Assessment and treatment of children and adults with face processing impairments

Dr Sarah Bate working with prosopagnosia patients to track eye movements and develop tools to help them with facial recognition.

Prosopagnosia, or the inability to recognise faces, affects one person in 50, but public and professional awareness of the condition is low. BU established The Centre for Face Processing Disorders (CFPD) to provide cognitive screening and training programmes to improve recognition skills for affected adults and children.

The developmental form of prosopagnosia affects up to one person in 50 worldwide.

Some children with the condition can encounter severe social and educational difficulties, demonstrating an urgent need for a specific developmental screening assessment and appropriate special needs provision. Likewise, adult sufferers who avoid embarrassment through self-imposed social isolation may need specialised psychological intervention.

BU established The Centre for Face Processing Disorders (CFPD) in 2012, where Dr Sarah Bate has led a prosopagnosia research programme including clinical and cognitive treatments for the condition.

The research team have addressed the lack of awareness of prosopagnosia through extensive dissemination of their research findings. Significant impacts include developing diagnosis methods, cognitive training and clinical treatment programmes to help prosopagnosia sufferers.

More recently the research has led to policy changes within health organisations and charities. These interventions improve the lives of sufferers, while demonstrating a proof of concept for a scalable prosopagnosia diagnosis and a treatment approach.

Assessment and diagnosis.

900 people with face processing difficulties have now registered on the CFPD website. All registrants are offered a cognitive screening session that establishes whether they meet diagnostic criteria for prosopagnosia.

Face processing impairments are evident in other disorders such as Moebius syndrome, autism, and ME, so the CFPD team has developed protocols for differential diagnosis and tested over 100 individuals to date.

The provision of prosopagnosia assessment is currently unique to the UK and the availability of this service—even on a limited scale—has been highly beneficial to individuals and their families. Frequently, they report a sense of relief when long-standing difficulties in normal social interaction are finally understood.

Treatment

The CFPD now has more than 30 adults and 10 children enrolled in cognitive training programmes. Participants are typically required to make fine-grained discriminations between pairs of similar faces.  The task becomes increasingly difficult as participants progress through levels in a computer-game format, over a 12-week period.

Researchers are now is investigating the effectiveness of combining these programmes with oxytocin inhalation after demonstrating a temporary improvement in face recognition skills following treatment with the hormone. This is the first example of clinical intervention in the treatment of prosopagnosia.

This proof of concept for a scalable assessment and intervention programme has considerable reach, capable of serving the needs of the estimated 300,000 children with prosopagnosia in the UK alone.

Organisational policy change

The CFPD’s research, extensive dissemination and lobbying activities have led to significant policy changes within health organisations and charities, including: The NHS, which has committed to have prosopagnosia added to the NHS Choices A-Z of conditions; The Encephalitis Society and Headway, who have both produced factsheets about prosopagnosia.

 

Publications

  • Bate, S., Parris, B., Haslam, C., & Kay, J. (2010).  Socio-emotional functioning and face processing in the normal population.  Personality and Individual Differences, 48, 239-242.
  • Bate, S., & Cook, S. (2012).  Covert recognition relies on affective valence in developmental prosopagnosia: Evidence from the skin conductance response.  Neuropsychology, 26, 670-674.
  • Bate, S., Cook, S.J., & Cole, J. (2013).  First report of generalized face processing difficulties in Möbius sequence.  PLos One, 8, e62656.
  • Bate, S., Cook, S.J., Duchaine, B., Tree, J.J., Burns, E.J., & Hodgson, T.L. (in press).  Intranasal inhalation of oxytocin improves face processing in developmental prosopagnosia.  Cortex.