Face Blindness and Autism

Face blindness isn’t necessarily part of autism but it is much more common in autistic people.   We’re discussing it here because it may be very hard to diagnose at a young age – in fact, many people reach adulthood without realizing they have this problem.   It can make social functioning much more difficult, and at the same time there are coping mechanisms which can make it somewhat less of a problem.

It turns out there are certain spots in the brain which are specialized for facial recognition.  DSCN0129[4]Jane Goodall, who has devoted her life to saving chimps, confesses that she has this condition.  Oddly, she’s able to recognize different chimpanzees by their hair coloring and their characteristic movements as they move through a forest, but unable to spot friends in a restaurant.   The well-known author and neurologist Oliver Sachs is another.  If one works around the problem of face blindness – for instance, by making and keeping appointments, by using voice to recognize others, by paying attention to hair styles or footwear – social functioning can be greatly improved and it may turn out that “autism” is less of a problem.

Of course there is no “blindness” involved in “face blindness.”  It’s a failure of recognition, not of attention or of eyesight.  The medical term for the condition is prosopagnosia.

Those with prosopagnosia are often blamed for “not really looking” or “not paying attention.”  Knowing that this is a real medical condition can help make their lives a little easier.   There is no cure, but there are many ways to work around the problem.  Many children with the condition are shy or standoffish, possibly a result of not being able to sort out the identities of those around them.   Some may even have a wrong diagnosis of autism (those who do not recognize faces may not look at faces very often).   Often people with face blindness rely on tone of voice to infer friendliness, unhappiness, joy or anger.   Workarounds will depend partly on the age, personality and abilities of a child with autism.  An outgoing child not afraid of making mistakes can be encouraged to engage everyone with a friendly greeting and then may be able to recognize voices of friends and acquaintances (but will have greeted strangers too).  A shy person may be helped by concentrating on just a few constant friends who can serve as social go-betweens.  In team sports, uniforms are important to recognize “our team” from “theirs.”  Music or individual sports will generally be a better fit than team sports.

Some adults can be informed of the problem, but this should be done with great care and involve a thoughtful discussion.  It can backfire if everyone at school knows about a child’s face blindness because children do sometimes target other children’s weaknesses.  Remember that one very important value of facial recognition is being able to tell friend from foe.  To let everyone know that someone is unable to do that can be a problem.

You can find face recognition tests online – search “prosopagnosia test” or try www.faceblind.org/facetests/.   Tests may not be appropriate to a child’s age or experience, so a less formal approach, asking your child to name others on a playground, for instance, may work better.  If you’re surprised by the results, please remember that this is a neurological condition.  First of all: do not blame.

-Jim Diamond, M.D.