Prosopagnosia... The Inability To Recognize/Recall Faces!
Implications for Face Recognition, Socialization, Perception of Emotions In Others...
And A Whole Lot More!!!
Someone who suffers from face blindness explained to me that the issue is one of FACE RECOGNITION in the sense of FACE RECALL... the face may be seen properly when one is actually looking at another person... the issue comes in when faces can not be recognized because of memory recall issues. I've updated the section below to reflect that. I encourage everyone to re-read this section to get a better understanding of some of these issues. Make sure you read the 5-1-06 Update at the end of this section also... important observations regarding face blindness issues in the autistic child...
Parents, the three website provided below are among the very top in what I have found on this issue... I encourage you to take the time to read these sites in full... I think it will greatly help you understand issues of "face recognition", "socialization issues", "perception of emotions in others", "safety issues" as they relate to moving objects like cars, and much, much more! These are definitely in the top few for "must read" sites for parents trying to understand these issues and how to help their children!
What is face blindness? It is the inability to recognize/recall faces. Faces that are visualized from memory may appear "blurry" to persons who suffer from face blindness, and thus, a person may be actually able to see a face in perfect focus, but be unable to recognize it later upon recall as the brain can not properly "match" the memory of the face to the actual face.
In Bill Choisser's book (link provided below), in Chapter 3, he states that he knows of many persons with Aspergers who suffered from "face blindness". Aspergers is the "high functioning" autistic. So... if persons who are on the "high functioning" end of the spectrum and who are verbal can suffer from "face blindness"... could not also those on the "lower end" of the autism spectrum... those who are non-verbal, etc. I very much suspect this is indeed the case and it would certainly explain things like "the inability to read emotions in others, the difficulty in looking straight ahead (persons who suffer from face blindness say they see better using their peripheral vision than by looking straight ahead). This would also explain why so many of these children find it so difficult to have "eye contact"... the eyes are among the parts of the face considered "most difficult to look at" for persons who suffer from face blindness.
Bill Choisser was 49 years old before he realized he suffered from face blindness... because of the fact that this was how he had always "seen faces" and "recalled faces"... he never knew anything "different", so, how could he have known "something was wrong"! I suspect the same may be true for many children with autism.
Note that face blindness would not be "caught" via a vision test... Regular vision tests had to do with seeing "objects" and the part of the brain used for seeing objects was the occipital lobe. But, the part of the brain used to "see faces" was in the temporal lobe and tests to "see objects" as we have today in regular vision tests would not capture the inability in one to recognize faces. So, you could have perfect vision in terms of "seeing things", but still be unable to "recall or recognize faces"... hence perhaps the tremendous issues these children have with reading emotions in others, socialization, and with the whole "look at me" trouble in general!
Also, as I read these sites, certain comments really stood out for me... like the fact that persons with face blindness could "see" faces better if they looked OUT OF THE SIDES of their eyes... again, certainly something we see in children with autism... that was certainly something Zachary did and continues to do somewhat! He still prefers to speak to me without looking at me directly in the eyes. Peripheral vision appeared to allow one to better see faces than "looking straight ahead". Again, that certainly would explain a lot of what we see in children with autism! Interestingly, persons who suffer from "face blindness" say that looking at faces "upside down" allowed one to "recall faces" a little better too because that appeared to make use of the part of the brain used to "recognize objects" rather than that part of the brain used to "recognize faces"... and thus, an "upside down face" was making one "see faces" as "objects" as opposed to faces... I could not help but wonder if this had something to do with the fact that Zachary used to put his forehead to the floor and look at us through his legs (upside down) when he was about 18 months old... I never understood that... but, just maybe, now I do!
I know that Zachary can see the color of my eyes, my nose, my mouth, etc. now... What I don't know is if that is because some of the neurons that may have been damaged in the past have now recovered or if that is simply because he has perhaps adapted (using his peripheral vision) to see and later recall what I may look like. He may also know what I look like because of "pictures of mom" that were pointed out to him (note that a picture would be "an object"... not "a face"). I have no idea.
