Memory in Autism: Interview with Dermot Bowler

Flaking Seaside Mural (Essaouira, Morocco)

Flaking Seaside Mural (Essaouira, Morocco)

Take a minute out from whatever you’re doing, close your eyes, and think back to your last holiday.

The minute’s up. Done it? Of course you haven’t: nobody takes orders from online text. In which case while I’m rambling on here try to imagine closing your eyes and remembering your last holiday.

But trying to imagine remembering something is quite a feat of dissociation; you might have to close your eyes to achieve it. So close your eyes and try to imagine yourself closing your eyes and…

You get the point. Hopefully by now there are little stories and images from your last holiday bobbing around in the back of your mind. How lovely. The way that will have happened, that little exercise in memory recall, probably seems completely “normal” to you.

But many people would remember a moment from their last holiday much in the same way that you remember, say, the boiling point of water in Kelvin1: as “an isolated fact without much self-involvement”. So, your way of doing things (so ego-driven! why do you always put yourself at the centre of everything?) isn’t that normal after all.

Such were my thoughts as I stepped out of the office of Dermot Bowler, Professor of Psychology at City University. Prof Bowler’s main research interest is in the functioning of memory in autistic individuals and the holiday/boiling-point-of-water analogy is his: the “many people” referred to above would be autistic.

I interviewed Prof Bowler for an audio feature on autism (which is still in the works) for the Elements website. As my own knowledge of autism is shaky – I come from a pharmacology background and the neurological  conditions that pharmacology undergrads are taught about tend to be those for which there is a drug “therapy” – I’d wondered if “memory in autism” wasn’t a rather academic, esoteric field, of interest only to specialists.

I was thinking much too neurotypically2. As Prof Bowler spoke I became increasingly aware that here was a group of people who perceived the world in a very different way to me, and that the work of researchers like Prof Bowler revealed not just how their minds work, but mine too3.

It was such an eye-opener that I’ve decided to present a transcript of the interview here. I’ve dropped in some links to explain in more detail some of the concepts and events that Prof Bowler touches on.

James Brooks: First of all, I’d just like to clear-up what high-functioning autism is4. Does it run a gamut of abilities and also include Asperger syndrome or is Asperger’s slightly separate?

Dermot Bowler: That’s quite a contentious issue. I think the growing consensus is that Asperger’s is included as part of the autism spectrum.

When autism was first described by [Leo] Kanner in 1943, he described a subgroup in what we now call the autism spectrum. The people he described were children, they were very often mute or had very low levels of language – which had particular characteristic features – and about three quarters of them also had an accompanying intellectual disability.

Hans AspergerA few years later another Austrian, but writing in German, called Asperger, described more able adolescents who had good language but whose clinical picture in many respects resembled that of the children that Kanner described. However, Asperger’s ideas lay largely dormant until the 1980s in the English speaking world.

The work of Lorna Wing5 was really responsible for bringing Asperger’s ideas into the mainstream and for alerting us to the fact that the condition that Kanner described was just one aspect of a much broader set of conditions called the autism spectrum. […]

A very severely autistic individual would be indifferent to other people, much more interested in objects in the room and not interested in joining in [with what other people are doing]. On the other hand somebody with Asperger’s syndrome might just come across as being a little bit cold, distant, eccentric and so on, but could engage with other people – albeit on a slightly different wavelength from what you would usually expect.

In parallel with this you have intellectual disability which can range from anything from severe intellectual disability right through to people that have got IQ’s that are way above the normal range.

JB: Across the wide autism spectrum, then, are there commonalities in memory function?

DB: There are some commonalities. The problem is that people with lower-functioning ASD [autism spectrum disorder] are a very under-researched group and the amount of memory research, although it’s not zero, is nothing by comparison with that carried out with higher-functioning individuals.

There are commonalities, but there are some differences as well. At the moment, various researchers including Professor Jill Boucher, who works in this lab, are investigating that. The role of language seems to play quite an important part.

JB: How so?

DB: It’s not fully specified as yet. My colleague Esha Massand has been doing some work looking at brain activity in episodic memory, that’s your memory for something you’ve directly experienced in the past, and it seems likely that the patterning of brain activity for “verbalisable” material – so that includes lists of words or lists of pictures of objects that you can give word-names to – is different from the pattern of brain activity for lists of abstract geometric patterns that you can’t readily give names to.

That difference is found in typical individuals but the way that difference manifests itself is different again in people with ASD6. This suggests the way that they use language to modulate their memory processes may not be the way that typical individual would.

And there’s another study relating to complex problem solving whereby when we have to solve a very complex task we have an internal dialogue with ourselves and if you disrupt that dialogue you actually disrupt performance on the task. You don’t find this for people with ASD. Although they engage an internal dialogue, disruption of that dialogue won’t impact on their task performance in quite the same way.

JB: I know that autistic people also have problems with facial recognition…is that also involved in how their memory works, does that arise from memory function…what’s the link there?

"difficulties recognising faces..."DB: There are certainly difficulties with processing faces that people with autism experience. The way they seem to process faces is as a completely fixed pattern rather than both as a completely fixed pattern and an assemblage of parts that can vary slightly. And that impacts upon their accuracy at recognising faces and as well as the way they look at faces and the information they get from them.

How that in turn impacts on memory is quite complicated. I think the way that individuals with autism see faces as this fixed, un-decomposable entity is one aspect of a more general tendency when it comes to processing any kind of complex information: they tend to process it in a fixed rather than a flexible fashion. So the two are related but they’re related because they both touch on a common underlying difficulty.

