Paul Isaacs' Blog

Autism from the inside


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Strategies For The “Pieces” of My Autism Using Donna Williams’ Fruit Salad Analogy

Fruit Salad Analogy Copyright D.Williams

Fruit Salad Analogy Copyright D.Williams

Note – That this is from a personal perspective of my profile and what makes up “my autism”

Here are all the pieces of my Autism broken down into bits and chucks with a personal perspective on each bit and personal strategies that have helped me over the years.

Expressive Agnosias

Alexithymia

This is an issue with processing one’s own emotions it affects about 85 percent of people on the autism spectrum and is experienced on different levels depending on how one is affected and what moods create the issue.

Personal Perspective

For me emotions come outside in and not inside out they are an invasion a wave of energy that is uncontrollable, invisible and scary – negative emotions take longer to process and configure as well – for example it took my 3 whole years to process (emotionally) that I was being bullied at work everybody else knew I didn’t. I a wave of energy hit me that night as I cried uncontrollably with the realisation of what happened again it took 3 years. As a teenager I would tense my face up and self-harm in the form of knuckling my cheeks, slapping my legs and hitting my arms in confusion and disconnect.

Strategies

  • Paul what are the origins of your feelings (helping me find a starting point)
  • Paul are these feelings environmental (situational) or is this not
  • Use objects of reference and gestural language and representation to explain

Receptive/Expressive Language & Movement Issues (Speech & Communication)

Aphasia

There are many different forms of aphasia which affect both expressive and receptive communication

Personal Perspective 

Sounds and language intermingled and became indisputable I would react with glee and find these “sounds” that people made and tilt my head in wonderment, perplexed and even intrigued by these “sounds” this was at pre-school – event now receptive language is difficult for me (words process back into sounds meaning deafness)

Strategies

  • Clipped telegraphic language
  • Tone and overt melody
  • Gestural language – creating movements which connect with the words like a play
  • Allowing processing time

Speech Delay

BewdjULCYAAzv0H Personal Perspective

Swirling sounds and words in my head – I had problems with expressive speech for about the first five years I had no functional language in head for many years – I would have moments of clarity, moments of language which slowly progressed but no one saw because of my external behaviours I had limited words within my head which progressed – no one should be written off if they don’t have expressive speech, I heard things in the playground and slowly processed them and because of how I appeared it looked like I didn’t hear/understand.

Strategies 

  • Word and sound play
  • Movement
  • Not presumed incompetence

Language Delay 

Personal Perspective

At around the ages of 7/8 years old I gained functional expressive speech of (from a developmental perspective a 3 year old) – with the receptive and expressive language disconnect I had issues with understanding to express and equally expressing to understand. This lead to confusion with not only myself but others around me Speech Apraxia (Verbal Dyspraxia) also compacted the issue (coordination of  the mouth and tongue and jaw muscles to extract speech) this was prevalent until late infancy in my CAMHS  (Child & Adolescent Mental Health Services) notes speech production was at times heard to understand.

Strategies 

  • Clipped Telegraphic Language
  • Gestural language (both from myself and speaker)
  • Word, Sentence & Language play (use of syntax, meaning, word production, sentence connections)
  • Contextualisation of words

Selective Mutism (once functional speech was acquired)

During late infancy and early teenage-hood I had bouts of mutism (having the ability to speak but because of anxiety would not) this included – people who I sensed were non genuine, too much expressive language from speaker (meaning deafness) so unable to give an answer that was contextually correct.

Strategies

  • Understanding the origins of the mutism (social anxiety, exposure anxiety, OCD obsessive compulsive disorder, language processing disorder, social phobia etc)
  • Boosting self-confidence – such as in my cases drawings and exercise
  • Understanding the receptive and expressive communication profile

Tic Disorder  & Globus Pharyngis – 8 Years old – was called a “Nervous Throat”

Personal Perspective

In mid to late infancy I had what was termed a nervous throat this was to do with the “feeling” or an obstruction in my throat causing me to in a tic-like fashion make a loud “Hum!” and “ahem!” sound.

Strategies

  • What are the places of anxiety in one’s life that has caused this
  • Making me aware of when I was doing this sound

Echophenomena

Personal Perspective

Sounds, patterns, themes, feeling, movement and experiencing this world, people and place. I don’t use elaborate constructions but do and sense in order to perceive, understand an process I don’t live in a world of literalism nor logic as basis of “concrete” understanding – even now that form of and basis of understanding things, people, environments etc.

Strategies

  • Movies (focusing on the sounds, movements and expressions)
  • Music (tone, melody and rhyming)
  • Observing surroundings and contextualisation

Visual Agnosias

 Personal Experience 

I see faces (face blindness), bodies and visual environment as fragmented (object blindness) which also meant I could not see body language or facial expression , flat tursh and without depth or meaning (meaning blindness) not understanding self and other of what is around me for example it took me until 16 years old to understand that when I looked in the mirror firstly I was looking at myself (although I still get a level of disconnect) and that what “seems to be in front of me” is in reality behind me. My visual perceptual systems have layered effect on what I see and interpret.