I think that this whole issue of "face blindness" would certainly explain a whole lot of what we see in these children and that this may have absolutely HUGE implications for therapy... and the whole "look at me" approach... which, quite frankly, I already thought was "junk" and now call "applied behavior absurdity". You can't have so many children having an issue with "eye contact" without there being a reason for it and likewise, if these children want to look at us using their peripheral vision... maybe it is because that is how they best see us and best "recall" faces. It is not that they don't want to see us... perhaps looking "straight" is what provides the least visual input of all for memory functions as they relate to "recalling faces" and as such, the reason for which they choose not to "look at us in the eyes" or "straight ahead"!
Note also that the part of the brain associated with face recognition also has visual functions tied to place and body part recognition. Again, I think that has huge implications for therapy. Persons who suffer from face blindness state that those parts of the face that move (i.e., eyes and mouth) are the most difficult to recall. A place, does not have "moving things in it"... that would be "extra" in "a place"... so, perhaps you can see or "recognize" a place, but "not see the moving objects within the place". I know that certainly had been an issue with Zachary as discussed in one of my books (i.e., not seeing a bull in the bull pen). And, that, would certainly have implications for safety issues (i.e., cars and other "moving objects") as well as for socialization and language development (i.e., eyes and mouth are "moving objects" too). Note also that the cerebellum - one of the areas most "hit" in autism - was also involved in the tracking of moving objects... and certainly - eyes and cars - would be "moving objects"!
This certainly could explain why my son, even though he has better eye contact, still never really wants to look at me directly when he speaks to me... and why so many children with autism prefer to focus on the mouth as opposed to the eyes (provide a lot more information... motion and emotions, and is how those who are deaf "decipher speech" via "lip reading"), etc.! As I read the information on these websites, I kept telling my husband... "you just won't believe this... this is so amazing and it totally explains what we see in Zachary in so many areas...". The only "vision" functions in the temporal lobe are those of face, place and body part recognition... and the information provided on these websites explains so much in terms of these issues.
This may also explain why some children with autism respond better to "sign language"... that part of the brain may be ok... and sign language would certainly involve "body part recognition" as well as motion... body part recognition and the understanding of language were co-located functions in the temporal lobe... and motion and the production of speech were co-located functions in the frontal lobe... I certainly now believed all this somehow played into the "autism puzzle"!
Another critical piece to this, I think, comes from the Simpsonwood meeting on mercury in vaccines. In that transcript, on p. 118, Dr. Keller stated - I quote:
"We know the developing neurologic system is more impacted than one that is full developed".
Why is that important? If metals indeed target immature or developing cells, this may go a long way in explaining something else.
Faces change every day... even the same face changes somewhat each day as we age. As such, the brain would have to create "new memories" for "faces" over time... for each person we knew and/or encountered over the course of a lifetime. Cecilia's site (link below) shows how her husband's face is the one she has the most difficulty recalling. That is very interesting to me. Is that because it is the face she is most familiar with... or could it be because it is one of the faces she would see most often... and as such, her brain would "pick up" slight changes in the face of her husband over time. As such, her "memory file" for her husband's face would have to be "updated" more frequently. That means that "face recognition functions" may involve the generation of "new memory files" almost on a daily basis. If metals target immature or developing cells, could this somewhat explain why "familiar faces" - which would be the ones we see most often - are the ones persons such as Cecelia have the most difficulty recalling. Thus, this may not be a "familiarity" issue so much as a devastation of newly formed memories issue. It would be most interesting, I believe, to see whether or not more persons with face blindness find familiar faces becoming "less recognizable" over time. In other words, personally, I would love to know if persons with face blindness once had a better "face recall" of those most close to them. Did that "face recall" change over time for someone close to the person having face blindness for persons for whom they would be making a new "face recognition file" almost on a daily basis...
Clearly, the ability to "recognize faces" would imply that we need to make "new memory files" for those faces each and every time we see them. Thus, again, if metals do target immature or developing cells (as would be the neurons involved in burning "new memories"), then this may have huge implications in matters of "face blindness", and so much of what we see in autism and other related disorders!
As I read the information on face blindness and shared it with my sister-in-law who has a son with PDD, I was so fascinated by this issue that I asked her if I could ask her son to view these images that were posted on Cecilia's site to ask him how he saw faces. My sister-in-law was fine with my asking Andrew (then 14) for his input on this matter. When we asked Andrew if faces were "blurry to him", he stated that they were not - that he saw faces properly. He did, however, make a VERY interesting comment when asked by his mother how he saw my face (auntie Jeanne's face)... he stated - and I quote: "Her face isn't a problem any more... I've memorized it!".