JB: I see. We’ve talked a bit about what could be called “deficit” in memory function, what about – and I think the general public is more aware of this – those autistic savants and people with Asperger’s who are able to demonstrate particular feats of memory? What’s going on there?

DB: First of all, savant syndrome is found more often in people with autism than it is in the general population but it’s still quite rare in people with autism. There are a few people with savant syndrome who come to our lab and there’s been quite a bit of research done into why people to have these exceptional memory skills.

The consensus appears to be that the particular characteristics that autistic people show enable them to, for example, spend a great deal of time studying calendars and learning the patterns of the way dates relate to days and so on. When you’ve got a lot of time to study something like that because you’re not particularly interested in other people…well, you’re going to be able to learn something that’s a fairly closed, algorithmic, structured system like that.

These are the kinds of things that capture the public imagination; what day did 31st August 1856 fall on? “It was a Wednesday!” they can tell you, almost instantly7.

One of the issues that this poses from a clinical point of view is that parents will often say [of their autistic child] that he or she has a terrific memory. But when you probe them about it, yes, the child can reel off an enormous amount of facts about something but actually has very little ability to apply that knowledge.

That seems to be a recurring theme in individuals with autism: they possess enormous amounts of information and yet are not able to recruit that in any adaptive, flexible way. It seems to be this rigid “well, I learn it and I can reproduce it” but that’s the end of the story. Whereas most of us, although we acquire incidentally huge numbers of useless facts, there’s an awful lot of stuff we know that helps us, like you would remember how to get out of this room, for example.

JB: Are there any brain structures which are particularly implicated in memory function in autistic people?

DB: Yes, our declarative memory system –the memory system that we use when we actively try to recollect something – is mediated by an area called the medial temporal lobe, specifically in its interactions with the rest of the cerebral cortex in terms of stored information and also with sensory cortical areas where new information comes in. The information [from these “inputs”] is processed in the medial temporal lobe and then is stored in other areas of the association cortex. All this happens under the tutelage or control of the frontal lobes.

[The hippocampus – a structure within the medial temporal lobe – is particularly important in this mediation: it functions as a kind of neural switchboard, relaying information between different parts of the brain.]8

The location of the hippocampus in the brainA lot of the difficulties that we see in people with autism – but not all – suggest some kind of hippocampal dysfunction. But the hippocampus can be dysfunctional not because there’s anything wrong with it, but because some of the other connections are functioning atypically. Several people have the view that people with autism have an enhanced perceptual function and so the hippocampus gets information that is overly perceptually detailed.

That impacts on the kind of information that the person stores. Most of our intellectual life is based on seeing what’s happening in the world, drawing on stored knowledge and then manipulating that in some way to achieve an adaptive outcome. If this knowledge is stored atypically then the hippocampus is going to be doing different things and so the adaptive behaviour is going to be different.

So the connectivity in the hippocampal-frontal-cortical system [seems to be very important].

JB: With regard to the work that you’ve done, do you think – and maybe it’s already happened – that you’re able to help autistic people with their memory in their day-to-day lives?

DB: We hope so. One of the major discoveries that we’ve made is that the sense of the personally experienced past – how when you remember the last time you went on holiday you relive your own experience of that event in your head – that’s much diminished in people with autism. It’s not that autistic people don’t have it but they remember things like that much in the same way that you’d remember what the boiling point of water is: it’s just an isolated fact without much self-involvement.

Knowing that is, I think, very important for somebody whose job it is to help those people with autism deal with the world.

And although autistic people [use this system less, they use it] in similar sorts of ways to typical individuals. So that’s encouraging because it gives us some kind of handle to help them develop the little that they’ve got.

It also helps autistic people understand us. You must remember that we’re very bewildering to them and if you can provide information that shows that the way we remember stuff is a bit different from the way they do – and that we’re flooded by things that they’re just dimly aware of and perhaps attach no particular consequence to – that can be very helpful.

JB: Is there anything else you’d like to add, perhaps something that when the subject of autism comes up in the press of the media you think doesn’t get enough attention?

DB: I don’t think so. I mean when I started working in the field of Asperger’s syndrome nobody had ever heard of it now everybody knows what it is and that’s terrific. I think the media profile of autism is good and getting better in that we’re recognising it not so much as a problem but more as something that affects individuals’ lives and makes them different in a way that we should try to understand – I think that’s important.

Notes

1.       373.15 K, if you were interested.

2.       This is a reference to the “neurodiversity” movement which (I can’t do better than Wikipedia here) “asserts that atypical (neurodivergent) neurological development is a normal human difference that is to be recognized and respected as any other human variation.” In the language of neurodiversity adherents, “normal” people are referred to as “neurotypical”. Autism rights campaigners are at the forefront of this movement. For more information I recommend Andrew Solomon’s article, “The autism rights movement” in New York Magazine.

3.       OK, I’m being disingenuous. This is always part of my (and most people’s, I would think) fascination with neurological or psychiatric conditions: they reveal as much about the neurotypical brain as they do the neurodivergent one.

4.       Prof Bowler’s work is primarily in the field of high-functioning autism and Asperger’s.

5.       With whom Prof Bowler worked.

6.       This passage illustrates some of the difficulties that arise when talking about autism: there are many differences in the differences!

7.       They’d be wrong: 31st August 1856 was a Sunday.

8.       This is some very loose paraphrasing and the switchboard analogy is my own. Prof Bowler went into more detail here.

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