Prosopagnosia Research at Bournemouth University

What is prosopagnosia?

Prosopagnosia (also known as “face blindness”) refers to a severe difficulty in recognizing familiar people from their face. While some people report a very selective impairment that only influences the recognition of faces, others find that their difficulty extends to the recognition of other visual categories, such as cars or animals. Many people also report difficulties with other aspects of face perception, such as judging someone’s age or gender, or interpreting their emotional expressions. A number of people with prosopagnosia also report navigational difficulties.

How does prosopagnosia affect a person’s life?

Some people cope well with their face recognition difficulties, and even develop elaborate compensatory strategies to help them with person recognition in everyday life. For others, however, the condition has a much greater impact on daily functioning. Some people avoid social interactions, experience problems with interpersonal relationships or damage to their career, and even report episodes of depression. In extreme cases, people with prosopagnosia can develop social anxiety disorder, characterized by fear and avoidance of social situations that may cause embarrassment. Specific difficulties are associated with prosopagnosia in children, where social isolation and safety issues are of particular concern.

What causes prosopagnosia?

Prior to the 21st century, it was thought that very few people experience prosopagnosia, and the condition had only been studied in a small number of people who acquired the disorder after brain damage (typically from stroke or head injury). However, it has more recently become clear that many more people have prosopagnosia without experiencing any damage to their brain. This form of the condition is known as “developmental” or “congenital” prosopagnosia, where it is thought that some people simply fail to develop normal face processing abilities despite typical intellectual and visual skills. People with developmental prosopagnosia seem to have experienced face recognition difficulties for most of their lives, and perhaps even since birth. Some evidence suggests there may be a genetic contribution to the condition in some families, with many people reporting at least one first-degree relative who also experiences face recognition difficulties.

How many people are affected by prosopagnosia?

The acquired form of prosopagnosia that occurs following brain damage is rare. However, developmental prosopagnosia appears to be much more common. In recent years, a flurry of media attention has raised awareness of the disorder, and thousands of people who believe they have prosopagnosia have approached researchers throughout the world. However, little work has resulted in a formal estimate of the prevalence of developmental prosopagnosia.

One study conducted in Germany surveyed the face recognition abilities of a large group of students, and reported a prevalence rate of 2-2.5%. A similar figure was obtained in objective screening of a large group of adults, and in a large-scale study of primary school children carried out by our group. Although this prevalence rate likely results from the statistical techniques applied to the data, it does indicate that as many as one in 50 people experience difficulties with face recognition. If this figure is correct, there may be 1.5 million people with developmental prosopagnosia in the UK alone.

Is prosopagnosia linked to autism spectrum conditions?

It is true that some people with autism spectrum disorder also experience face recognition difficulties, although these are not always as severe as those seen in prosopagnosia. Problems with face-processing have also been reported in other developmental disorders such as Williams’ syndrome and Turner’s syndrome. There are various theories about the face recognition difficulties that have been observed in different developmental conditions, with some researchers suggesting that they may result from a lack of social interest in faces, whereas others believe that an unusual visual processing strategy may be the critical factor.

How do I know if I have prosopagnosia?

Many people occasionally fail to recognise a familiar face, or even mistake an unknown person for someone that they know. However, individuals with prosopagnosia have a severe face recognition problem, affecting even the most familiar faces, such as their spouse or children. You can download our symptom checklist using the button below.

Some researchers advocate the use of self-report measures alone (such as our symptom checklist) to diagnose prosopagnosia. However, much research indicates that we have limited insight into our own face recognition ability, particularly if there is no point of comparison (i.e., where someone has experienced face recognition difficulties for their entire life, as opposed to suddenly losing the ability after brain damage). While we recognize that it is important to understand the impact that a person’s face recognition difficulties have on their everyday life, we nevertheless recommend that participation in objective face recognition tests is required to make a diagnosis.

Unfortunately, this service is not available via the NHS (UK), and most people contact a university for formal screening as part of a research programme. Screening typically involves participation in some online computerised face recognition tests, and you will also be asked if your difficulties could result from a psychiatric, developmental, visual or neurological condition. If you are an adult who lives in the UK and believe that you may experience prosopagnosia, we may be able to offer you an online assessment of your face recognition skills. If you are the parent of a child that experiences face recognition difficulties, you can also register with us for a tailored assessment.

Is there any treatment for prosopagnosia?

There is currently no formal treatment for prosopagnosia. However, our laboratory has recently published some attempts to remedy face recognition difficulties, either through the use of training programmes or temporary pharmaceutical intervention. While we have had some success, these techniques are still being investigated and developed. If you believe you have prosopagnosia and would like to take part in some research investigating intervention techniques, the first step is to register your details with us.

If you live close to our laboratory in Bournemouth and don’t mind travelling to us (travel expenses can normally be reimbursed), we will do our best to accommodate you within our current research programmes. However, some of our programmes operate remotely, and we also have collaborators in other parts of the UK, Australia and America, and may be able to put you in touch with a researcher who is based closer to your home.

Are there any techniques I can use to get round my difficulty with faces?

Many people with prosopagnosia report compensatory strategies that can often help them circumvent their difficulties. For instance, teachers have described how they use classroom seating plans to identify their pupils, or even recognize different children by an external cue, such as their backpacks. Other elaborate compensatory strategies have been described, such as the use of jewellery, clothing, voice or gait to recognize a familiar person. Of course these strategies do not always work, and particularly break down when a person is met out of context and logic cannot be combined with these external cues. You can download our list of recommended coping strategies using the button below.

Supporting children with prosopagnosia

It can be difficult to spot prosopagnosia in children, and the first thing you might notice is their difficulties in maintaining friendships with their peers. You may find it useful to download our symptom checklist (see above), although the key behavioural signs of face blindness in children are:

• Your child frequently fails to recognize familiar people when encountering them in unexpected contexts.
• Your child is particularly ‘clingy’ when in public places where they may lose you.
• Your child waits for you to wave when collecting them from school, and has mistakenly approached strangers thinking they are you.
• When asked to imagine a familiar person’s face, your child displays an unusual reliance on external cues to recognition (e.g. hairstyle), rather than describing the facial features themselves.
• Your child may be socially withdrawn at school and appear to have a difficulty making friends. This may be in contrast to their more confident behaviour at home when recognition is not an issue.
• Your child has difficulty following the plots of TV shows or films.

It is currently very difficult to obtain a formal diagnosis of prosopagnosia from either an educational or a medical professional in the UK. Indeed, while there are formal systems in place for the diagnosis of other cognitive, perceptual, or socio-emotional disorders, both public and professional awareness of prosopagnosia is low. While the condition is recognised by the NHS (UK), it can be hard to access a professional with suitable expertise.

Some laboratories based at universities may offer screening sessions that are suitable for children, often linked to a formal research programme and dependent on current research funding. If you would like to have your child tested by our team, please register your details with us and we will contact you as soon as we can.

Because there is little awareness of prosopagnosia, it can be very difficult to gain professional support for your child. You may also be unsure whether you should advise your child’s teachers and/or friends about the issue, perhaps because you are worried about how they will react. However, there are clearly safety issues associated with prosopagnosia, not least because a face blind child may be more likely to approach and trust a stranger. You could also discuss strategies with teachers that may help your child at school. For instance, a teacher could use a set seating arrangement to help your child locate their peers, and the teacher may also encourage other children to initiate conversations to remember that it would be helpful if they identify themselves at the start of an interaction. It may also help for your child to have a ‘buddy’ in the playground who wears a distinctive marker.