Metacognition and Mindreading in Autism
Metacognition and Mindreading in Autism
Catherine Grainger
University of Kent
David M. Williams
University of Kent
Sophie E. Lind
City University London
This article may not exactly replicate the final version published in Journal of Abnormal
Psychology. It is not a copy of the record. The article can be accessed at:
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Authors Note
The authors would like to sincerely thank all of the participants who took part in this
study. Without their support, this research would not have been possible. The authors would
also like to thank the National Autistic Society and Durham University Service for Students
with Disabilities for their assistance with participant recruitment. Finally, we would like to
thank Anna Peel and Emma Grisdale for their assistance with data collection. Catherine
Grainger was funded by an Economic and Social Research Council doctoral studentship, and
a University of Kent PhD scholarship.
Correspondence concerning this article should be addressed to Catherine Grainger,
School of Psychology, Keynes College, University of Kent, Canterbury, CT2 7NP. Email:
[email protected]
Contact information for authors:
Catherine Grainger
School of Psychology,
Keynes College,
University of Kent,
Canterbury,
CT2 7NP
Email: [email protected]
Tel: +44(0)1227 823090
David Williams
School of Psychology,
Keynes College,
University of Kent,
Canterbury,
CT2 7NP
Email: [email protected]
Tel. +44 (0)1227 827652
Sophie E. Lind
Autism Research Group
Psychology Department
Social Sciences Building
City University London
Whiskin Street
London
EC1R 0JD
Email: [email protected]
Tel: +44(0)20 7040 3372
Abstract
Objectives: Metacognition refers to cognition about cognition, and encompasses both
knowledge of cognitive processes and the ability to monitor and control ones own
cognitions. The current study aimed to establish whether metacognition is impaired in autism
spectrum disorder (ASD). According to some theories, the ability to represent ones own
mental states (an aspect of metacognition) relies on the same mechanism as the ability to
represent others mental states (mindreading). Given numerous studies have shown
mindreading is impaired in ASD, there is good reason to predict concurrent impairments in
metacognition. Metacognition is most commonly explored in the context of memory, often by
assessing peoples ability to monitor their memory processes. The current study addressed
the question of whether people with ASD have difficulty monitoring the contents of their
memory (alongside impaired mindreading).
Method: Eighteen intellectually high-functioning adults with ASD and 18 IQ- and
age-matched neurotypical adults participated. Metamemory monitoring ability and
mindreading ability were assessed using a feeling-of-knowing task and the animations task,
respectively. Participants also completed a self-report measure of metacognitive ability.
Results: In addition to showing impaired mindreading, participants with ASD made
significantly less accurate feeling-of-knowing judgements than neurotypical adults,
suggesting that metamemory monitoring (an aspect of metacognition) was impaired.
Conversely, participants with ASD self-reported superior metacognitive abilities compared to
those reported by neurotypical participants.
Conclusion: This study provides evidence that individuals with ASD have
metamemory monitoring impairments. The theoretical and practical implications of these
findings for our current understanding of metacognition in ASD and typical development are
discussed.
Metamemory judgments
One of the most commonly-used and classic paradigms to assess metamemory
monitoring involves asking people to make feeling-of-knowing (FOK; Hart, 1965)
judgements. During a typical FOK task, participants are asked (during a study phase) to
memorise a series of stimulus pairs (e.g., pairs of words, such as pen-key, computerelephant etc.). Participants are then presented (during a cued-recall test phase) with one
stimulus from each pair (the cue; e.g., pen), and asked to recall its missing pair (the target;
e.g., key). Importantly, on trials in which participants fail to correctly recall the target they
are asked to judge the likelihood that, at a later point, they would be able to recognise it.
Finally, participants are then presented with the cue and are asked to select the unrecalled
target from several options (a recognition test phase). The accuracy of participants
judgments on metamemory tasks is typically assessed using Gamma correlations (Goodman
& Kruskal, 1954), which measure the association between individuals predictions about their
future ability to recognise the correct target with their actual subsequent recognition
performance (see the Method section for a detailed description of how Gamma correlations
are calculated).
