Rothenberg Assessment Report 2009 S A S T A P S Y Conf 10
Dp train lab_mtngpresentation
1. Configural face training
enhances face processing in
developmental
prosopagnosics, particularly in
“better trainers”
Joe DeGutis
Sarah Cohan
Ken Nakayama
2. Rehabilitation of Prosopagnosia
Compensatory skills vs. Remediation
◦ Teaching non-face skills
◦ Verbal coding of internal facial features
◦ Training configural/holistic processing
Teaching specific relevant faces vs.
teaching a general skill
◦ Most rehabilitation approaches teach
specific faces
3. Rehabilitation of Acquired
Prosopagnosia
Ellis & Young, 1988
◦ After> two years of daily face matching training, no
improvement was observed in child prosopagnosic
Provoked overt recognition, (Diamond,1994)
Francis et al, 2002
◦ Rehabilitated a patient with prosopagnosia and person-
based semantic disorder by emphasizing both semantic
information (name/occupation) and visual imagery
Patient PS (Mayer &Rossion, 2007)
◦ Taught her to verbalize internal facial features for 4 months
◦ Showed improvements in recognizing pupils in her class
and increased confidence
4. Rehabilitation of Developmental
Prosopagnosia
8 and 4 year-old DPs; Brundson (2006)
&Schmalzl (2008)
◦ Taught to perceive, discuss, and remember
five distinctive facial characteristics of
personally familiar faces
◦ Improved recognition of novel views of target
faces; Schmalzl also found more normal eye
movement scan paths
48 year-old DP, DeGutis et al., 2007
◦ Sought to expand perceptual integration
ability
9. Current Study
Larger population of developmental
prosopagnosics (N=24)
Test-retest (waitlist) control group
Broader battery of face perception/recognition
and self-report diaries
Design Tweaks
◦ Emphasized speed as well as accuracy
◦ Initial face size set to maximize holistic processing
◦ With improved performance, we included more varied
sizes of faces
10. Difficulty Levels
Level 1 Level 2 Level 3 Level 4
Subjects were advanced in level after three rounds of training at or
above 93% average accuracy, and faster than 1000ms average RT
11. Single Training Trial
500ms Category 1 or 2?
+
Wait for Feedback
response 500ms
Subjects participated in 15 days of training.
3 rounds per day. 300 trials per round.
Prompted for a short break after 100/200 trials.
12. Assessments
Simultaneous Face Matching
• Philadelphia Face Similarity Test (Thomas et. al, 2008)
• Cambridge Face Perception Test (Duchaine et. al, 2007)
Sequential Face Matching
• Faces, Objects, Bodies Perception Test (Pitcher et. al, 2009)
Face Working Memory
• Face Working Memory Test (Chatterjee & Nakayama)
Part and Whole Processing
• Part Whole Face Test (Tanaka et. al, 2004)
Real World Improvements
• 5-day Diary Entry
17. Assessments
Part and Whole Processing
• Part Whole Face Test (Tanaka et. al, 2004)
500ms
1000ms
or
500ms
18. Assessments
Real World Improvements
• 5-day Diary Entry
1. Today, on a scale of 1 to 10, what was your level of anxiety about recognizing people?
(1=not anxious, 10=extremely anxious)
2. Today, on a scale of 1 to 10, how confident did you feel about recognizing people?
3. Today, did your face recognition difficulties cause you to avoid social situations? (If you
had no opportunity for social interaction today, please choose N/A. Other options: Not at
All, Somewhat, Yes, Very Much.)
For the following questions, please be sure to think carefully about whether you recognized
someone by their FACE rather than any cues or characteristics such as
context, hairstyle, clothes, voice, gait, etc. We understand this is challenging, but do your
best to limit your answers to experiences of FACE recognition.
4. How many people who you know personally, did you recognize today by their face IN
PERSON?
5. How many people who you know personally, did you recognize today by their face in
PICTURES or VIDEO? (i.e. Facebook, photographs)
6. How many FAMOUS people did you recognize today by their face (in person, pictures, or
video - i.e. TV, Movies, Magazines)?
