\

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
There has been much debate on whether Asperger|s
syndrome ð0\ 1Ł and autism ð03Ł constitute distinct dis!
orders or are situated on a continuum ð04Ł[ Whereas
classically autistic children are frequently mentally
retarded\ show motor stereotypies and delayed and devi!
ant language\ people with Asperger|s syndrome are of
normal intelligence\ show more abstract stereotypies\
such as specialized interests in radio transmitters or bus
timetables\ and show no abnormalities of language apart
from either ~at or exaggerated intonation patterns[ The
current consensus is that\ although there are di}erences
in some areas of psychological functioning\ there are also
many areas of similarity\ most notably in the area of
social impairment[
Clinical accounts of children with Kanner!type autism
describe them as having a good rote memory ð05Ł\ and
such accounts of higher!functioning children and adults
with Asperger|s syndrome document prodigious mem!
ories for information centred on highly specialized inter!
ests such as bus timetables or dinosaurs ð16Ł[
Experimental studies of children with Kanner!type
autism show that\ while they appear to be unimpaired on
 Address for correspondence] Department of Psychology\
City University\ Northampton Square\ London EC0V 9HB\
U[K[^ e!mail] d[m[bowlerÝcity[ac[uk[
short!term and serial memory tasks ð10Ł\ they are imp!
aired in their longer!term memory\ especially in free recall
tasks ð4\ 5\ 6Ł[ Such observations have led Boucher and
Warrington to draw comparisons between autism and
the amnesic syndrome\ which is partly characterized by
a de_cit in long!term memory and in the ability to form
new associations "see ð19Ł#[ Autistic children\ unlike con!
trols\ have also been found to be unable to use category
information to help their free recall ð15Ł\ thereby re_ning
an earlier observation\ made by Hermelin and O|Connor
ð09Ł\ that autism involves a basic cognitive de_cit in the
ability to process stimuli in an elaborative\ meaningful way[
However\ several studies have failed to _nd evidence
of any impairment in cued recall\ either with perceptual
cues\ such as FR for FRUIT or CHA for CHAIR ð6Ł\
rhyme cues or category name cues ð15Ł\ or other con!
ceptual cues such as leading questions ð5Ł[ Here\ the par!
allel between autism and amnesia breaks down\ since
amnesics are typically impaired in cued recall too\ as
they are in all explicit memory tasks*those that require
conscious recollection of previous experiences ð7Ł[ The
idea that the memory impairments of people with autism
are less evident when cues are provided than when free
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
"people who _t current diagnostic criteria for Kanner!
type autism but who are of normal IQ# and controls on
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
complex visual and auditory material[ Minshew suggests
that the patterns of strengths and weaknesses seen in the
memory of high!functioning adults with autism may be
the result not of a memory de_cit per se but of an impair!
ment in the application of general strategies\ such as
the organization of information into categories\ to the
information to be remembered[ This pattern resembles
the memory impairments reported by Baddeley and Wil!
son ð2Ł and Stuss et al[ ð14Ł in patients with frontal lobe
damage\ and underpins other work such as that by Ozon!
o} et al[ ð08Ł\ who demonstrated impairments in frontal
lobe functioning in Asperger and high!functioning autis!
tic subjects[
Although memory in both high!functioning children
and adults with Kanner!type autism has been extensively
researched\ as far as we are aware\ there has been little
or no previous experimental investigation of possible
memory impairment in adults with an Asperger diag!
nosis[ The major purpose of this article is to describe such
an investigation[ In the light of the recent debate over
whether or not Asperger|s syndrome and autism are sep!
arate disorders\ the _rst experiment was a replication on
adults with Asperger|s syndrome of Tager!Flusberg|s ð15Ł
study of autistic children and Minshew et al[|s ð07Ł study
of autistic adults\ in order to ascertain if Asperger adults
resemble the other two groups by producing similar
results in their free recall of related and unrelated words[
If they do\ then performance across Asperger and control
groups should be similar for an unrelated word list\ and
the Asperger group should show signi_cantly lower per!