Metacognition as applied theory of mind
Theory of mind (ToM) is the ability to attribute mental states, such as beliefs, desires,
and intentions, to self and others in order to explain and predict behaviour (Premack &
Woodruff, 1978). While most research into ToM focuses on awareness of other minds
(henceforth called mindreading), research into metacognition focuses on awareness of
ones own mind. Indeed, given the potential role of metacognition in self-regulation, Flavell
(2000) considered metacognition an example of applied ToM.
Several different perspectives have been proposed to explain the potential relation
between mindreading and metacognition. According to one perspective (e.g., Carruthers,
2009; Frith & Happ, 1999), the ability to represent ones own mental states (metacognition)
relies on the same underlying metarepresentational mechanism as the ability to understand
mental states in others (mindreading). Crucially, according to this one-mechanism theory, no
dissociation should exist between mindreading and metacognition ability; individuals who
demonstrate mindreading impairments should also demonstrate impaired metacognition.
However, this proposal has been disputed. According to a version of the simulation theory,
our ability to read other minds stems from our ability to directly introspect the contents of our
own mind, and then use this information to mentally simulate the contents of anothers mind
in imagination (e.g., Goldman, 2006). From this perspective, metacognition is both
ontogenetically and phylogenetically prior to, and foundational for, mindreading. According
to a third theory, proposed by Nichols and Stich (2003), mindreading and metacognition are
underpinned by separate mechanisms; the monitoring mechanism is responsible for access
to/awareness of ones own mental states, whereas a separate mindreading mechanism is
responsible for processing information about others mental states. Crucially, both of these
latter two theories imply that there should be some people who manifest diminished
mindreading abilities, despite undiminished metacognition. Indeed, both Goldman, and
Nichols and Stich explicitly suggest that people with autism spectrum disorder (ASD) present
precisely this pattern of impaired mindreading, but intact metacognition.
diminished mindreading ability (see Yirmiya, Erel, Shaked, & Solomonica-Levi, 1998).
However, until recently the question of whether metacognition is diminished among people
with ASD has remained largely unexplored.
The study of metacognition in ASD could have important implications for educational
practice among individuals with ASD. Metacognition in general and, more specifically,
metamemory play key roles in aspects of learning and decision-making that we know people
with ASD have difficulties with. According to Nelson and Narens (1990) metamemory
model, information gained by monitoring ones own memory feeds back to memory
functioning, allowing individuals to control their learning efficiently. As such, having a good
awareness of what one has learnt can improve an individuals subsequent learning ability.
For example, when revising for an exam, if an individual can accurately assess what
information they already know, they are able to spend their time effectively, revising the
topics they do not know. This issue may be particularly relevant for intellectually highfunctioning people with ASD, given that many of these individuals show significantly lower
academic achievement than would be expected on the basis of their intelligence, which in
turn impacts negatively on their life chances (see Estes, Rivera, Bryan, Cali, & Dawson,
2011). Indeed, the educational domains in which people with ASD frequently under-achieve
are just those in which learning is known to be fostered by metacognitive training. Such
training has been shown to remediate difficulties in reading comprehension (see Brown &
Campione, 1996), writing (e.g., Sitko, 1998) and mathematical reasoning (e.g., Fuchs et al.,
2003). In each of these domains, individuals with ASD show statistically significant underachievement, relative to IQ (see Estes, et al., 2011; Jones et al., 2009) . It is possible that
diminished metacognitive monitoring contributes to the lower-than-expected levels of
academic achievement in ASD in these areas.