At the time, I used to think persons with face blindness couldn't actually SEE faces in focus... but, since then, a person who suffers from face blindness contacted me and stated it was more an issue of "face recall" and that faces themselves could be properly perceived and "in focus". Thus, Andrew's comment is now very, very interesting to me... because it certainly indicates he too, may suffer from issues with face blindness!
Autism used to be called childhood schizophrenia... and I do believe schizophrenia may very well be "the middle generation" in all this... For more on that, I encourage you to read the section on the HISTORY of AUTISM-SCHIZOPHRENIA-ALZHEIMER'S ... these 3 disorders not only have over 140+ across the board parallels... they also share a very common history...
In one article I had read on Schizophrenia, a person described what it was like for her and had described how her visual perception was very much like a puzzle in that if she moved, the entire visual field crumbled and had to be rebuilt from scratch... thus, again, we certainly see issues with "vision" that very much appear to parallel what some of these children may experience in autism. I have that article on schizophrenia somewhere... in my tons of binders/files on schizophrenia.... I will look for it and try to post the link to the article when I find it... hope to have it posted by Dec. 1, 2005...
But, if indeed autism-schizophrenia-Alzheimer's are the same disorder over the life spectrum - what I now truly believe to be the case - that would explain a lot of things.
Why would my nephew need to "memorize my face"? That comment on his part has definitely taken me by surprise because it was such an unusual comment for him to have made. Certainly "food for thought" but it would make a lot of sense if he might suffer from issues with face blindness... as clearly many autistics do.
I thank Cecilia, Bill and Joel (an autistic adult who suffers from face blindness) for taking the time to provide this INVALUABLE information for so many who suffer from these issues... and that includes a LOT of people! You can not even begin to imagine how much you have helped me to understand what I see in my son and in "autism" and other disorders where this is such a huge issue... and so many of the comments in these pages as they relate to face recognition, "looking sideways", motion and/or moving parts of the face, place recognition (i.e., involves moving objects like cars - implications for safety), body part recognition (moving vs non-moving), socialization and emotion issues, etc. now make so much sense to me. Some of these issues, you do not specifically mention (i.e., place recognition issues) but, like face recognition, they are processed in that same part of the brain - the temporal lobe - as is body part recognition... and so that has huge implications for what we see in these disorders if indeed these children may suffer from "face blindness" as I now very much suspect many may... especially given the comment in Bill's book about the fact that he knew of quite a few persons with Aspergers who suffered from this - clearly - Aspergers is an autism spectrum disorder!
As I always state, "understanding the issues is the first step in addressing them"... and now, I understand so much more. I can not emphasize to parents enough how important I think it is that you take the time to read the information provided on these websites. If indeed our children suffer from face blindness - that certainly would have huge implications for teaching and therapy! As a result of this, I developed "teaching tools" that may be more useful than what we have out there for helping children to develop language skills. If your child is non-verbal, consider reading Book 4 also, Breaking The Code To Language And Communication: The Ultimate Puzzle For A Child With Autism! (make sure you read the updated section on PRONOUNS... found a little lower down on this link... it is CRITICAL to language development and another "issue" that in my opinion is "acknowledged but truly not understood in terms of its importance in the development of language, sense of self and sense of others in these children ). Any parent with a child on the autism spectrum has my permission to download these for free.
Note to parents: Visiting these sites will certainly, in and of itself help you begin to grasp these issues, however, it is when you combine this information with so much of what I discuss in my books (especially Book 3 and Book 4 - both posted in full on this website) that you really get a much fully appreciation for the implications of all this... and in my opinion, they are absolutely HUGE... but within that come HUGE KEYS to helping our children and loved ones and will make you see what may be huge shortcomings in approaches like picture systems that are currently used to teach these children! Personally, I think if "picture systems" were the answer, we would not have so many of these children still considered so "non-verbal"... and I think that when parents look at all this from a brain structure and function approach, by reading these books, that you will truly see why that is... it all makes PERFECT sense!
Prosopagnosia - face blindness - explains SO MUCH of what I saw and still see in Zachary! Of course, I don't know the extent or severity of this in Zachary... but, in my opinion there is absolutely no denying this is may be an issue for my son!
