Understanding Face Blindness & Autism

Elemy
Updated: January 10, 2021

Face blindness, or prosopagnosia, is a condition that can be acquired through a brain injury, but it is also closely associated with developmental disorders like autism. About 40% of people with autism have prosopagnosia symptoms.

Research into the extent of these symptoms shows that face blindness is more associated with social identification and communication problems when someone with autism has this condition. People with only prosopagnosia may also struggle to understand distance or angles, recognize objects or places, or understand navigation — none of which has to do specifically with human faces. People with autism and face blindness together can still recognize landmarks, but they struggle with faces and body language.

Support groups for both autism and prosopagnosia can help you find people with similar struggles, so you can get social support. Behavior therapy is the leading approach to treating autism. A therapist may be able to help someone with prosopagnosia develop coping mechanisms so they can eventually recognize people more often.

Face Blindness: What Is It? Does It Relate to Autism?

Face blindness is the colloquial term for a mental health condition, prosopagnosia. Essentially, this condition means that you cannot recognize people’s faces, although you may be able to recognize other characteristics about them, like their voice, the shirt you first met them in, or the surroundings you normally see them in, like work.

Unfortunately, this condition can deeply impact everyday life, including job prospects, friendships, and dating relationships. Tricks used to remember people do not work forever, and the interaction can then become tense, unhappy, or uncomfortable.

People with prosopagnosia may avoid social interaction because of their condition and develop social anxiety disorder. Depression is also common, and struggles with relationships and careers are also common.

Failing to recognize the faces of people you care about is one of the sadder effects of this condition, but other impacts of face blindness may not even relate to faces. These include:

Failure to recognize facial expressions or emotions.
Struggles to understand television or movies because of an inability to recognize characters.
Inability to determine a person’s gender.
Trouble following a person’s gaze or looking in their eyes.
Difficulty recognizing objects or places.
Trouble navigating, processing angles, and understanding distance.
Difficulty remembering places or landmarks.

There are two types of prosopagnosia:

Developmental prosopagnosia is part of brain development from childhood.
Acquired prosopagnosia occurs if the person experiences brain damage, such as through a brain injury or a stroke.

For years, the medical community believed that most cases of prosopagnosia occurred because of brain damage; however, recent studies on developmental conditions, especially people with mild symptoms like Level 1 autism, suggest that more people struggle with developmental prosopagnosia than originally believed.

About 1 in 50 people may have developmental face blindness. At the same time, the Centers for Disease Control and Prevention (CDC) report that 1 in 54 children in the United States will be diagnosed with autism spectrum disorder, a condition that is closely correlated with face blindness.

The Overlap Between Face Blindness & Autism

Developmental disorders, including autism, are closely correlated with higher rates of face blindness. Some research suggests that a lack of social interest in faces — focusing on surroundings or on a specific part of the face besides the eyes, for example — may increase the risk of developing prosopagnosia.

Importantly, face blindness does not seem to contribute to autism. Many people with the condition do not meet the diagnostic criteria for this developmental disorder.

Face blindness does not involve one specific area of the brain. Instead, it is a network of brain regions, and when one area struggles, the others may falter. Since autism is a developmental disorder with complex effects on brain development, testing for face blindness, especially through eye gaze studies, may be a way to identify autism in children as young as 2 years old when other behavioral signals may be more difficult to decipher.

Between 2% and 2.5% of the general population has prosopagnosia. People with autism make up between 4% and 5% of the population. Some research suggests that up to 40% of people with autism also have face blindness. This means that about three-quarters of people who have prosopagnosia do not have autism.

Scientific Research on Face Blindness, Autism & Their Co-Occurrence

Some studies have shown specific prosopagnosia-like issues in people with autism, so there may be similarities with face blindness, but the condition is not exactly the same. For example, a review published in 2011 reported that people with autism have specific deficits in facial recognition, but they are not as strong as in people with true face blindness.

People with autism tend to perform worse compared to their neurotypical peers when it comes to measurements like remembered or discriminated facial identity. This impairment seems to get worse when there is a time delay between looking at a face and then taking a test. When there are no other tasks that cause demand on the person’s memory, they are able to recognize faces more clearly. This memory struggle seems to be specific to faces and does not translate to surroundings or objects, as among some people with prosopagnosia.

A later study solidified the theory that people with autism struggle with social cues, which may have symptoms similar to face blindness, but it is not precisely prosopagnosia. The study reported that struggles with faces were both domain-specific and process-specific, meaning both instances caused a deficit in face memories. However, there was no evidence that objects, locations, and non-human memories were impaired, as they can be with prosopagnosia.

The study did find that body details were impaired in the memories of people with autism too, suggesting that social stimuli were more impaired, so they did not end up in long-term memory. Other aspects of a person may remain in memory though.

Support for People Who Struggle With Prosopagnosia & Autism

There is no cure for prosopagnosia, nor is there a cure for autism. For people with autism, behavior therapy to manage communication and socializing problems will help children struggle less in everyday situations as they grow.

For people with prosopagnosia, there are some coping strategies, like specific external cues to identify people, such as favored jewelry, hair color or style, the sound of their voice, their dialect, or even their gait. Unfortunately, these cues are not always helpful. For example, the person may cut their hair, so they are no longer easily identifiable. This can be very frustrating and increase the severity of autism symptoms, along with anxiety and depression.

Getting support from people who understand your struggles can help to relieve anxiety and depression. Here are some places to find support for those who face similar obstacles:

The Autism Support Network lists online discussion groups. You can read stories from people who also struggle with prosopagnosia and autism. Ask questions and receive input.
Autism Speaks has a resource guide with plenty of information for people with autism and their families or caregivers.
The Prosopagnosia Research Discussion Forum offers online support through a peer chat.

If your child has autism, work with your pediatrician and behavior therapist to understand if they have any comorbid conditions, like face blindness. For people with autism who have symptoms like prosopagnosia, it might be a social comprehension issue that a behavior therapist can help manage.

While the person may always struggle with some level of face blindness, a behavior therapist can help them acquire strategies to reduce the issue. In addition, working with an applied behavior analysis (ABA) therapist can also help the individual learn to better manage symptoms of autism. There is no cure for autism, but consistent therapy can result in much improved symptom management, to the point where many individuals with autism are able to function very well in everyday life.