Thus, for several reasons it is important to establish the extent to which individuals
with ASD show diminished metacognitive ability. In a seminal paper, Frith and Happ
(1999) argued explicitly that individuals with ASD are as impaired at metacognition as they
are at mindreading. More recently, Williams (2010) has taken up this idea, citing evidence
that individuals with this disorder are as impaired at recognising their own and others
thought processes (Hurlburt, Happ, & Frith, 1994), emotions (Williams & Happ, 2010a)
and specific mental states, such as beliefs and intentions (Williams & Happ, 2010b), as they
are at recognising these states in others. Evidence from self versions of classic mindreading
tasks (e.g., Williams & Happ, 2009), in which participants are asked to report their own
previously held (now false) belief, also suggests that individuals with ASD demonstrate
diminished awareness of their own beliefs. Each of these findings suggests that
metacognition is impaired in individuals with ASD, which appears in keeping with the view
that mindreading and metacognition rely on the same underlying mechanism. As such, in our
view, the evidence from studies of mental state attribution in ASD provides support for the
one-mechanism account.
However, some have argued that there is a critical limitation with these types of
studies that prevents definitive conclusions being drawn about metacognitive ability in ASD
(see Carruthers, 2009; Nichols & Stich, 2003). The potential difficulty is that test questions
in self versions of classic mindreading tasks require participants to recall their prior mental
states, rather than report their current mental states. Simulation and two mechanisms theories
claim that only current mental states are directly accessible without the need for mindreading.
Thus, arguably, the results from the above studies do not necessarily show that metacognition
is impaired in ASD, because these tasks require inferences to be drawn about past mental
states (but see Williams, 2010, for a counter-argument).
neurotypical groups were not matched for verbal IQ (VIQ). Matching for VIQ is essential in
such studies, because differences between groups in this respect can potentially entirely
explain between-group differences in experimental task performance (see Mervis & KleinTasman, 2004). Wojcik et al. (2013) recognised this limitation and tried to overcome it using
an ANCOVA to control for group differences in VIQ. However, ANCOVA does not, in
fact, solve this problem (see Miller & Chapman, 2001) and, thus, we cannot determine
whether group differences were driven by diagnostic status or by VIQ differences. In the
current study, we explored FOK accuracy among ASD and comparison groups that were
closely matched for VIQ, as well as for age, PIQ, and FSIQ. If, as we predicted, betweengroup differences in FOK accuracy were apparent, this would provide the first definitive
evidence of a diminution of this ability among individuals with ASD.
ability in individuals with ASD using a self-report questionnaire. It was predicted that
individuals in the ASD group would report diminished confidence in and awareness of and
their own thoughts, as reflected by lower scores on the cognitive self-consciousness sub-scale
and higher scores on the cognitive confidence sub-scale of the MCQ.
A measure of mindreading ability was also included in the current study. It was
important to assess participants mindreading ability, because according to the onemechanism theory, metacognitive impairments should only be apparent if mindreading
impairments are also present. To assess mindreading ability, we employed a version of the
animations task (Abell, Happ, & Frith, 2000). During this task, individuals are asked to view
a series of clips in which animated triangles interact with one another. Participants are asked
to provide descriptions of/explanations for the patterns of interaction between the triangles in
each clip. An adequate explanation of the triangles interactions requires the attribution of
mental states (e.g., intentions, desires). We employed two conditions from the task, namely a
mentalising condition and a goal-directed condition. Both of these conditions appear to rely
on the mindreading system, although performance on the mentalising condition is thought to
rely on mindreading to a greater extent than the goal-directed condition. Based on the
findings from previous studies (e.g., Abell, et al., 2000; Lind, Williams, Bowler, & Peel,
2014), we predicted that participants with ASD would show diminished overall performance
on the animations task, but not a group (TD/ASD) by condition (mentalising/goal-directed)
interaction on the task.
Method
A priori power analysis
Prior to commencing the study, G*Power 3.1 (Faul, Erdfelder, Lang, & Buchner,
2007) was used to conduct a power analysis to determine the sample size required to detect
10
the predicted group differences in gamma correlation on the FOK task. In our view, no valid
studies of FOK accuracy have been conducted among individuals with ASD. Thus, for the
purpose of this power analysis, we could not predict an effect size for the between-group
difference in FOK accuracy based on effect sizes found in previous studies. Therefore, based
on our theoretical inclination toward the one-mechanism view, we predicted that
metacognitive impairments in ASD should be of a similar magnitude to the magnitude of
mindreading impairments in this disorder. As such, our prediction for the effect size
associated with between-group difference in FOK accuracy in the current study was based on
the effect size found for between-group differences in mindreading ability in studies of ASD.
