Medical Subject Headings where applicable: [cogniti* OR neurocogniti* OR neuropsycholog* OR executive function* OR IQ OR intelligence quotient OR social cognition OR emotion perception OR affect perception OR emotion recognition OR attribution OR ToM OR mentalising OR mentalizing OR prosody OR social knowledge OR mind reading OR social cue OR social judgment] AND [autis* OR ASD OR Asperger OR Asperger's OR PDD OR pervasive developmental disorder]. The search was further limited to studies published between 1980 (first inclusion of autism diagnosis in the DSM-III) and July 2018.

STUDY SELECTION

Studies included were published as a primary peer-reviewed research article in English, included individuals with ASD 16 years or older, and assessed at least 1 domain of neurocognitive functioning or social cognition using standard measures.

DATA EXTRACTION AND SYNTHESIS

Of 9892 articles identified and screened, 75 met the inclusion criteria for the systematic review and meta-analysis.

MAIN OUTCOMES AND MEASURES

Hedges g effect sizes were computed, and random-effects models were used for all analyses. Moderators of between-study variability in effect sizes were assessed using meta-regressions.

RESULTS

The systematic review and meta-analysis included 75 studies, with a combined sample of 3361 individuals with ASD (mean [SD] age, 32.0 [9.3] years; 75.9% male) and 5344 neurotypical adults (mean [SD] age, 32.3 [9.1] years; 70.1% male). Adults with ASD showed large impairments in theory of mind (g = -1.09; 95% CI, -1.25 to -0.92; number of studies = 39) and emotion perception and processing (g = -0.80; 95% CI, -1.04 to -0.55; n = 18), followed by medium impairments in processing speed (g = -0.61; 95% CI, -0.83 to -0.38; n = 21) and verbal learning and memory (g = -0.55; 95% CI, -0.86 to -0.25; n = 12). The least altered cognitive domains were attention and vigilance (g = -0.30; 95% CI, -0.81 to 0.21; n = 5) and working memory (g = -0.23; 95% CI, -0.47 to 0.01; n = 19). Meta-regressions confirmed robustness of the results.

CONCLUSIONS AND RELEVANCE

Results of this systematic review and meta-analysis suggest that adults with ASD show impairments in social cognitive domains and in specific nonsocial cognitive domains. These findings contribute to the understanding of the patterns of cognitive functioning in adults with ASD and may assist in the identification of targets for cognitive interventions.

A Meta-Analysis and Critical Review of Prospective Memory in Autism Spectrum Disorder

Prospective memory (PM) is the ability to remember to carry out a planned intention at an appropriate moment in the future. Research on PM in ASD has produced mixed results. We aimed to establish the extent to which two types of PM (event-based/time-based) are impaired in ASD. In part 1, a meta-analysis of all existing studies indicates a large impairment of time-based, but only a small impairment of event-based PM in ASD. In Part 2, a critical review concludes that time-based PM appears diminished in ASD, in line with the meta-analysis, but that caution should be taken when interpreting event-based PM findings, given potential methodological limitations of several studies. Clinical implications and directions for future research are discussed.

Episodic future thinking improves children's prospective memory performance in a complex task setting with real life task demands

Research on children's prospective memory (PM) shows an increase of performance across childhood and provides first evidence that encoding strategies such as episodic future thinking (EFT; i.e., engaging in a vivid prospection of oneself performing future tasks) may improve performance. The present study aimed at testing whether the beneficial effects of EFT extend from typical lab-based tasks to more complex tasks with real life demands. Further, it was tested whether children's ability to project themselves into different perspectives (i.e., self-projection) moderates the effects of EFT encoding on PM. Overall, 56 children (mean age: M = 10.73 years) were included in this study who were randomly assigned to either an EFT or control condition. Children participated in a 'sightseeing tour' (ongoing activity) inside the lab with various socially relevant and neutral PM tasks embedded. Results showed significantly higher PM performance in the EFT compared to the control group. There was no difference between neutral and social PM tasks and no interaction between type of PM tasks with encoding condition. Further, self-projection did not moderate the effects of EFT encoding on PM. Results suggest that EFT is an effective strategy to improve children's everyday PM. These beneficial effects seem to occur independent from children's general ability to change perspectives and for different types of PM tasks.

