Event-based prospective memory in children with autism spectrum disorder: The role of executive function
Introduction
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by socio-communication impairments, and restricted and repetitive behaviors. Many individuals with ASD also have impairments in executive functioning skills (see Hill, 2004 for review), and thus have difficulty with tasks that require planning, organizing, inhibiting behavior, keeping track of multiple things simultaneously, and keeping track of time. Day to day living skills, as well as some types of memory functions requires implementation of executive functioning skills.
One type of memory that requires executive functioning skills is prospective memory (PM). PM is the type of memory required to conduct future actions (e.g., McDaniel and Einstein, 2007, Williams et al., 2013). PM plays an important role in daily cognition and activities of daily living, ranging from relatively simple tasks (e.g., remembering to buy groceries) to more fundamental tasks (e.g., remembering to take necessary medication). There are two ways in which PM retrieval can occur, by an event, event-based PM, for example remembering to call a friend for their birthday; or by a specific time point, time-based PM, for example remembering to make a phone call in 20 minutes. Due to the presence of an external cue, event-based PM tasks are relatively simpler than time-based PM tasks, which require more self-initiation (Williams et al., 2013).
PM requires the integration of several complex processes. First, one has to plan the future action, and maintain the intention to complete the action while processing other information. Second, when either an event-based or a time-based cue is presented, one has to retrieve the PM, inhibit, and flexibly switch from an on-going task to the planned action (Kliegel, Martin, McDaniel, & Einstein, 2002). Therefore, successful PM requires a certain level of executive functioning ability, which typically involves three functional domains: working memory, cognitive flexibility, and inhibitory control (Altgassen et al., 2009, Mackinlay et al., 2006, Miyake et al., 2000). Impairments in these aspects of executive functioning have been highlighted in several studies of children with ASD (e.g., Cui et al., 2010, Dichter et al., 2010, Ozonoff and Jensen, 1999, Prior and Hoffman, 1990, Yi et al., 2012). In light of these executive functioning deficits, it is reasonable to postulate that individuals with ASD would also have associated deficits in PM.
The few studies that have examined PM in individuals with ASD have had contradictory findings. While several studies have repeatedly demonstrated impaired time-based PM in individuals with ASD (Altgassen et al., 2009, Altgassen et al., 2012, Williams et al., 2013), studies examining event-based PM have been less conclusive. Some studies have reported intact event-based PM skills in ASD (Altgassen et al., 2010, Williams et al., 2013), while other studies have reported impairments (Altgassen et al., 2012, Brandimonte et al., 2011, Jones et al., 2011). Two factors may be contributing to this discrepancy–heterogeneity of the sample and heterogeneity of the types of PM tasks used. Participants in the Altgassen et al. study (2012) were adults, while participants in other studies were primarily children and adolescents (Altgassen et al., 2010, Williams et al., 2013). In terms of task heterogeneity, tasks used in previous studies included standard PM tasks, such as the Red Pencil test, the Dresden Breakfast task (Altgassen et al., 2012), the Rivermead Behavioral Memory test (Jones et al., 2011), and several computer-based games (Altgassen et al., 2009, Williams et al., 2013). These tasks are varied in their nature and complexity, as such the performance of PM in individuals with ASD varied dependent on task difficulty. For example, in the Dresden Breakfast task, a naturalistic prospective memory task which has high demands on inhibition and switching, adult participants with ASD demonstrated more impaired event- and time-based PM performance than typical controls (Altgassen et al., 2012).
Despite its theorized relationship with PM, the exact role that executive functioning plays in PM in individuals with ASD has been difficult to establish. It has been postulated that event-based PM tasks have less of a demand for executive functioning than time-based PM tasks (Altgassen et al., 2012); as such, these skills may not be as affected when an individual has executive functioning deficits. In school-aged children with ASD, Williams et al. (2013) did not find a relationship between executive functioning and PM; and in adults with ASD, only time-based PM tasks were related to executive functioning skills (Altgassen et al., 2012).
An important aspect to consider however is the effect of age on executive functioning skills. These skills develop with age, and studies have found significant age effects on executive functioning in typically developing children (e.g., Kvavilashvili et al., 2001, Somerville et al., 1983). In a longitudinal study examining the development of executive functioning in typically developing children, Lee, Bull, and Ho (2013) demonstrated that the organization of these skills change from early childhood to adolescence, with older children having better developed inhibitory control. In ASD, while some executive functioning skills improve over time, it is at a slower rate, and it generally remains impaired compared to typically developing children (O’Hearn, Asato, Ordaz, & Luna, 2008). Thus, some of the differences observed across studies may in fact be related to the age difference of the participants, as executive functioning may play a more important role in the PM development in younger children. An alternative explanation is the possible effect of intellectual functioning on executive functioning skills.
Executive functioning skills are difficult to disentangle from cognitive skills. Many of the cognitive processes that are associated with intellectual functioning, for example working memory and processing speed also involve executive functioning skills. Studies have found that some aspects of executive functioning are associated with IQ. However, the previous studies that have examined the PM abilities of individuals with ASD have primarily included a homogeneous group of participants with average to above average cognitive skills (Altgassen et al., 2009, Altgassen et al., 2010, Altgassen et al., 2012, Brandimonte et al., 2011, Jones et al., 2011, Williams et al., 2013).