19. Assessments
Real World Improvements
• 5-day Diary Entry
7. Of the times you successfully recognized people, how often did you use an alternative
strategy such as gait, hair, context, or voice? (If you did not successfully recognize anyone
today, please choose N/A. Other options: Never, Sometimes, Often, Always)
8. Of all the people you successfully recognized today in the questions above, how many
can you form a clear mental image of their face?
9. How many incidents are you aware of in which you failed to recognize someone familiar?
10. Please tell us about any negative experiences you had today regarding face recognition:
11. Please tell us about any positive experiences you had today regarding face recognition:
12. Please describe the type of day you had today (weekday at home, typical work
day, weekend day at home, any social events with mostly familiar or mostly unfamiliar
people, time surfing on Facebook/looking at photos or magazines, TV/Movie watching, etc):
13. Do you have any other comments or questions to share?
20. Timeline
DP Train-Only Group (N=12)
Screening Pre-training Post-training
& Random Diary Entries Pre-training Training (15 Post-training Diary Entries
Assignment (5 Days) Tests (1 Day) Days) Tests (1 Day) (5 Days)
3 rounds of 300
faces per day
DP Waitlist Group (N=12)
Screening Pre-training Post-training Post-training Post-training
& Random Diary Entries Pre-training Waiting (15 Tests - Round Training Tests - Round 2 Diary Entries
Assignment (5 Days) Tests (1 Days) 1 (1 Day) (15 Days) (1 Day) (5 Days)
Day)
23. Train-Only vs. Waitlist Control Waitlist Training
Results Experimental
Train-Only
80% Control
Waitlist 80%
Philadelphia Face
78% 78%
Similarity Test
76% 76%
74% 74%
72% 72%
70% 70%
68% 68%
66% 66%
64% 64%
Before After Before After
Pre-Training Post-Training 1 2
2.10 2.10
2.00 2.00
Face Working
Memory Test
1.90 1.90
1.80 1.80
1.70
1.70
1.60
1.60
1.50
1.50 1 2
Before
Pre-Training After
Post-Training Before After
75% 75%
Part Whole
Whole Trials
70% 70%
65% 65%
60% 60%
55% 55%
Before
Pre-Training After
Post-Training Before
1 After
2
24. Self-reported Face
Results Recognition Failures/Day
p<.05
2.50
2.00
1.50
1.00
0.50
0.00
Before
1
After
2
Training Training
Self-reported Face
Recognition Confidence
5.50
p<.05
5.00
4.50
4.00
3.50
3.00
Before
pre After
post
Training Training
25. Results
Train Only Waitlist Training Groups Combined
Better Trainers
Worse Trainers
Face Working 2.30 2.30 2.30
Memory Test 2.20 2.20 2.20
2.10 2.10 2.10
2.00 2.00 2.00
1.90 1.90 1.90
1.80 1.80 1.80
1.70 1.70 1.70
1.60 1.60 1.60
1.50 1.50 1.50
1 2
80% 80% 80%
Part Whole Face Task
75% 75% 75%
70% 70% 70%
Whole Trials
65% 65% 65%
60% 60% 60%
55% 55% 55%
50% 50% 50%
Before After Before After Before
1 After
2
Training Training Training Training Training Training
26. Results
Train Only Waitlist Training Groups Combined
Better Trainers
Part-Whole Task: Holistic Processing
Worse Trainers
0.15
Parts regressed from Wholes
0.15 0.15
0.10
0.10 0.10
0.05
0.05 0.05
0.00
0.00 0.00
-0.05
-0.05 -0.05
-0.10
-0.10 -0.10 1 2
Pre-Training Post-Training
0.50
Inverted regressed from Upright
0.50 0.40
Face Working Memory: FIE:
0.50
0.40 0.30
0.40
0.30 0.30 0.20
0.20 0.20 0.10
0.10 0.10 0.00
0.00 0.00 -0.10
-0.10 -0.10 -0.20
1 2
-0.20 -0.20
Before After Before After
Pre-Training Post-Training Before After
Training Training Training Training Training Training
27. Results
Worse Trainers Better Trainers Healthy Controls
90%
85%
Part Whole Face Task
80%
75%
Eyes Trials
whole
trials
70%
65% parts
trials
60%
55%
50%
Before Training
Before After Training
After Before Training
Before After Training
After Untrained
Untrained Controls
Training Training Training Training Healthy
Controls
28. Results Summary
Training showed modest overall
improvements on 3 out of 5 tasks
Significant overall self-reported
improvements included increased confidence
and decreased daily face recognition failures
“Better Trainers” showed significantly more
improvement than worse trainers, more
holistic/configural processing, and more
holistic processing of the eye region
29. Future Directions
Make the training more fun!... and longer
◦ Set up game-like points and reward system
◦ Incorporate a phase II training
e.g., Matching training that emphasizes eye discrimination
Include real face stimuli
