The eVect of semantic and emotional context on written recall for verbal language in high functioning adults with autism spectrum disorder

Objective—Several deficits have been proposed to account for cognitive impairment in autism including an inability to comprehend the perspectives of others (“theory of mind”), an inability to process emotional information, and diYculty drawing together diverse information in context (“central coherence”). Because context (central coherence) and emotion can influence memory, a study was designed to show if autism spectrum disorder was associated with impaired utilisation of context and emotion in recall; and if impairments in theory of mind processing would influence recall in autism spectrum disorder. Methods—Ten high functioning subjects with autism spectrum disorder and 13 age and IQ matched controls were tested using recall tests. In the first coherence memory test, subjects listened to a series of word lists that were in varying degrees of syntactic and semantic (coherent) order and were asked to recall the words. In the second coherence memory test, subjects listened to stories consisting of sentences that were, or were not, in logical (coherent) order. In the emotional memory test, the subjects listened to sentences that were highly emotional or nonemotional. In the theory of mind test, the subjects listened to stories requiring varying levels of understanding of the perspectives of others. Results—There were no significant diVerences between groups in recall of coherent versus incoherent word lists, nor was there a significant diVerence between groups in recall of coherent versus incoherent stories. However, the control subjects recalled more of the emotional than non-emotional sentences, whereas the autism spectrum disorder group did not show such a diVerence. No significant difference existed in recall of stories requiring varying levels of understanding of the perspectives of others among subjects with autism spectrum disorder, and subjects with autism spectrum disorder did not diVer from control subjects in the influence of theory of mind content on story recall. Conclusion—The study shows that memory in high functioning adults with autism spectrum disorder is facilitated by emotional content to a lesser degree than it is facilitated by coherence. Therefore, impairments in emotional processing cannot be considered as simply an eVect of the “weak central coherence” theory in autism spectrum disorder. Whereas the reasons for this emotional deficit are unknown, evidence of abnormalities of the limbic structures in autism spectrum disorder may provide an anatomical explanation. (J Neurol Neurosurg Psychiatry 1998;65:685–692)