How does autism affect working memory and managing multi-step instructions?

PostedDecember 29, 2025

UpdatedDecember 29, 2025

ByMy Patient Advice

Author: Lucia Alvarez, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Working memory is the ability to hold information in mind long enough to use it, such as remembering the next step in a task or recalling what someone has just said. Many autistic people experience differences in working memory, processing speed and task sequencing, which can make multi-step instructions much harder to manage. NHS guidance explains that difficulties with holding information, switching attention and processing language all contribute to these challenges, as described by NHS Berkshire Healthcare and CNTW NHS.

Why multi-step instructions can be harder

Understanding and executing multi-step instructions relies on several executive functions: working memory, flexibility, planning and attention shifting. According to Leicestershire Partnership NHS Trust, up to 80% of autistic people experience executive functioning differences, meaning long or verbal instructions may be lost before they can be acted on.

NICE guidance reinforces this. For adults, NICE CG142 recommends using structured communication, written supports and clear sequencing of information. For children and young people, NICE CG170 advises breaking tasks into smaller steps, using visual and written formats, and offering regular breaks to reduce cognitive load.

Peer-reviewed research supports these findings. A meta-analysis of working memory in autism (PMC study) found consistent difficulties across phonological and spatial working memory. More recent studies (2023 PMC article) suggest targeted, school-based interventions may help improve working memory skills over time.

Practical strategies that support working memory

Charities and education services offer practical tools to make multi-step tasks more manageable. Strategies recommended by the National Autistic Society and Ambitious About Autism include:

Breaking tasks into single steps

Providing written or visual instructions

Using checklists, colour coding and calendars

Repeating or modelling tasks before expecting independence

Allowing extra processing time

Using “first–then” sequencing or structured routines

Visual supports, such as those outlined by Scottish Autism, can make instructions easier to understand and reduce memory load.

Formal plans such as EHCPs often include targeted working memory strategies, as seen in EHCP examples. In adult services, the Care Act requires assessors to understand autism and adapt communication accordingly, described in Care Act guidance.

Takeaway

Autism can affect working memory and the ability to manage multi-step instructions, often because of differences in processing speed, attention and executive functioning. With clear, structured communication, visual supports and step-by-step guidance, many autistic people can complete complex tasks more confidently and independently.

Lucia Alvarez, MSc

Author

Lucia Alvarez is a clinical psychologist with a Master’s in Clinical Psychology and extensive experience providing evidence-based therapy and psychological assessment to children, adolescents, and adults. Skilled in CBT, DBT, and other therapeutic interventions, she has worked in hospital, community, and residential care settings. Her expertise includes grief counseling, anxiety management, and resilience-building, with a strong focus on creating safe, supportive environments to improve mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.