Effects of Episodic Future Thinking and Self-Projection on Children's Prospective Memory Performance

The present study is the first to investigate the benefits of episodic future thinking (EFT) at encoding on prospective memory (PM) in preschool (age: M = 66.34 months, SD = 3.28) and primary school children (age: M = 88.36 months, SD = 3.12). A second aim was to examine if self-projection influences the possible effects of EFT instructions. PM was assessed using a standard PM paradigm in children with a picture-naming task as the ongoing activity in which the PM task was embedded. Further, two first- and two second-order ToM tasks were administered as indicator of children’s self-projection abilities. Forty-one preschoolers and 39 school-aged children were recruited. Half of the participants in each age group were instructed to use EFT as a strategy to encode the PM task, while the others received standard PM instructions. Results revealed a significant age effect, with school-aged children significantly outperforming preschoolers and a significant effect of encoding condition with overall better performance when receiving EFT instructions compared to the standard encoding condition. Even though the interaction between age group and encoding condition was not significant, planned comparisons revealed first evidence that compared to the younger age group, older children’s PM benefitted more from EFT instructions during intention encoding. Moreover, results showed that although self-projection had a significant impact on PM performance, it did not influence the effects of EFT instructions. Overall, results indicate that children can use EFT encoding strategies to improve their PM performance once EFT abilities are sufficiently developed. Further, they provide first evidence that in addition to executive functions, which have already been shown to influence the development of PM across childhood, self-projection seems to be another key mechanism underlying this development.

Recognition memory and source memory in autism spectrum disorder: A study of the intention superiority and enactment effects

It is well established that neurotypical individuals generally show better memory for actions they have performed than actions they have observed others perform or merely read about, a so-called 'enactment effect'. Strikingly, research has also shown that neurotypical individuals demonstrate superior memory for actions they intend to perform in the future (but have not yet performed), an effect commonly known as the 'intention superiority effect'. Although the enactment effect has been studied among people with autism spectrum disorder, this study is the first to investigate the intention superiority effect in this disorder. This is surprising given the potential importance this issue has for general theory development, as well as for clinical practice. As such, this study aimed to assess the intention superiority and enactment effects in 22 children with autism spectrum disorder, and 20 intelligence quotient/age-matched neurotypical children. The results showed that children with autism spectrum disorder demonstrated not only undiminished enactment effects in recognition and source memory, but also (surprisingly for some theories) typical intention superiority effects. The implications of these results for theory, as well as clinical practice, are discussed.

Event-based prospective memory in mildly and severely autistic children

BACKGROUND

There is a growing body of research into the development of prospective memory (PM) in typically developing children but research is limited in autistic children (Aut) and rarely includes children with more severe symptoms.

AIMS

This study is the first to specifically compare event-based PM in severely autistic children to mildly autistic and typically developing children.

METHODS AND PROCEDURES

Fourteen mildly autistic children and 14 severely autistic children, aged 5-13 years, were matched for educational attainment with 26 typically developing children aged 5-6 years. Three PM tasks and a retrospective memory task were administered.

OUTCOMES AND RESULTS

Results showed that severely autistic children performed less well than typically developing children on two PM tasks but mildly autistic children did not differ from either group. No group differences were found on the most motivating (a toy reward) task.

CONCLUSIONS AND IMPLICATIONS

The findings suggest naturalistic tasks and motivation are important factors in PM success in severely autistic children and highlights the need to consider the heterogeneity of autism and symptom severity in relation to performance on event-based PM tasks.