In a meta-analysis exploring mindreading ability in individuals with ASD compared to
neurotypical individuals, Yirmiya and colleagues reported an average Cohens d of 0.88
(Yirmiya, et al., 1998). Thus, assuming d = 0.88 for between-group differences in
metamemory accuracy and = .05, it was established that a total sample size of n = 17
participants per group would achieve Cohens (1992) recommended power of .80.
Participants
Ethical approval for this study was obtained from Durham University ethics
committee. Eighteen adults with ASD (13 males, 5 females) and 18 neurotypical comparison
adults (11 males, 7 females) took part, all of whom gave written, informed consent before
participating. Participants in the ASD group had all received formal diagnoses of autistic
disorder (n = 4) or Aspergers disorder (n = 14), according to DSM or ICD criteria (American
Psychiatric Association, 2000; World Heath Organisation, 1993).
In order to assess current ASD features, 15 of the 18 participants in the ASD group
completed Autism Diagnostic Observation Schedule-Generic (ADOS; Lord et al., 2000)
assessments. The remaining three participants declined to complete the ADOS, as they did
11
not feel comfortable being filmed. The three participants who did not complete the ADOS
had rigorous diagnoses and scored above the cut-off on the Autism-spectrum Quotient (see
immediately below). All participants who completed the ADOS received a total score 7, the
defined cut-off for ASD (Lord, et al., 2000). All participants completed the Autism-spectrum
Quotient (AQ; Baron-Cohen, Wheelwright, Skinner, Martin, & Clubley, 2001), a self-report
questionnaire that assesses ASD/ASD-like features. Fifteen out of 18 participants with ASD
scored above the defined cut-off for ASD on the AQ (total score 26; Woodbury-Smith,
Robinson, & Baron-Cohen, 2005). Only three participants missed this cut-off. However, all
three of these participants scored well above the defined ASD cut-off on the ADOS (all
ADOS scores among these three participants were 12). All comparison participants scored
below the defined cut-off for ASD.
No participants, in either group, reported using any psychotropic medication or any
history of neurological or psychiatric disorders (apart from ASD). The participant groups
were closely equated for verbal and non-verbal ability (see Table 1 for participant
characteristics). Verbal IQ (VIQ), performance IQ (PIQ), and full-scale IQ (FSIQ) were
assessed using the full (four subtest) version of the Wechsler Abbreviated Scale of
Intelligence (WASI; Wechsler, 1999). Groups were also closely equated for chronological
age.
Feeling-of-knowing task. The stimuli used in the FOK task were 80 word pairs,
comprising of 160 concrete nouns (80 cue words and 80 target words). Cue words were
matched with the target words for syllable length and word frequency (Kucera & Francis,
1967), as reported in the MRC psycholinguistic database (Coltheart, 1981). The adequacy of
12
13
14
particular relevance to this study. In contrast, the remaining subscales addressed issues about
worrying and the effects intrusive negative thoughts may have on ones functioning, which
seemed less related to the aims of the study,
Animations task. During the animations task, participants were required to provide a
verbal description of eight silent video clips, each of which displayed an interaction between
a large red triangle and a small blue triangle. These clips were taken directly from Abell et
al. (2000). In four of the clips, an adequate explanation of the triangles interaction required
the attribution of propositional attitudes, such as beliefs, intentions, and/or desires. As in
Abell et al.s study, these four clips comprised a mentalising condition (assessing higherlevel mindreading). In the remaining four clips, an adequate explanation of the triangles
interaction required the attribution of goal states, such as copying or following (lower-level
mindreading), but not necessarily propositional attitudes. As in Abell et al. (2000), these four
clips comprised a goal-directed condition.