formance for a related word list[
The second experiment was designed to investigate the
performance of Asperger and control groups in explicit
compared with implicit memory tasks[ If there is any
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
implicit test[ This outcome should be obtained even when
the two tests involve identical test cues\ such as word
stems\ and di}er only with respect to whether subjects
are instructed to use these cues to recall words from the
study list\ or to complete them with the _rst words that
come to mind "e[g[ ð8Ł^ see ð11Ł for a general review#[
In addition\ although some of the earlier _ndings with
autistic children showed no impairment in cued recall\ at
least some of these cued recall tasks might actually have
allowed subjects to perform the task as if it were an
implicit task "e[g[ ð6Ł#\ that is\ responding with words that
{came to mind| rather than trying consciously to recollect
the study list[ The present study would allow us to deter!
mine whether impaired cued recall resulted from the oper!
ation of automatic or involuntary processes[
That subjects may not always obey the instructions
they are given in explicit compared with implicit tests\
and hence that performance might be {contaminated|\ is
a problem that has greatly exercised memory theorists in
recent years[ One solution to this problem\ {the retrieval
intentionality criterion|\ was suggested by Schacter et al[
ð13Ł who suggested that\ in addition to keeping all test
conditions constant\ except the retrieval instructions\ one
should also include some variable known to dissociate
explicit from implicit performance[ The level of pro!
cessing has proved a popular choice\ since it is well estab!
lished that\ although this variable strongly in~uences
explicit performance\ it has little e}ect on performance
in perceptual priming tasks like word!stem completion
"e[g[ ð12Ł#[ If the level of processing were to be shown to
have a strong e}ect on performance in such an implicit
task\ it could be concluded that subjects must have been
responding on an explicit basis[ A particularly powerful
demonstration of this logic was reported by Java ð01Ł\
who used word stem cues for both explicit and implicit
tests following a generate vs read manipulation at study
"cf[ ð3\ 00Ł#[ Java found that generating words at study
led to superior recall in the explicit test\ but reading words
at study led to superior completion in the implicit test[
Obviously\ if subjects had been responding in the same
way in each test\ such a crossover interaction could not
have occurred[ Though this interaction replicated Blax!
ton ð3Ł and Jacoby|s ð00Ł _ndings\ only the study by Java
meets the criteria suggested by Schacter et al[ ð13Ł by
having identical cues in each kind of test[
A further aim of our second experiment was to rep!
licate Java|s ð01Ł study[ Accordingly\ subjects in both
groups either generated or read the words in a study list\
and were then given implicit and explicit memory with
word stem cues[ Both groups should show superior recall
of generated words in the explicit test\ and superior com!
pletion of read words in the implicit test[ The question
then is whether the Asperger group and the control group
perform similarly in the implicit test\ but di}erently in
the explicit test[
Experiment 0
Method
Subjects
The Asperger group consisted of 05 adults "09 men\ 1
women#[ They all had a diagnosis of Asperger|s syndrome
according to draft ICD09 research criteria but excluding the
requirement for absence of delay or deviance in language devel!
opment[ None showed any obvious present state abnormalities
in the structural or semantic aspects of their language[ In
addition\ on the basis of parental interviews\ all were reported
as not having engaged in symbolic play or joint attention behav!
iours as children\ and all had Wechsler verbal IQs above 69[
All diagnoses were made by clinicians experienced in the diag!
nosis of autism and were con_rmed by the _rst author[ The
control group consisted of 05 volunteers recruited from a local
Job Centre "7 male\ 7 female#[ The control subjects were mat!
ched to the Asperger subjects on both chronological age and
verbal IQ as measured by the WAIS[ Table 0 summarizes the
age and IQ means for both groups[ All subjects were tested
individually and were paid for participating[ The present experi!
ments formed part of a larger test battery taken by the subjects\
all of whom participated in Experiment 1 followed by Experi!