The current study has three aims: (a) to compare the performance of event-based PM in young children with ASD to their typically developing age- and ability-matched peers; (b) to investigate the role of executive functioning on event-based PM in young children with ASD with below average nonverbal IQ (NVIQ); and (c) to examine the role of age and cognitive functioning in the development of event-based PM in young children with ASD with below average NVIQ compared to age- or ability-matched typically developing peers. Based on the few studies examining PM in children with ASD, we expected that this young group of children with ASD would demonstrate poorer performance on the event-based PM task than their typically developing peers. Additionally, we expected that the PM performance in children with ASD would be related to cognitive functioning and to some aspects of executive functioning.
Section snippets
Participants
Participants included 25 preschool or school-aged children diagnosed with ASD (range = 4–10 years, Mage = 7.66 years, SD = 1.56; 6 female), 25 age-matched typically developing children (TD; range = 4–11 years, Mage = 7.68 years, SD = 1.72; 6 female), and 28 ability-matched TD children (age range = 4–9 years, Mage = 5.79 years, SD = 1.34; 6 female). In order to match the nonverbal and verbal abilities of the ASD group to the TD group, we recruited younger typically developing participants, thus, these
Results
All analyses were conducted using R and SAS. Significance was set at p < .05. As there was no variability in scores in the TD groups, all children earned the highest possible score, we conducted a series of Wilcoxon–Mann–Whitney tests to compare the PM performance between groups. The Wilcoxon–Mann–Whitney test is a nonparametric test used to compare differences between populations; this test does not require that samples are normally distributed, and is thus appropriate for the current sample.
Discussion
The aims of the current study were (a) to compare the performance of event-based PM in young children with ASD to their typically developing age- and ability-matched peers; (b) to investigate the role of executive functioning on event-based PM in young children with ASD with below average NVIQ; and (c) to examine the role of age and cognitive functioning in the development of event-based PM in young children with ASD with below average nonverbal IQ (NVIQ) compared to age- or ability-matched
Conclusions
In conclusion, the present study provides evidence for PM deficits with a younger and lower-functioning ASD group, and the important role of NVIQ in the development of PM in ASD. The study also suggests that executive functioning may play an important role in the development of PM in typically developing children, and that some aspects of executive functioning may be more sensitive to age than cognitive ability.
Acknowledgments
This work was supported by the National Natural Science Foundation of China (31200779), Humanity and Social Science Youth Foundation of Ministry of Education of China (12YJC190034), NSFC for Excellent Young Scholar (11322108), Major State Basic Research Development Program (2012CB517900), and the Fundamental Research Funds for the Central Universities (13wkpy40). The authors are grateful to Chigangyuan Kindergarten, Ruibao Primary School, Juying Huang, and Shuangshuang Yu, for their generous
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2021, Research in Developmental DisabilitiesCitation Excerpt :For example, the picture cue employed by Brandimonte et al. (2011) did not differ visually to the items of the ongoing task, whereas the cue employed by Altgassen, Phillips et al. (2010) was a distinctive bright yellow, covering much of the screen and the cue presented by Altgassen and Koch (2014) were distinctive blue words which may have stood out as compared to the usual ongoing task trials (though in both studies, the changing background / word colour was not unique to the PM cue, but occurred for every trial). The cues of the other studies demonstrating intact event-based PM of autistic participants were also arguably of relatively high salience, such as large, distinctive lorries in a computer game (Williams et al., 2013), whereas the small heart in the corner of a card (Yi et al., 2014) and the kettle changing colour (Altgassen et al., 2012), cues within studies that found impaired event-based PM, were less contextually distinctive. According to the Multiprocess Framework (McDaniel & Einstein, 2000) differences in cue salience could contribute to the contrasting results of the event-based PM and autism literature.
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2017, NeuropsychologiaCitation Excerpt :This has been confirmed in several recent studies. Studies investigating laboratory-based prospective memory tasks in children and adolescents with ASC have generally found that their performance is impaired in comparison with neurotypical controls (Altgassen et al., 2009; Brandimonte et al., 2011; Henry et al., 2014; Jones et al., 2011; Mackinlay et al., 2006; Rajendran et al., 2011; Sheppard et al., 2016; Williams et al., 2013; Yi et al., 2014). The difficulties of children with ASC may be particularly pronounced for time-based tasks (where something needs to be done at a particular time) rather than event-based tasks (where something needs to be done when a particular cue appears; Henry et al., 2014; Williams et al., 2013).
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2019, Cognitive DevelopmentCitation Excerpt :First, Table 1 illustrates that although most studies agree on the existence of a link between EF and PM, so far, there is no consensus on how the three EF are specifically associated to the different PM types. For example, looking at children's nonfocal PM, Table 1 shows that Spiess, Meier, and Roebers (2015) found a significant association with shifting and updating but not with inhibition, whereas Mahy et al. (2014b) as well as Yi et al. (2014) present the exact opposite pattern of results. Similarly, inconsistent correlational patterns are observed for focal and time-based PM (again, see Table 1).
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