Assessment & Research

Are people with autism prosopagnosic?

Kamensek et al. (2023) · Autism research : official journal of the International Society for Autism Research 2023
★ The Verdict

Face memory in autism forms one long skill line, not a separate face-blind group.

✓ Read this if BCBAs who assess social-perceptual skills in verbal adults with autism.
✗ Skip if Clinicians only serving autistic toddlers or clients with severe ID.

01Research in Context

01

What this study did

Kamensek et al. (2023) compared face recognition in adults with and without autism.

They used a case-control design. Each adult completed the same face tests.

The goal was to see if poor face memory clusters into a separate prosopagnosic group.

02

What they found

Scores spread evenly from good to poor. There was no clear break or extra cluster.

The authors say face problems in autism sit on one long continuum.

A special face-blind subtype does not explain the mix of scores.

03

How this fits with other research

Cholemkery et al. (2016) saw the same smooth spread when they clustered ADI-R scores into three severity grades.

Morales-Hidalgo et al. (2018) also found autism traits distribute evenly in school kids.

Qiao et al. (2025) looks like a clash. Their brain scans split autism into two firm subtypes. The difference is method: imaging can show groups that behavior alone does not.

04

Why it matters

Stop hunting for a face-blind autism subtype. Instead, measure each client’s exact face skill and teach from that point. Use step-by-step prompting, extra practice, and errorless learning for clients who score low. Keep the same plan for mild or severe weakness; only the dose changes.

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Give the client a quick face matching test, note the score, and add extra face drills if they lag.

02At a glance

Intervention
not applicable
Design
case control
Population
autism spectrum disorder
Finding
null

03Original abstract

Difficulties in various face processing tasks have been well documented in autism spectrum disorder (ASD). Several meta-analyses and numerous case-control studies have indicated that this population experiences a moderate degree of impairment, with a small percentage of studies failing to detect any impairment. One possible account of this mixed pattern of findings is heterogeneity in face processing abilities stemming from the presence of a subpopulation of prosopagnosic individuals with ASD alongside those with normal face processing skills. Samples randomly drawn from such a population, especially relatively smaller ones, would vary in the proportion of participants with prosopagnosia, resulting in a wide range of group-level deficits from mild (or none) to severe across studies. We test this prosopagnosic subpopulation hypothesis by examining three groups of participants: adults with ASD, adults with developmental prosopagnosia (DP), and a comparison group. Our results show that the prosopagnosic subpopulation hypothesis does not account for the face impairments in the broader autism spectrum. ASD observers show a continuous and graded, rather than categorical, heterogeneity that span a range of face processing skills including many with mild to moderate deficits, inconsistent with a prosopagnosic subtype account. We suggest that pathogenic origins of face deficits for at least some with ASD differ from those of DP.

Autism research : official journal of the International Society for Autism Research, 2023 · doi:10.1002/aur.3030