Each clip was presented to participants on an LG desktop computer and the order in
which the experimental clips were presented was counterbalanced across participants. Before
undertaking the experimental trials, participants also completed two practice trials, to
familiarise themselves with the task (one goal-directed and one mentalising). During practice
trials participants were asked to describe the behaviour displayed by the triangles in each of
the video clips, and the experimenter gave feedback after each description. During the
experimental trials, participants were asked to watch the clip and provide a running
commentary, describing how the triangles interacted. During experimental trials a digital
solid state audio recorder was used to record participants descriptions, which were later
transcribed. No feedback was given on experimental trials.
Scoring
15
representing the number of correct Yes predictions an individual made, (b) the number of
incorrect Yes predictions, (c) the number of incorrect No predictions, and (d) the number
of correct No predictions. Gamma scores range between + 1 to -1, where a score of 0
indicates chance-level accuracy, a large positive value indicates a good degree of accuracy,
and a large negative value indicates less than chance-level performance on the task. However,
when calculating gamma scores, the score cannot be calculated when two or more of the
prediction rates (a, b, c, or d) are equal to 0. As such, the raw data were adjusted by adding
0.5 onto each prediction frequency and dividing by the overall number of FOK judgements
made (N) plus 1 (N+1). This correction is recommended by Snodgrass and Corwin (1988)
and is routinely used when calculating gamma scores on metamemory tasks (e.g., Bastin et
al., 2012; Wojcik, et al., 2013).
16
The number of errors made by participants in each group was calculated for two
different types of errors in FOK predictions. The number of under-confident errors
participants made was calculated as the number of incorrect No predictions, in which
individuals failed to predict their subsequently successful recognition of a target word. The
number of over-confident errors participants made was calculated as the number of incorrect
Yes predictions made, in which individuals inaccurately predicted that they would
recognise a word that they subsequently failed to recognise.
Meta-Cognitions Questionnaire. MCQ Sub-scale scores were calculated for the
Cognitive confidence subscale and the Cognitive self-consciousness subscale. Lower total
scores on the Cognitive confidence sub-scale indicated a greater confidence in ones own
cognitions, whilst higher total scores on the Cognitive self-consciousness sub-scale indicated
a higher reported awareness of ones own thought processes.
Animations task. Voice recordings of participants commentaries were transcribed
verbatim by an independent transcriber who was nave to participants diagnoses and to the
hypotheses of the study. These transcriptions were then scored by the first author and a
second, independent rater (who was blind to the hypotheses of the study and the diagnostic
status of the participants) on the basis of scoring criteria outlined in Abell et al. (2000).
Participants descriptions of each animation were given a score of 0, 1, or 2 according to their
level of accuracy, and defined as the extent to which the participants description captured the
intended meaning of the animation. As such, the total score achievable in each condition
(mentalising/goal-directed) was eight. Inter-rater reliability for scores across the eight
animations was almost perfect, Cronbachs = .98.
Statistical Analyses
17
A standard alpha level of .05 was used to determine statistical significance. All
reported significance values are for two-tailed tests. Where ANOVAs were used, we report
values as measures of effect size ( .01 = small effect, .06 = moderate effect, . 14 =
large effect; Cohen, 1969). Where t-tests were used, we report Cohens d values as measures
of effect size (.0.20 = small effect, 0.50 = moderate effect; 0.80 = large effect; Cohen,
1969).
Results
18
An additional analysis was also carried out to investigate whether the marginally
significant group difference in object-level recall of target words confounded performance at
the meta-level of the task (i.e., FOK judgements). For the purpose of this analysis, two
participants from each group were excluded to create ASD and neurotypical groups that were
matched closely for recall ability, t(30) = 1.11, p = .28, d = 0.39. Groups also remained
matched for chronological age, VIQ, PIQ, and FSIQ (all ps > .33, all ds < 0.35). An
independent-samples t-test indicated that even when groups were equated closely for recall
ability, FOK gamma scores were still significantly lower in the ASD group (M = .08, SD =
.16) than in the neurotypical group (M = .25, SD = .16), t(30) = 2.99, p = .005, d = 1.06.
Although participants with ASD made more errors overall during the task (as
reflected by reduced gamma scores), they did not show a specific bias toward being more
over-confident or under-confident in their predictions than neurotypical participants (see
Table 2 for statistics).