This information on "face blindness" is "difficult to read" in that it can be so heartbreaking to realize that this may be how children who suffer autism may recall or perhaps more accurately, not recall, faces. You truly have to consider the implications of all this... and how we can best use this information to help these children. Within all this, there is still tremendous hope because once you understand the issues (i.e., that peripheral vision may be better for these kids), in my opinion, you can start to make teaching tools to help these children better understand their world and those around them (and this to me... also explains why Zachary absolutely loves the computer... I think it is among the best tools we have out there to help these children overcome so much). The human brain is indeed amazing in how it can "recover" from so much... and I have no doubt that in understanding these issues we can better help these children (i.e., allowing them to use their peripheral vision instead of insisting on the "look at me" ... again... I now call the whole "look at me" approach "applied behavior absurdity"... because if these kids do suffer from such issues, as I very much suspect they do (although perhaps in varying degrees), then that is exactly what these approaches would be... "applied behavior absurdity"... and I suspect that 99.9% of "therapists" out there are completely clueless as to these issues and as such, they continue to be "part of the problem" and not "part of the solution" (and I think it is also very true in the issue of "teaching pretend play".. another area in which I find therapists to have little or no understanding of the underlying issues and that as a result of that... again, therapists may be doing more harm than good as they attempt to "teach" pretend play... I encourage all parents to take the time to read this info on "pretend play" also... after you look at the information on "face blindness")!
"Therapists" need to take their cues from the children... and not "force them" to do what - overwhelmingly - these children are showing us - they don't want to do - look straight ahead. In my heart, I believe there is a reason for that... that looking ahead may provide for them the worse information for vision recall as it relates to faces! If therapists took our cues from the children instead of "rushing in there to fix issues they really don't understand" (and that applies to not only issues of face blindness but also to gastrointestinal/dietary issues - usually completely ignored by "behavior therapists" - in spite of the fact that these things are known to very much known to impact behavior and ability to learn), perhaps they would get a lot further in helping these kids!
As you look at Cecilia's site (first link especially), notice also the "disappearance of colors" in matters of "face blindness"... colors were something I knew played a huge role in Zachary's development... at least... as far as "objects"... how very interesting that colors "disappear" in this person's life when it comes to "face recognition"! Also absolutely amazing is that the face of the person closest to Cecilia (her husband's face), is the one that is the "most blurry" or provides fewest details when it comes to "face recall"l... again... I suspect that would have huge implications for children with autism... families would be "familiar", as would be "therapists", and anyone else the child with autism may be in daily contact with...
UPDATE POSTED 05-01-2006
The issue of face blindness is one that is now weighing rather heavily on my mind as far as my son Zachary (now almost 9) is concerned. The past year has been a very difficult one for us as we are still trying to sell our house in MI. I have gone back and forth between Canada and the US quite a bit in the past year. My husband is now working in Canada and the children and I are back in MI... still trying to sell our house here. As a result of all this, my husband may be away from us for a couple of months at a time. On his visit to see us in Michigan for Easter this spring, I became keenly aware that Zachary may indeed be suffering from face blindness to a certain extent. My husband arrived late at night... my daughter was aware that he had arrived just past midnight... but Zachary was not. He slept through it all.
In the morning, when I awoke, my husband was already up and in the kitchen. I went to Zachary - who was just waking up himself - and said: "Zachary, go see who is in the kitchen... it's a surprise"!
Zachary went into the kitchen. I followed behind him to see his expression. I had expected to hear a joyful "it's daddy"... instead, Zachary slowly walked up to my husband who was at the kitchen sink, and he said: "What's your name?" My heart sank... as I am sure my husband's did too. Had Zachary forgotten what his father looked like in just 2 months... or was it a matter of "face recall"... that he didn't recall the face and was unable to "match it" to the face in front of him?
My husband was wearing clothes Zachary had not seen before... a new shirt... and he was slightly thinner than when we had last seen him. It was not until my husband began to speak that Zachary recognized him. His voice - he could obviously recognize - his face - that might indeed be another issue!
As I thought more about this issue in the past week, I came to realize that there may actually be something to this... that Zachary may indeed suffer from some face blindness. Sure... children can forget what even their loved ones look like if they don't see them for a while... but Zachary was almost 9 years old now... and that "forgetting of even a loved one after some time" was usually something we saw in much younger children... not in 9 year olds!
