Tag: therapy

Some of the types of therapies are the same or very similar to those used for people with AP (acquired Prosopagnosia). This is a listing of a few of the most common types of therapies:

1. Comparison of photos of unknown and known faces
2. Schematic faces, meaning faces reduced to lines
3. Learning face-name associations
4. Benton Face Recognition Task in where the participant should identify which face of a selection of faces best matches the target face
5. Comparison of photos of unknown and known faces with and without hair
6. Faces that look similar or the same should be matched into pairs
7. Recognize and distinguish between distorted faces and normal ones
8. Mooney Faces Task where the face consists only of black and white areas and must be recognized whether it is a face or not
9. Participants’ attention is drawn to prominent facial features
10. Two faces are shown and participants should determine age and gender
11. Faces must be judged by emotions or expressions
12. Jane Task with detection of spacing, feature, and contour changes 

To give a little more insight into a few of the many types of therapies, here a little more informationen about these methods and what goal should be achieved:
One type of compensatory therapy is to learn how to recognize a person’s face based on 5 characteristic features. In this case, the persons are known to the patient. These can be features such as the shape of the face, the width of the nostrils, shape of the eyebrows, freckles or wrinkles. In this way it can be achieved that certain features can be remembered better and therefore it is easier to recognize a person. This kind of therapy brings improvements especially in children.
An example of remedial treatment approaches is to divide the face into two areas – distance between eye and eyebrows and mouth and nose – and then categorize them. The goal, after some attempts, should be that people with DP can focus on several features at the same time, allowing them to process rather unfamiliar faces holistically in the brain.
Completely different therapeutic approaches have also been tried. For example, it has been found that intranasal inhalation of oxytocin can improve the processing of faces. Oxytocin is a hormone produced in the brain that can influence the processing strategy in the brain. It was also discovered that much more time is spent looking at the eye region. It is believed that the eye region provides important information about who the other person is. This is therefore associated with prosopagnosics, as they spend little time looking at the eye area from the opposite. After giving this hormone and doing various tasks, better performance was observed in some people with DP.

Types of therapies that are most likely to be successful are those where familiar faces are to be learned and recognized using additional information.
The goal of these therapies is to eventually be able to better perceive and distinguish facial features, to reduce dependence on certain characteristics or accessories, and to be able to recognize familiar people more likely. However, because these therapies bring little or at least no long-term improvement, it is still advised to use alternative strategies, such as learning how the important people around them talk, walk, or what style of clothing they have. Probably the most important thing is that programs are adapted to the person’s problem, otherwise therapies have little to no success.

Sources

1. Face Processing Improvements in Prosopagnosia: Successes and Failures over the last 50 years, Joe DeGutis, Christopher Chiu, Mallory E Grosso, Sarah Cohan (8.2014), https://www.researchgate.net/publication/264940858_Face_Processing_Improvements_in_Prosopagnosia_Successes_and_Failures_over_the_last_50_years
2. Developmental prosopagnosia: A case analysis and treatment study, Lyndsey Nickels, Pamela Joy (09.2006) http://www.researchgate.net/publication/47677051_Developmental_prosopagnosia_A_case_analysis_and_treatment_study
3. Training of familiar face recognition and visual scan paths for faces in a child with congenital prosopagnosia, Laura Schmalzl, Romina Palermo, Melissa Jayne Green, Ruth Brunsdon (08.2008), https://www.researchgate.net/publication/23187083_Training_of_familiar_face_recognition_and_visual_scan_paths_for_faces_in_a_child_with_congenital_prosopagnosia

Short detour into how we humans actually perceive faces

There is a model that describes how we humans perceive faces. 
It happens in several phases and starts with the brain identifying something that looks like a human face. This is also the phase where we perceive basic visual things like size, figure-ground or orientation. After that, the face is mentally represented while at the same time the brain distinguishes what gender the person is and how old he or she is. In the next phase, the facial features that we perceive are compared with each face that we have stored in our brain and if the face matches we have the feeling that we recognize the person. After these phases we come to the fourth and last phase and we remember the name of the person.

Forms and treatments for Prosopagnosia 

People with this condition can see every detail of the face. The difference between the brains of these people and people who can recognize faces is that the collected impressions cannot be combined into a complete picture. Since no other cognitive areas in the brain are affected in prosopagnosia, it is not considered a disease. It is more of a dysfunction of the brain, or a genetically determined perceptual weakness. Therefore, the term face blindness is not actually correct, but is still often used to describe this condition.

Once again briefly as a repetition: aquired prosopagnosia develops by for example an accident or as a consequence of an illness, developmental prosopagnosia is since birth and remains in most cases a lifetime.
For simplicity, from here on aquired prosopagnosia will be shortened to AP and developmental prosopagnosia to DP.

As mentioned in my previous blog post, there is no guarantee of cure. The condition can improve, regardless of age or gender. However, if the damage to the brain is too great, no cure and little to no improvement is possible. Since every condition is different, all training programs must be customized to the person’s needs. Other important points to consider are: does the person only have problems recognizing faces or also objects. In the worst cases – apart from the typical consequences such as anxiety, difficulties with finding and practicing a job or generally social interaction with others – things such as food or doorknobs can no longer be recognized or it is necessary to learn to read and write again.

There are many training programs that are supposed to help to remember faces or at least to be able to distinguish them. If therapies are actually successful, it is in most cases the fact that these effects do not last long and the therapy must be repeated after a few months. Interestingly, sometimes minor distinctions are made in the programs depending on what form of condition it is. This is because certain mechanisms in the brain, related to face processing, can be modified or changed, at least in people with DP.

Spoiler: Two specific cognitive training programs have been found to work best for AP and DP. One is face morph training and the other is holistic training. These two trainings were the most likely to show improvements.

(Next up in Part 2: Treatment approaches in acquired Prosopagnosia)

Sources

1. Rehabilitation of face-processing skills in an adolescent with prosopagnosia: Evaluation of an online perceptual training programme, Sarah Bate, Rachel Bennetts, Joseph A. Mole, James A. Ainge, Nicola J. Gregory, Anna K. Bobak, Armanda Bussunt (04.11.2019), https://www.researchgate.net/publication/343935303_Prosopagnosia
2. Approaches to Improving Face Processing in Prosopagnosia, Joe DeGutis (2016), https://www.cdnetwork.org/wp-content/uploads/2016/12/Degutis_12.13.pdf
3. Face Processing Improvements in Prosopagnosia: Successes and Failures over the last 50 years, Joe DeGutis, Christopher Chiu, Mallory E Grosso, Sarah Cohan (8.2014), https://www.researchgate.net/publication/264940858_Face_Processing_Improvements_in_Prosopagnosia_Successes_and_Failures_over_the_last_50_years
4. Face to Face Prosopagnosia Research & Community Spring 2020, o.A. (Spring 2020), https://www.faceblind.org/assets/files/newsletters/Face%20to%20Face%20Newsletter%20-%20Spring%202020.pdf