Table 2 shows the means and standard deviations for the two key MCQ subscale
scores in the ASD and neurotypical group. A significant between-group difference was found
in scores on the Cognitive self-consciousness subscale, indicating that participants in the
ASD group believed they were superior at monitoring their own thoughts, and more aware of
their own thought processes compared to comparison adults. There was no significant
between-group difference in scores on the Cognitive confidence subscale.
Animations task
19
Table 2 shows the means and standard deviations for performance on the animations
task. A mixed-model ANOVA was carried out on these data with Group (neurotypical/ASD)
entered as the between-subjects variable, and Animation Type (mentalising/goal-directed)
entered as the within-subject variable. There was a significant main effect of Group on
animations scores, reflecting the fact that participants with ASD performed significantly less
well than comparison participants on the task overall, F(1, 34) = 9.02, p = .005,
= .21.
There was also a significant main effect of Animation Type, indicating that, across both
groups, scores were higher in the goal-directed condition than the mentalising condition, F(1,
34) = 72.82, p < .001.
interaction, F(1, 34) = 0.29, p = .59, = .01, suggesting that individuals in the ASD group
were impaired at both higher- and lower-level mindreading, compared to individuals in the
neurotypical group.
of the animations task, or scores on either of the MCQ sub-scales, among ASD or comparison
participants, all rs -.467, all ps .06.
Discussion
Until now, no study has established the extent to which individuals with ASD are able
to accurately monitor their own memory by judging feelings-of-knowing, As such, the
primary aim of this study was to establish this. In terms of the central experimental finding,
the study found that participants with ASD showed significantly diminished FOK accuracy.
This diminution was associated with a large effect size (d = 1.06), indicating a substantial
difficulty with metamemory monitoring.
This result is in keeping with our predictions that individuals with ASD would show
impairments in metamemory monitoring. However, there are several potential explanations
for the observation of diminished gamma scores in the ASD group1. One possibility is that
individuals with ASD demonstrated a positive illusory bias during the task. The concept of
a positive illusory bias refers to a tendency for an individual to self-assess their perceived
competence as greater than their actual ability. This bias has been observed among
individuals with attention deficit hyperactivity disorder (see Owens, Goldfine, Evangelista,
Hoza, & Kaiser, 2007). More importantly, some studies have indicated that individuals with
ASD tend to self-report their own social functioning more positively than parents will report
(e.g., Lerner, Calhoun, Mikami, & De Los Reyes, 2012), and will self-report the level of their
own autistic traits as less severe than parents will report (e.g., Johnson, Filliter, & Murphy,
2009). These studies have been interpreted as suggesting that individuals with ASD may also
show a tendency to manifest a positive illusory bias. Demonstrating a positive illusory bias
may indeed partly explain our finding that participants with ASD self-reported (on the MCQ)
greater awareness of their own mental states than neurotypical comparison participants
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reported. This self-reported superior awareness among participants with ASD stood in direct
contrast to their diminished performance on an objective, well-established measure of
metamemory monitoring ability. As such, the idea that some individuals with ASD manifest
a positive illusory bias provides a plausible explanation for the MCQ findings.
However, it is not apparent that a positive illusory bias can explain our central finding
of diminished FOK accuracy among participants with ASD. Individuals who manifest a
positive illusory bias would, by definition, overestimate their memory ability and would,
thus, be expected to make more over-confident errors when making FOK judgements. In
other words, diminished FOK accuracy among people whose judgements were driven by a
positive illusory bias would be driven by over-confidence. Yet, participants with ASD did
not specifically make significantly more over-confident errors than comparison participants.