I truly wondered... was this an issue for Zachary... and then... more and more came back to mind as I thought about this...
While in Canada... we stayed in a house on one of the farms my in-laws owned. My father-in-law (Zachary's grandfather) came over almost daily to check on cattle, etc. There was no doubt that Zachary knew his grandfather and saw him often as he worked about the farm, coming and going in that red diesel truck that Zachary loved so much. Yet, when we went to visit Chris, one of my sisters-in-law who was about 10 miles away, upon the entering of my brother-in-law, it was not unusual for Zachary to ask my brother-in-law, Dave, "What's your name"?
I used to think this was just Zachary's way of getting a conversation started since I had taught him that if you want to talk to another child at the park, a good way to start talking to them is to ask "What's your name"? But now... I really wondered if this didn't have more to do with face blindness issues in my son.
During one of our visits to Chris' house, my father-in-law had stopped by. Zachary knew his grandfather because he saw him so much on the farm... yet... as this same man sat there on a bench next to the entrance, Zachary asked him: "Who are you"? The more I thought about this, the more I was becoming concerned now... the same thing had happened with other relatives... my sister... Lucie.. "What's your name?" (Zachary didn't see her as often.. but she lived in the same town as Chris)... my other sister-in-law (Wanda) and her husband (Wayne)... again... upon seeing each of them... Zachary had asked... "What's your name"? or "Who are you"? in spite of the fact that he knew the homes of both my sisters-in-law quite well... and he knew the names of those who lived in each house... "Auntie Wanda", "Auntie Christine", "Uncle Dave", "Uncle Wayne"... yet... he still asked upon seeing 3 of them... Wanda... Dave... and Wayne... "Who are you"? or "What's your name"? - and he had done the same thing when his grandfather had stopped by and was sitting on that bench next to the door in Chris' house! Zachary was much more familiar with Chris since she and I were very close. He never seemed to have to ask Chris "Who are you"? or "What's your name"? - at least not that I could recall... but this was something I would now watch for much more closely! Chris had a child who was PDD (Pervasive Developmental Disorder) and so, we had traveled this journey with autism together and shared many a conversation and experience relating to autism.
So... did Zachary have issues with "face blindness" and the inability to match the face in front of him to a past memory of that face? I truly wondered. This was something I was now going to keep a rather close eye on... and something I would have to "test" some way (i.e., making my husband wear clothes Zachary had never seen with a hat he had never seen... then going out of the room to change into a different outfit... again... something Zachary would not have seen... to see if he could recognize his father's face or if he just went by other clues such as glasses, hair, familiar clothing, etc. To see if this was an issue with "initiating conversation" because I had taught Zachary in the past that "What's your name"? and "Who are you"? were ways to introduce himself and "break the ice" with children at the park or whether or not this had to do with actual face blindness... I would obviously have to make sure Zachary also knew that saying "hi" was enough to initiate conversation too! All this is certainly an area of concern for me at this time - especially since Zachary's conversation/communication skills had just exploded in the past year and a half and he was now quite verbal when it came to actual communication (asking questions, responding to questions, speaking in full sentences using pronouns properly, overall awareness of what things meant, excellent reading skills, etc.)! He had truly come a very, very long way in all these areas. With my husband in Canada right now... I might have to wait a while to do a few "experiments" in this area... END OF UPDATE POSTED MAY 1, 2006
UPDATE OCTOBER 2007 - I truly believe Zachary still has issues with this... he still constantly asks family members and other persons he has known for a long time "what's your name" when he first sees them again... although I find he is much better with this issue now (and that may simply be due to finding ways of coping with this... as so many with face blindness do). I have no way of knowing how much of an issue this is for him, but, in my opinion, there are certainly signs of face blindness issues in my son. END OF OCT 2007 UPDATE
Again, take the time to surf these sites to truly understand this issue... in my opinion, its implications for autism may be HUGE!
http://www.prosopagnosia.com/main/faces/index.asp (This is the "difficult one to look at"... part of Cecilia's site... shows what she recognizes/RECALLS of faces she sees... truly eye opening... !)
http://www.prosopagnosia.com (Cecilia's site)
http://www.choisser.com (Bill Choisser's site... entire book on face blindness)
http://www.geocities.com/growingjoel (Joel's site.. an autistic adult who suffers from face blindness)