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
The results of this experiment are outlined in Table 1[
Analyses of the data using a repeated measures
ANOVA showed signi_cant main e}ects for Group ðF
"0\29#  5[03\ P ³ 9[91# and Related:Unrelated lists "F
"0\29#  16[35\ P ³ 9[990Ł and a Group by Related:
Unrelated lists interaction ðF "0\29#3[36\ P ³ 9[94Ł[
Inspection of means shows that the di}erence between
related and unrelated lists was greater for the control
than for the Asperger subjects[
These results demonstrate that the Asperger subjects
used here\ like Tager!Flusberg|s ð15Ł autistic children and
Minshew et al[|s ð06Ł high!functioning adults\ are imp!
aired in using semantic information in free recall[ The
_ndings thus suggest that Minshew et al[|s ð06\ 07Ł obser!
Table 1[ Mean number of words recalled in Experiment 0
Asperger subjects Control subjects
Unrelated word list 4[95 "1[07# 4[45 "0[26#
Related word list 5[02 "0[87# 7[95 "0[95#
vs explicit test# ×1 "generate vs read# mixed repeated measures
design with the order of conditions counterbalanced across
subjects[ Stimuli consisted of 79 di}erent six!letter words taken
from a previous study list designed by Java and Gardiner ð02Ł
and listed in the appendix[ Study list words were hand!printed
on index cards with the generate cards showing the initial letter
of the target word and either a descriptive phrase or the opposite
of the target word[ These words were randomly divided into
two sets of 39 words each to produce study lists A and B[ Half
the subjects in both experimental groups studied list A and
half studied list B[ Within each study list\ the 39 words were
randomly divided into half again\ 19 being presented using the
generate task and 19 using the read task[ Within each study list\
generate and read words were counterbalanced across subjects[
The two methods of presentation were blocked so that half the
subjects in each group received the generate task _rst and half
received the read task _rst[
Two test lists were devised\ consisting of 39 word stems each
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
and novel items[ The novel items that had not previously been
presented to that subject for study provided the baseline mea!
sures of priming and intrusion rates in cued recall[ Of the 19
word stems that had previously been studied by the subjects\
half of these were taken from the generated list and half from
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
subjects were tested for all 79 words[
Procedure
Study list items were hand!printed on index cards and pre!
sented individually[ The presentation rate was approximately
one card every 4 sec[ In the generate condition\ subjects were
asked to read the clue silently and then to say the target word
aloud[ In the read condition\ subjects were simply asked to read
the words aloud[ The order of presentation was blocked\ i[e[
either all generate followed by all read tasks or vice versa\ but
within each task\ the target words were presented in a unique
random order for each subject[ Neither group of subjects
showed any di.culty in reading the test materials[
After the presentation of the study list\ subjects were told
that there would be two more tasks before they were given a
memory test[ Half the subjects were given the Mill Hill Vocabu!
lary Test and half the Digit Symbol test from the WAIS as
_ller tasks[ The _ller task was then followed by a word stem
completion task which\ in turn\ was followed by the alternative
test list as a cued recall test "following Java ð01Ł#[ In the word!
stem completion test\ subjects were given sheets with word
stems printed in capital letters and asked to complete as many
as they could with the _rst word "apart from proper nouns#
that came into their heads[ They were then told that they would
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
previously[ They were also told that only half the stems related
to words from the study list and were asked not to guess[ Neither
group of subjects showed any evidence of having di.culty in
completing the generate or read tasks[
Results and discussion
The baseline completion rates for nonstudied words
for the implicit test were 9[02 for both groups[ The cor!
responding intrusion rates for nonstudied words in the
cued recall test were 9[91 for the Asperger group and 9[92
for controls[ As these baseline and intrusion rates are
almost identical\ all further analyses were conducted on
uncorrected study word completion rates[ The principal
results from the word stem completion and the cued recall
tests for both experimental groups are outlined in Fig[ 0[
These results indicate that both groups performed in a
similar way in each test[ Both groups showed a superior
Fig[ 0[ Cued recall and word stem completion in Experiment 1[
recall of generated words in the explicit test\ and superior
completion of read words in the implicit test[
Repeated measures analysis of variance supported this
description of the data by showing no signi_cant di}er!