Future thinking improves prospective memory performance and plan enactment in older adults

Efficient intention formation might improve prospective memory by reducing the need for resource-demanding strategic processes during the delayed performance interval. The present study set out to test this assumption and provides the first empirical assessment of whether imagining a future action improves prospective memory performance equivalently at different stages of the adult lifespan. Thus, younger ( n = 40) and older ( n = 40) adults were asked to complete the Dresden Breakfast Task, which required them to prepare breakfast in accordance with a set of rules and time restrictions. All participants began by generating a plan for later enactment; however, after making this plan, half of the participants were required to imagine themselves completing the task in the future (future thinking condition), while the other half received standard instructions (control condition). As expected, overall younger adults outperformed older adults. Moreover, both older and younger adults benefited equally from future thinking instructions, as reflected in a higher proportion of prospective memory responses and more accurate plan execution. Thus, for both younger and older adults, imagining the specific visual–spatial context in which an intention will later be executed may serve as an easy-to-implement strategy that enhances prospective memory function in everyday life.

Prospective memory in adults with high-functioning autism spectrum disorders: exploring effects of implementation intentions and retrospective memory load

This study examined, for the first time, the impact of implementation intentions on prospective memory (PM) performance in adults with autism spectrum disorders (ASD) and further explored the role of retrospective memory for PM in ASD. PM was assessed with Virtual Week, a computerized game simulating upcoming everyday-life tasks. Twenty-seven adults with ASD and 27 age- and ability-matched controls were included. Half of the participants were instructed to form implementation intentions (i.e., encoding PM tasks in form of if-then statements), while the rest received simple PM instructions. Results provide first tentative evidence for beneficial effects of implementation intentions and PM tasks with low demands on retrospective memory for adults with ASD's PM. Overall, results point to the importance of planning and retrospective memory for successful prospective remembering in ASD.

Task dissociation in prospective memory performance in individuals with ADHD

OBJECTIVE

The present study investigated, for the first time, event- and time-based prospective memory (PM) in the same sample of adults with ADHD within one paradigm using parallel task constraints.

METHOD

A total of 25 individuals with ADHD and 25 matched neurotypical controls completed a computerized version of the Dresden Breakfast Task, which required participants to prepare breakfast following a set of rules and time restrictions.

RESULTS

Although groups did not differ in event-based PM, results demonstrated a large-sized impairment in individuals with ADHD in time-based PM.

CONCLUSION

Findings suggest a task-specific impairment in PM functioning and are discussed in an executive control framework of neurocognitive functioning in ADHD.

Everyday life consequences of substance use in adult patients with a substance use disorder (SUD) and co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD): a patient's perspective

BACKGROUND

Although the prevalence of substance use disorder (SUD) with co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) is relatively high in adult patients, there is hardly any knowledge about these dual diagnoses. A recent study reported met- and unmet needs for several life domains regarding these patient groups. To improve treatment, it is necessary to identify the everyday life consequences of SUD and co-occurring ADHD or ASD in adult patients.

METHODS

Qualitative study using in-depth interviews. 11 SUD + ADHD and 12 SUD + ASD patients participated in the study. The interview transcripts were coded and analysed according to the seven steps for descriptive phenomenology by Colaizzi.

RESULTS

Both patients with ADHD and patients with ASD can get caught in a jumble of thoughts and emotions which can often lead to agitation and impulsivity in the case of ADHD or passivity and melancholia in the case of ASD with co-occurring SUD in both cases. Initially substance use ameliorates the symptoms and related problems, but both patient groups can later experience even greater problems: difficulties with the structuring of daily life due to a lack of planning (SUD + ADHD) or due to a lack of initiative (SUD + ASD). Both groups indicate that structure helps them function better. They also recognize that substance use disorganizes their lives and that an absence of structure contributes to substance use in what becomes a vicious circle which needs to be broken for effective treatment and care.

CONCLUSIONS

This study provides insight into the daily life consequences of SUD with a co-occurring ADHD or ASD. Substance use is reported to solve some ADHD- or ASD-related problems in the short run but have negative consequences in the long run (i.e., contribute to already impaired cognitive functioning). Insight is provided into what clinicians can do to break this vicious circle and thus help ADHD patients to refrain from action and ASD patients to take action.