◦ Include more „variances‟ such as viewpoint and
emotion and incorporate them earlier in training
Combine with non-invasive brain stimulation
Pre/post neuroimaging
◦ Assay N170/N250 and OFA/FFA
In this task, participants were presented with a central target face, above two test faces. The target face disappeared after 3 seconds, and participants had to choose which test face was most similar to the target face. One modification from Thomas et al. included cropping out all external facial features (hair, ears, contour, etc.) from all images so that only the internal features of the face appeared in each stimulus.
The Cambridge Face Perception Test (CFPT) is a computerized sorting task in which participants arrange six front-view faces according to their similarity to a three-quarter-view target face. There were 9 upright trials, and participants had 1 minute for each trial.
The Faces-Objects-Bodies Perception Test is a battery consisting of three separate same-different tasks, using face, body, and object stimuli. Each test consisted of 80 trials with 10 practice trials, during which a fixation cross was presented (2000ms), then a sample stimulus (500ms), then a mask (200ms), the probe stimulus (500ms), and then a blank screen which remained until subject pressed “s” if the two stimuli presented were the same, or “d” if the two were different. The order in which these three tests were taken was counterbalanced across subjects.
The dependent measure in this task is the average number of faces that a participant can accurately hold in working memory. The stimuli used were a random assortment of 3,241 computer generated faces, created using FaceGen software. A trial begins by showing two repeated sequences of target faces to the participant. Each face is shown for 500ms with a 200ms interstimulus interval, follow by a 500ms scrambled mask image. The participant is then presented with a three alternative forced choice task in which they must choose a target face from two foils (presented for 3000ms.) The subject is prompted for a reply and after their response is recorded, feedback is provided, and they press the spacebar to continue to the next trial. The task begins with two repeated sequences of one target. Once a participant provides correct responses on three trials in a row, the repeated sequences then consist of two different face stimuli. At that point, if they again provide three correct responses, the sequences then consist of three difference face stimuli. The test progresses in this staircase pattern, but at any time should an incorrect response be given, the number of faces in the sequences is decreased by one. Subjects were provided with 5 practice trials at the beginning of the test.
The Part-Whole Face Task assesses the ability to use the face context when discriminating changes in individual facial features. After encoding a target face, neurotypical subjects demonstrate an advantage for discriminating a feature change when features are shown within the context of the target face compared to when discriminating features shown in isolation. Each trial began with a central fixation display presented for 500ms. Next, one of the 6 target faces was centrally presented for 1000ms and subjects attempted to encode this face. Next, a scrambled face mask was displayed for 500ms. During the subsequent test period, participants were presented with a pair of probe images side-by-side, either whole faces (whole trials) or isolated features (part trials). Stimuli remained on the screen until participants indicated with a button press which probe stimulus matched the target face (respond 1 for left image, respond 2 for right image). For whole trials, subjects chose between the whole target face and a whole foil face, which was the same as the target face except that one of the features (eyes, nose, or mouth) was replaced with a foil feature. For part trials, subjects chose between a face part from the target face (either eyes, nose, or mouth), and the same facial feature from a foil face. On a given trial, subjects had no indication on which feature they would be tested, nor did they know if isolated features or whole faces would be shown during the test period. There were 72 trials (36 parts trials and 36 whole trials), 24 for each feature type.
