Transcript Handout 1 - Minnesota School Psychologists Association

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Face Blindness: A
Disorder We’ve (Often)
Been Missing
Sherryse Corrow
Institute of Child Development
University of MN
http://researchfestival.nih.gov/festival06/default.htm
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Why am I here today?
Face Blindness
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A lot of work investigating face blindness has been done with
adults.
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However, very little work has been done with children.
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Parent’s of children with DP often find that no one in their
state has any information for them about their child’s inability
to recognize faces.
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Researchers
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Educators
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Doctors
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Psychologists
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Clarification
Face Blindness
=
Developmental
Prosopagnosia (DP)
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Outline
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What is DP?
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Definition
Prevalence
Symptoms and Consequences
Reasons for Studying DP
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What causes DP?
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What do we know about DP in childhood?
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Case Studies
Comorbidities
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How can we differentiate DP from ASD?
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How can DP be identified in the classroom and what should
be done about it?
+ What is Developmental
Prosopagnosia?
Definition, Prevalence, Symptoms, Reasons for
Studying DP
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What is Developmental
Prosopagnosia (DP)?
 Developmental
Prosopagnosia: An inability to
recognize faces despite no history of brain
damage and intact early visual processing (no
visual deficit) and intellectual function (Duchaine &
Nakayama, 2006).
Courtesy of University of MN
“Prosopagnosia is clearly not "face
blindness" - people with the condition
can see faces fine - what they can't do
is distinguish people by their facial
features. Faces just seem all the same
- in the same way that you might have
trouble distinguishing sheep by their
faces.”
“Take a dozen donuts--all chocolate
sprinkles or cinnamon twists. Now look at
each one. Note the details - see the curves,
the angles of the sprinkles. Name them:
George, Susan, Harry, Joe, Billy, etc. Now mix
them all up. Who was George? Are you sure?
But you saw them in exact detail right? Same
thing for me with faces. I see them perfectly,
but I can no more tell one face from another
than one donut from another - even though
they are all different - when they go away
and come back.”
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Example of Prosopagnosia
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Prevalence
Prevalence rates of approximately 2% are common
around the world.
Prevalence: Kennerknecht et al. (2006), Kennerknecht et al., (2008), Bowles et al. (2009), Duchaine, (2008)
Image: http://en.loadtr.com/World_Map-483552.htm
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Symptoms:
There are many symptoms of DP.
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Failure to recognize someone if they dramatically change
their appearance (e.g. hairstyle) or are encountered out of
their expected context (e.g. teacher in the grocery store).
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Reliance on other cues for recognition such as: hairstyle,
voice, gait, clothing, context, etc.
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Little interest in TV shows that portray human characters—
Difficulty following the plot.
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Social Isolation and anxiety.
“Four years ago on Christmas Eve we
all laughed when he ran to me saying
"there’s a strange man at the door!" It
was one of my Dad's infrequent visits,
my older sons knew it was Grandpa.”
“She is 9 years old and has very little
friends. We found it interesting that her
2 friends have distinctive looks. One
has slightly darker skin and one has a
round face.”
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Social Consequences (Adults):
There are many social consequences of DP that
affect the ability to create and maintain friendships.
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Feelings of embarrassment, guilt, and failure
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Avoidance of social situations
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Anxiety
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Limited employment opportunities
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Loss of self-confidence
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Difficulty telling others about DP
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Dependence on others in social situations
Yardley et al. 2008
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Social Consequences (Children):
The social consequences of DP in childhood may be
even more severe.
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Limitations in activities and courses (e.g. drama).
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“Ostracized by peers”– appearing aloof and unfriendly.
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Unable to maintain social relationships.
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Concerns about getting lost and being separated from
parents or teachers.
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Extreme difficulty with the transition to middle school (more
students, different each hour).
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Anxiety in the classroom – effect on learning?
Diaz, 2008
” A face blind child does not have the secure feeling
to know whether she is talking with someone she
knows or a stranger.”
“I remember in 2nd grade, not being able to tell
Stuart the bully from Jack, the guy who protected me
from the bully.”
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Why should you be interested in
DP?
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Many cases of DP in childhood, especially mild cases,
probably go undiscovered until adulthood (Behrmann &
Avidan, 2005; Duchaine & Nakayama, 2006).
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We need to identify these children earlier in life—hopefully,
even the mild cases.
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By accomplishing this task, we can better understand the
disorder so that the social and safety consequences can be
alleviated.
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What causes DP?
Experiential Factors, Neurological Factors,
Genetic Factors
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Experience Based Theories
Could early deprivation lead to DP?
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Children deprived of all
visual input in the first few
months of life show a
configural-deficit in face
processing (Le Grand et al.
2001, 2003, & 2004).
Le Grand et al. 2003
Nytimes.com
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Children who are raised in
instutionalized settings
(Pollack et al., 2010) or who
are extremely shy (Brunet
et al. 2010) show slight
deficits in face processing.
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Neurologically Based Theories
Is DP a result of inadequate development of the
cortex?
http://labnic.unige.ch/nic/htms/fmri.html
Haxby et al. 2001
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It is possible that some are born with a deficit in or lack of the
proper functioning of a neural mechanism needed to
properly encode face information.
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The Fusiform Face Area, is a portion of the fusiform gyrus
that is associated with face recognition in adults.
