Autism Newtwork For Deaf/Hard Of Hearing and Blind/Visually Impaired: Face Blindness

Face Blindness or prosopagnosia, developmental or acquired condition impacting social looking skills. For hearing and visually impaired individuals with autism, this further complicates how their adaptive skills are perceived. Options for assessment and supportive educational tactics will be included. Face processing, recognizing people from their facial features or image is important at all stages of our lives. It is especially important to our socialization and safety.  That is, we need to recognize messages that are positive, providing nurturance and direction and messages that are negative, warning of danger or avoidance.  Babies at 9 minutes old prefer looking at a human face but 20/200/400; 4 month olds develop depth perception or stereopsis, recognize gender, eye contact; 4 years or earlier, track without moving head, 20/20. Eye contact affects brain efficiency accessing and categorizing people according to our own preexisting criteria.  Direct eye contact between people facilitates important social-cognitive effects.

 Prosopagnosia – Face Blindness (FB) - can appear very early and has genetic components. In addition to Developmental Prosopagnosia, an Acquired Prosopagnosia can follow brain injury, stroke or unknown neurobiological condition. Variations in how FB is experienced occur; more recent studies suggest 1 in 50 individuals have some form of it.  “Some degree of prosopagnosia (Face Blindness) is often present in children with autism and Asperger’s syndrome, and may be the cause of their impaired social development.” http://www.ninds.nih.gov/disorders/prosopagnosia

            A person may not know they are “face blind” because they may already have strategies for using cues, memorizing other details (typing), voice identification, behavior maps of the other including affect. Timing in using these strategies can affect social encounters. Adults usually take 1 second to recognize whole face; taking longer may lose friends, offend or get you in trouble.  Any additional differences in sensory input and sensory processing also affect interpretation and development. Studies on FB and Autism Spectrum Disorders have included: fMRI studies of individuals looking at cars and faces. ASD viewers activated inferior temporal lobe, lumping faces with objects. Did use fusiform gyrus to recognize pictures of own mothers. (UW Autism Center, 2004); eye tracking visual fixation reduced for faces; different patterns of social visual engagement for eyes & mouth showing patterns of adaptation/maladaptation. (Yale, 2011)

When addressing the complex learning and social strategies deaf/hard of hearing and visually impaired individuals also on the autism spectrum, sometimes issues are consolidated to be more manageable and then systematically addressed as goals or made more global as all expected behaviors of a person multiply handicapped.   If the environment reads it as avoiding eye contact, off target, socially uninterested or in focusing on details actually losing the holistic face or story. Sometimes, we get to an accepted worst case scenario, and consider individuals as not able to attend, getting the necessary patterns that form intellectual abilities and then increasingly less able and less motivated. What if behaviors we see are attempts to adjust, accommodate, structure the environment, even reduce stress from less efficient looking skills. Further, attempts at solutions may become behavioral targets so interventions are assigned to deal with assumed “antecedents” adding to everyone’s frustration.

Attendees will be introduced to several ways of approaching new tasks for FB. One was developed by Ruth Elaine Hane, a woman of accomplishment and self advocate for ASD. Her description of her product, The Hane Face Window follows. It” is a tool for organizing the eyes, nose and mouth of a face using rectangular shapes for the openings. Recent research supports the concept that the human brain is more flexible than previously believed and can be enhanced to form connections in various regions of the visual system, to organize the face.  The HFW is a tool, similar to wearing eye glasses that help a person see better. Parts of a face are viewed through the openings, therefore reducing the input that seems to overload the underdeveloped operating system of a person with autism.” In my review of the HFW, I consider it a pragmatic method to provide necessary structure (including highlighting targets, boundary detection and selective attention), limiting movement and slowing components of it, neutralizing some of the emotional valence of face looking.

            Another option to support elements of adaptive visual skills to better capture facial information would be considering specific visual training components as described by Susan R. Barry, “Fixing My Gaze”, © 2009. “ If our actions and habits reshape our neural circuits then a person’s own visual habits influence their wiring…if modify circuitry by creating experiences that required  me to change my way of seeing.”  Some further details will be discussed within the framework of re-considering looking behaviors.