Rather, individuals with ASD made less accurate FOK judgements overall, as a result of
making both over-confident and under-confident errors. Participants with ASD showed a
quantitative diminution of FOK accuracy, but did not appear to demonstrate a consistent
qualitative difference in the kinds of error they produced. As such, it appears that
demonstrating a positive illusory bias cannot explain the specific pattern of results shown in
our study
Another possible explanation for diminished FOK accuracy in the ASD group is that
individuals with ASD may have been more inclined than comparison participants to make
yes FOK judgements only when absolutely certain about their future memory ability. This
would again result in relatively inaccurate FOK judgements, because participants would end
up being unduly under-confident about their future performance. However, it is not apparent
that this explanation can explain the specific pattern of results found in this study, given
diminished FOK accuracy among participants with ASD was not driven by under-confident
errors.
22
Instead, what can explain reduced gamma scores in the ASD group in an underlying
problem with metacognitive monitoring in individuals with ASD (leading both to overconfident and under-confident errors on the FOK task). These results have several potential
practical and clinical implications. Ultimately, if an individual has a reduced ability to
accurately assess what information they know, and what they do not know, this may have
several consequences. From an educational perspective, studies have shown that several
outcomes (such as exam performance) can be predicted by metacognitive monitoring
accuracy (e.g., Hartwig, Was, Isaacson, & Dunlosky, 2012; Thiede, Anderson, & Therriault,
2003). Findings that individuals with ASD show impaired metamemory monitoring need to
be taken into account in educational environments, and should inform intervention efforts
designed to remediate cognitive impairments in ASD. Studies in typical development have
also shown that cognitive impairments can be remediated by fostering metacognition (e.g.,
Dunlosky, Kubat-Silman, & Hertzog, 2003). Indeed, training metacognitive skills has been
shown to remediate difficulties in reading, writing and mathematical reasoning (see Brown &
Campione, 1996; Fuchs, et al., 2003; Sitko, 1998) in typical development. The results of the
current study make it plausible to suggest that diminished metacognitive monitoring ability
contributes to educational underachievement in these areas among people with ASD. If this
turns out to be correct, it could have revolutionary effects on educational practices for people
with ASD. We believe it is important for future research to build upon the current results by
exploring the extent to which metacognitive impairments contribute to educational success
among individuals with ASD.
As well as having important educational implications, our central finding of reduced
FOK accuracy in ASD also has theoretical implications. The central findings of diminished
FOK accuracy alongside diminished mindreading ability are in keeping with the predictions
of the one mechanism theory of the relation between metacognition and mindreading. Of
23
course, the results do not definitively prove the theory, but certainly they are not in keeping
with a key prediction made by either the simulation theory or the two-mechanisms theory that
metacognition is unimpaired in ASD. As such, the main results of this study provide some
support for the one-mechanism account. Having said this, we did not find a significant
positive association between FOK accuracy and performance in either the mentalising or
goal-directed conditions of the animations task. The one-mechanism account would have
predicted such associations between metamemory and mindreading, so the current results did
not support the theory in this respect. However, caution should be taken when interpreting
the results of the correlation analyses. The exploration of associations between FOK task
performance and animations (mindreading) task performance was carried out as exploratory
analysis, and no a priori power analysis was conducted to establish that the study had
adequate power for this secondary aim. A subsequent power analysis (after completion of the
study) was conducted with a view to determining what sample size would have been
necessary to detect meaningful, statistically significant associations between metacognitive
monitoring ability and mindreading ability. Assuming a moderate association (r = 0.30) and
= .05, a total sample size of n = 67 participants would be needed to achieve Cohens (1992)
recommended power of .80 for the correlational analyses. Thus, our study was underpowered to detect a meaningful association between these two abilities. This represents a
limitation of our study and, as such, caution should be taken when interpreting the findings
from our correlation analyses. Future studies using larger sample sizes are warranted to
further investigate relations between metacognitive monitoring and mindreading ability.