A Virtual Week study of prospective memory function in autism spectrum disorders

Prospective memory (PM) refers to the implementation of delayed intentions, a cognitive ability that plays a critical role in daily life because of its involvement in goal-directed behavior and consequently the development and maintenance of independence. Emerging evidence indicates that PM may be disrupted in autism spectrum disorders (ASDs), potentially contributing to the functional difficulties that characterize this group. However, the degree, nature, and specificity of ASD-related impairment remains poorly understood. In the current study, children between 8 and 12 years of age who were diagnosed with ASDs (n=30) were compared with typically developing children (n=30) on a child-appropriate version of the Virtual Week board game. This measure provides an opportunity to investigate the different sorts of PM failures that occur. The ASD group showed significant PM impairment on measures of time-based (but not event-based) prospective remembering. However, only a subtle difference emerged between regular and irregular PM tasks, and group differences were consistent across these tasks. Because regular and irregular tasks differentially load retrospective memory, these data imply that the PM difficulties seen in ASDs may primarily reflect a monitoring deficit and not an encoding and memory storage deficit. PM performance was poorer under conditions of high ongoing task absorption, but the magnitude of this effect did not vary as a function of group. In both groups, time-based (but not event-based) PM difficulties were associated with functional outcomes in daily life, but only an inconsistent association with executive control emerged.

Time-based and event-based prospective memory in autism spectrum disorder: the roles of executive function and theory of mind, and time-estimation

Prospective memory (remembering to carry out an action in the future) has been studied relatively little in ASD. We explored time-based (carry out an action at a pre-specified time) and event-based (carry out an action upon the occurrence of a pre-specified event) prospective memory, as well as possible cognitive correlates, among 21 intellectually high-functioning children with ASD, and 21 age- and IQ-matched neurotypical comparison children. We found impaired time-based, but undiminished event-based, prospective memory among children with ASD. In the ASD group, time-based prospective memory performance was associated significantly with diminished theory of mind, but not with diminished cognitive flexibility. There was no evidence that time-estimation ability contributed to time-based prospective memory impairment in ASD.

Diminished time-based, but undiminished event-based, prospective memory among intellectually high-functioning adults with autism spectrum disorder: relation to working memory ability

Objective: Prospective memory (PM) is the ability to remember to carry out an intended action. Working memory is the ability to store information in mind while processing potentially distracting information. The few previous studies of PM in autism spectrum disorder (ASD) have yielded inconsistent findings. Studies of working memory ability in ASD have suggested a selective impairment of “visual working memory.” However, it remains unclear whether any such impairment is the result of diminished (domain-specific; visual/verbal) storage capacity or diminished (domain-general) processing capacity. We aim to clarify these issues and explore the relation between PM and working memory in ASD. Method: Seventeen adults with ASD and 17 age- and IQ-matched comparison participants completed experimental measures of both event-based (perform action x when event y occurs) and time-based (perform action a at time b) PM, plus a self-report measure of PM skills. Participants also completed a working memory test battery. Results: Participants with ASD self-reported diminished PM skill, and showed diminished performance on the time-based, but not event-based, PM task. On the working memory test battery, visual but not verbal storage capacity was diminished among participants with ASD, as was processing ability. Whereas visual storage was associated with event-based PM task performance among comparison participants, verbal storage was associated among ASD participants. Conclusions: ASD appears to involve a selective deficit in time-based PM and a selective difficulty with aspects of working memory that depend on the storage of visual information. However, event-based PM may be achieved through compensatory strategies in ASD.

Revisiting the age-prospective memory-paradox: the role of planning and task experience

The present study aimed at investigating age-related differences in prospective memory performance using a paradigm with high ecological validity and experimental control. Thirty old and 30 young adults completed the Dresden Breakfast task; a meal preparation task in the lab that comprises several subtasks including event- and time-based prospective memory tasks. Participants were required to plan how to perform the task. Results showed that young adults outperformed old adults: they completed more subtasks, showed better event- and time-based prospective memory performance and planning quality. In contrast, old adults adhered to their plans more closely than young adults. Further exploratory gender-specific analyses indicated that old women did not differ from young men in time-based prospective memory performance, general task performance and time monitoring in contrast to old men. Possibly, differences in experience in breakfast preparation might account for these differential findings.