A Meta-Analysis of Working Memory Impairments in Autism Spectrum Disorders

Wang, Ya; Zhang, Yibing; Liu, Lu‐lu; Cui, Ji‐fang; Wang, Jing; Shum, David; van Amelsvoort, Thérèse; Chan, Raymond C. K. · 2017 · OpenAlex-citations

DOI: 10.1007/s11065-016-9336-y

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Summary

This meta-analysis addresses the inconsistent findings regarding working memory (WM) impairments in individuals with Autism Spectrum Disorders (ASD). While executive dysfunction is a core characteristic of ASD, previous studies have yielded conflicting results concerning the presence and nature of WM deficits. The authors aimed to quantitatively synthesize existing evidence to determine the overall magnitude of WM impairment in ASD and to evaluate potential moderating variables, including WM type (verbal vs. spatial), cognitive processing components (maintenance vs. manipulation), diagnostic criteria, age, and IQ. The study included 28 published studies comprising 819 individuals with ASD and 875 healthy controls. Data were extracted from databases such as Elsevier, PsychINFO, and Springer, covering literature from 1986 to 2014. Effect sizes (Cohen’s d) were calculated using Comprehensive Meta Analysis software. The analysis examined overall WM performance and conducted moderator analyses for diagnostic criteria (ADI/ADOS, DSM/ICD, or both), WM domain, cognitive load (1-back vs. 2-back tasks), and meta-regressions for age and IQ. The results identified a significant overall WM impairment in individuals with ASD, with a pooled effect size of -0.61, indicating a medium-to-large deficit compared to controls. Moderator analyses revealed that spatial WM was more severely impaired (d = -0.72) than verbal WM (d = -0.44). The severity of impairment was also influenced by diagnostic criteria; individuals diagnosed using both ADI/ADOS and DSM/ICD criteria exhibited larger deficits (d = -0.68) than those diagnosed with only one set of criteria. Conversely, the component of cognitive processing (maintenance alone vs. maintenance plus manipulation) and cognitive load did not significantly affect the severity of WM impairments. Furthermore, meta-regression analyses showed that neither age nor IQ significantly predicted the magnitude of WM deficits. These findings confirm that WM is a robustly impaired domain in ASD, particularly within the spatial subsystem. The lack of association with age suggests that WM deficits are persistent across development rather than transient. The study implies that interventions for ASD should specifically target spatial working memory. Additionally, the finding that stricter diagnostic criteria correlate with greater impairment suggests that WM deficits may be more pronounced in individuals with more severe or conservatively diagnosed ASD. The results also challenge theories suggesting that superior visuospatial abilities in ASD compensate for executive dysfunction, instead indicating that spatial processing demands may exacerbate underlying cognitive deficits.

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• working memory