What is clear is that the current study was sufficiently powered to detect predicted
group differences in FOK accuracy and that results indicated participants with ASD showed a
substantial diminution of metamemory monitoring. Of course, there are other forms of
judgement that can be used to assess metamemory, namely judgements of learning and
24
judgements of confidence. It remains possible that people with ASD will show undiminished
accuracy in these judgements. Judgments of learning involve assessing how well one thinks
one has learnt a piece of information, and judgements of confidence involve making
retrospective judgments about how certain one is in ones knowledge about a piece of
information. The literature on typical development suggests that metamemory accuracy is
only modestly correlated across different types of metamemory judgement (Kelemen, et al.,
2000; Leonesio & Nelson, 1990). This has led to suggestions that different metamemory
judgments may be based on different sources of information. Metamemory judgements are
thought to be based on mnemonic cues and it is possible that different judgements are based
on different cues (see Koriat, 1993; Metcalfe, Schwartz, & Joaquim, 1993). Although we
predict that individuals with ASD will demonstrate impairments across different
metamemory judgements, this may not turn out to be the case. So far there have been only
two published studies of judgment of confidence accuracy (Wilkinson, Best, Minshew, &
Strauss, 2010; Wojcik, Allen, Brown, & Souchay, 2011). Results from these studies have
been inconsistent; whereas Wilkinson et al. (2010) report that confidence judgments made by
children with ASD were less accurate than those made by typically developing children,
Wojcik and colleague report no impairments in JOC accuracy in children with ASD (Wojcik
et al., 2011). Thus, the study of metacognitive monitoring in ASD is in its infancy and, in our
view, a sustained study of metamemory and its neurocognitive basis in ASD would be
fruitful.
Future research should address these issues, and should also aim to address whether it
is possible to foster metacognitive skills in individuals who do show impairments. In our
view, a comprehensive investigation of metacognition in ASD is essential, given the
consequences that impaired metacognitive monitoring and regulation may have on an
individuals cognitive performance. It is hoped that alongside future research the findings
25
from this study will help to establish a more definitive account of metacognitive ability in
ASD, and that a greater understanding of this area will eventually contribute to successful
remediation of cognitive and behavioural impairments in this disorder.
26
27
Cohens d
30.49 (14.54)
0.37
.710
0.12
111.67 (14.66)
112.28 (10.87)
0.14
.888
0.05
PIQ
109.67 (15.75)
114.50 (10.96)
1.07
.293
0.36
FSIQ
113.17 (15.22)
114.94 (10.50)
0.41
.686
0.14
AQ Total Score
33.39 (9.24)
13.00 (6.22)
7.77
<.001
2.59
ADOS Social +
11.20 (3.57)
ASD
Neurotypical
(n = 18)
(n = 18)
Age (years)
28.92 (10.27)
VIQ
Communication Score*
AQ: Autism-spectrum Quotient; ADOS: Autism Diagnostic Observation Schedule; PIQ =
performance IQ; FSIQ = full scale IQ; VIQ = verbal IQ
*Based on 15/18 participants
28
Table 2: Means (SDs) and inferential statistics for group differences in performance on the FOK task, MCQ, and animations
task
Experimental Measure
FOK Task: Object-level Proportion of targets recalled
memory performance
Proportion of targets recognised
FOK Task: Metamemory Gamma score*
performance
Number of over-confident judgments
Number of under-confident judgments
MCQ
Cognitive self-consciousness subscale
Cognitive confidence subscale
Animations task
Mentalising condition
Goal-directed condition
Group
ASD
Neurotypical
Cohens d
.18 (.16)
.31 (.22)
2.01
.052
0.68
.68 (.23)
.09 (.16)
.76 (.16)
.26 (.16)
1.29
3.25
.205
.003
0.40
1.06
9.56 (9.59)
19.72 (11.54)
21.24 (3.90)
18.82 (4.14)
3.78 (1.70)
5.83 (1.50)
6.11 (4.85)
14.55 (7.69)
16.89 (4.31)
19.83 (5.17)
4.89 (1.71)
7.22 (0.73)
1.36
1.58
3.12
.635
1.96
3.52
.183
.123
.004
.530
.059
.001
0.45
0.53
1.06
0.22
0.65
1.18
Note: ASD = autism spectrum disorder; FOK = Feeling of knowing; MCQ = Meta-cognitions Questionnaire
*Gamma scores index metamemory monitoring accuracy
Footnotes
1
article, who helpfully suggested several possible explanations for reduced gamma scores in
the ASD group.
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