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The findings are mixed. It may be that some with DP have a
neurological deficit and others do not.
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Genetics Based Theories
Is face recognition inherited from our parents?
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This is the most widely accepted theory in the literature.
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Many investigators have reported cases in which many family
members will have DP (e.g. Duchaine et al., 2007).
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Wilmer et al. (2010) reported a higher concordance rate of
face recognition skills in identical twins (0.70) than fraternal
twins (0.29).
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However, it is unlikely that ALL cases of DP can be explained
by genetic factors (Duchaine, 2008).
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What do we know about DP
in Childhood?
Case Studies and Comorbidities
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Where is research being done with
kids?
“Children change schools more often than adults
change jobs. Children change classrooms more
often than adults change offices. Children are
expected to recognize their parents' friends who
have no context for the child to know them.
Even if a child learns her classmates, when the
school year changes, she has to [sometimes]
relearn who they are.”
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Case Study Details
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How can we differentiate DP
from ASD?
When so many of the criteria are so similar?
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Commonalities and Differences
How can ASD be distinguished from DP?
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Commonalities
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Unusual eye contact (this may not apply to ALL children with DP)
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Failure to develop peer relationships
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Lack of spontaneous seeking to share enjoyment
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Lack of social reciprocity
Differences
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Restricted and stereotyped patterns of behavior, interests and
activities.
“Our child very often will just reach for
a book at school during breaks, recess etc. rather
than try to play with anyone. He has a few casual
friends, but no close friends. I'm sure it is because he
can't find them. He is still very young - early
elementary school.”
“I was always shy as a child, much more so than I am
as an adult. Always being told to look up at people
when I spoke to them & to hold my head straight (by
my grandmother, no-one else minded) because I
tended not to look at their faces I suppose. “
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CAST – Direct Items
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Does s/he join in playing games with others easily?
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Is it important to him/her to fit in with a peer group?
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Does s/he find it easy to interact with other children?
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Does s/he have friends, rather than just acquaintances?
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Are people important to him/her?
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Does s/he make normal eye contact?
Questions provided by ARC website.
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CAST – Indirect Items
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Does s/he come up to your spontaneously for a chat?
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Can s/he keep a two-way conversation going?
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Does s/he mostly have the same interests as his/her peers?
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Does s/he appear to have difficulty understanding the rules
for polite behavior?
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Does s/he appear to have an unusual memory for details?
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Does s/he try to impose routines on him/herself, or on
others, in such a way that it causes problems?
Questions provided by ARC website.
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CAST – Non-DP Items
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Does s/he tend to take things literally?
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Can s/he read appropriately for his/her age?
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Does s/he have an interest which takes up so much time that
s/he does little else?
Questions provided by ARC website.
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So what?? What does it mean?
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Are ASD and DP really different?
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Is DP a version of ASD, representing a particular location on
the spectrum? (Problem: many adults with DP do not have
ASD).
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What about children who CLEARLY have an ASD but still
cannot recognize faces?
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Which comes first, the chicken or the egg?
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What about kids who are just shy of an ASD diagnosis?
+ How can DP be identified in the
classroom and what should
done about it?
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How to Identify DP in a Child
Things to Look For
How to Test for DP
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Social isolation and anxiety.
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NEPSY
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“Mistakes” in recognizing
classmates.
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WMS
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Discrepancy between behavior at
home and at school.
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KABC
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Similar to high functioning ASD but
lack of stereotyped or restricted
behaviors.
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CMS
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Home-made Tests
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Name tags = Change in behavior?
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Mismatch between intelligence and
social skills
A word of caution . . .
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identical
(easy)
test
harder
hardest
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A word of caution . . .
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Adapting the Learning
Environment
Training Face Recognition
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Training studies with individuals with DP have been few and
far between.
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DeGutis et al. (2007) successfully trained an adult to
recognize faces.
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Two children have been trained to recognize photographs of
familiar faces but the effects did not generalize to other
people.
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A pilot study of a training program in our lab may be
effective.
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Adapting the Learning
Environment
Encouraging Effective Coping Strategies
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Have the children in the classroom wear name tags (problem:
good for elementary but not middle or high school).
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Schedule one-on-one time between the child and other
students.
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Face Blindness is a form of “blindness” to a certain degree.
Identify yourself when you approach the child.
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Maintain a picture set of students in the classroom with key
identifiers written on the back of each one.
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Summary
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Knowledge of DP in both applied and research fields is very
limited.
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DP is much more prevalent than we once believed.
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The social effects of the disorder are problematic for both
children and adults.
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These children need to be identified, and their needs
addressed, before the cumulative effects of the disorder
become too severe.
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Resources
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Our Lab: Yonas Visual Perception Lab, University of Minnesota,
[email protected], (612) 626-4344.
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Our Harvard Collaborators: www.faceblind.org
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CNN Article on Face Blindness: http://articles.cnn.com/2007-0202/health/face.blindness_1_prosopagnosia-blindness-fusiformgyrus?_s=PM:HEALTH
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National Institute of Heath:
http://www.ninds.nih.gov/disorders/prosopagnosia/Prosopagn
osia.htm
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Yahoo Face Blind Group:
http://tech.groups.yahoo.com/group/faceblind/
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Just for Fun: You Don’t Look Like Anyone I Know by Heather
Sellers
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Thank you!!!
QUESTIONS?