ence in overall performance between the two groups ðF
"0\29# ³ 0Ł[ Signi_cantly more items were completed
under the implicit than under the explicit conditions
ðF "0\29#  16[24\ P ³ 9[990Ł[ Neither the group by
generate:read nor the group by implicit:explicit nor the
three!way "group by generate:read by implicit:explicit#
interactions were signi_cant[ However\ the inter!
action between the two within!subject variables
"implicit:explicit by generate:read# was signi_cant ðF
"0\29#  20[02\ P ³ 9[990Ł[ These results therefore rep!
licated those obtained by Java ð10Ł and further showed
that Asperger subjects do not show any evidence of mem!
ory impairment in explicit compared with implicit tests
when the retrieval intentionality criterion is met ð13Ł[
Since amnesic subjects do show memory impairment
under such conditions "e[g[ ð8Ł#\ our results provide no
support for a parallel between the amnesic syndrome and
autistic disorders[
General discussion
The central aim of this study was to provide a sys!
tematic investigation into the nature of the memory de_!
cits in Asperger|s syndrome[ The results of Experiment 0
clearly showed that the Asperger subjects resemble classi!
cally autistic individuals in their failure to use semantic
information to aid free recall ð15\ 06Ł\ but that in Experi!
ment 1\ they did not resemble amnesic subjects in a direct
comparison between explicit and implicit tests with word
stem cues[ There is\ therefore\ no support for the parallel
between autism and the amnesic syndrome that was _rst
proposed by researchers such as Boucher and Warrington
ð6Ł[ In addition\ by replicating Java|s ð01Ł demonstration
of a cross!over interaction between the kind of test and
generating vs reading the words at study\ the results of
the second experiment rule out the possibility that the
Asperger subjects were responding to the cued recall test
 D[ M[ Bowler:Asperger|s syndrome and memory
in an implicit manner[ This last point is further supported
by the observation that on the cued recall test admin!
istered here\ implicit responses on the explicit test would
probably have led to in~ated intrusion rates for the
Asperger group had they been responding implicitly[
However\ the comparable baseline and intrusion rates
found for both groups suggest that this did not happen[
We can\ therefore\ conclude with con_dence that unim!
paired cued recall in people with Asperger|s syndrome
does not result from the operation of automatic processes
on an explicit test[
The most obvious explanation of the di}erence
between the impaired performance in Experiment 0 and
unimpaired performance in Experiment 1 centres on the
degree of conscious control that subjects had to exercise
over their memory in the two situations[ In the _rst
experiment\ subjects were given a general instruction to
learn the word lists and to remember as many of the lists
as they could[ By contrast\ in the second experiment\
both the encoding and the retrieval strategies were tightly
constrained by the demands of the task[ At the study
phase\ subjects had to read or to generate words\ and
at recall\ had to complete word stems[ The _nding in
Experiment 0 of impairment under unconstrained con!
ditions coupled with unimpaired performance in Experi!
ment 1\ where constraints were strong\ is in line with
Minshew et al[|s ð06\ 07Ł conclusion that people with
autism perform poorly when they have to develop com!
plex organizing strategies to help in their recall of infor!
mation[ Further tests of this account of autistic memory
de_cits should be aimed at devising a series of experi!
ments that systematically manipulate the degree of con!
trol required of the subject both at study and at recall[ It
remains possible that the Asperger subjects| performance
on the cued recall task remained unimpaired because\
being a recognition task\ it was easier than free recall
tasks[ With this argument\ there could still be a similarity
between Asperger|s syndrome and amnesia with the two
conditions di}ering only in the degree of impairment[
However\ this question cannot be settled by the results
of the present study[
Acknowled`ements*The work reported here formed part of a
dissertation by the second author for the degree of B[Sc[ of
City University[ The _rst and last authors would also like to
acknowledge the support of the Wellcome Trust and the ESRC\
respectively[ Sincere thanks are also due to the Centre for Social
and Communication Disorders for help in the recruitment of
subjects[
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