Strategies 

  • Sculpting objects in my space this would including licking, sniffing, mouthing as a way to externalise the object making it real for me this help me map out my space
  • Preference for having no shoes of socks on in my youth and around the house (patterning movements)
  • Sculpting faces remembering and connecting with someone by touching their face (I have only done that to 7 people in my lifetime to date)
  • Having objects on display not “hidden” because I don’t have visual memory so placement is important
  • Recognising people by sensing their patterns of movement and their voice
  • Tinted lenses help with sensory integration, moving in visual space, depth perception, body language, posture and confidence

Auditory Agnosias/Aphasia

Personal Perspective

Hearing sounds environmental with no on origin (auditory agnosias) hearing words as “sounds” (verbal auditory agnosia/receptive aphasia) missing tone, sarcasm, idioms not because of literalism but because of how much language I can process before I “hear” nothing.

Strategies 

  • Telegraphic language and clipped words for the origins of environmental sounds (auditory agnosias)
  • Telegraphic and gestural language – being overt, pantomime like in expression, tone and melody
  • Music, rhythmic beats and movement help my brain “work”

Body Disconnection

Personal Perspective

Not being connected to my body means that pain is not recognised as well as a sense of my own body its inter-connectivity and its connection (as a whole form) around the world around me, I appeared odd to bouts of trauma having a tooth almost knocked out (an elbow to the mouth) was me with indifference to pain but shock and sadness at the blood (this element coming out of me) and a dislocated arm was met with anger and confusion because of the lack of movement not the pain. During times of mental illness I self-harmed both my arms not “knowing when to stop”  and as a child I didn’t have knowledge of my fingers (my limbs also rolled into one another as if they didn’t exist).

Strategies

  • Pressure points around my body – bracelets on wrists, tight shoes, belt, jacket and/or shirt and long hair tied back (adding pressure getting a sense of my head)
  • As a young child smearing paint, moulding play dough and sifting sand (to get a sense of my “foreign fingers”)
  • Messy play as a child
  • Dental appointments (for me this is form of sensory integration and very relaxing) :-)

Dissociative Disorders – Recognised  in 2012/Revised 2014

Personal Perspective

In late infancy I started to dissociate as coping mechanism during these years and for many after taking myself away from both the situation and environment, persistent bullying during my educational and work years didn’t help the issue and I “created” personas (with strong reactionary personality profiles) to deal with this. I developed PTSD some years ago reliving an abusive incident that happened in my mid teenager years.

Strategies 

  • Understanding that dissociation is on a spectrum from daydreaming to higher frequencies and detachment of you the person and/or the environment you are in.
  • Therapy that includes mapping memory, incidents, personas and coping mechanisms
  • Understanding trigger responses
  • Personal origins of dissociation

Mental Health

Personal Perspective 

I started to develop OCD in my early teenager years this was persistent and would resulted in hand washing, placement moving and plug and switch checking, door-slamming and checking. Exposure anxiety was to do with an involuntary response to direct exposure interaction this would lead me to run away literally (or in my mind). Like many people on the spectrum I advocate the personhood first in the late 2000s I developed two distinct personality disorders (extreme versions of my “normalised” personality traits.

Strategies

  • Origins of OCD – in my case this was fear of the house being burned down, burglary,  germs and confirmation, and invasive illness that would lead to pain and/or death
  • Indirect confrontation for exposure anxiety talking away from me, talking about me but allowing me to hear it and integrate it without being in the mix
  • Knowing personality its traits and extremes (disordered versions of “normalised” versions/traits)

Learning Difficulties

Personal Perspective

Words swilling in my head I found them hard to process and strand together as words formed in my head over time I found it hard to translate them onto the page, the same with numbers which don’t swill in my head I found it hard to grasp numbers their meaning and their interpretation and their overall function.

Strategies

  • Clipped sentences – one stage at a time
  • Pens with extra grip (fine motor movements)
  • Alternate ways of writing
  • Function and context of what number “mean”

Auto-Immune

Candida Albicans

Personal Perspective

Many foods would make me fill ill both in body and mind causing me to have brain fog, lack concentration and further hinder my processing and integration of information from my surroundings, language and sounds.

Strategies

  • Understand foods, their content and what ingredients they have in them
  • Piecing  together what foods are making you ill, unwell and have brain fog
  • Piecing together what foods you can have that don’t make you ill

Other

Personal Perspective

This can be related to anxiety it is the slow stripping of enamel making them look “smooth” and/or “chipped” in appearance I have this with many teeth on one side of mouth

Strategies

  • For me regular checks at the dentist and a gum guard at night has helped with issue
Dr Casanova

      Dr Casanova

Genetics – Developmental Agnosias & Minicolumns

Some agnosias, sensory hypersensitivity, sensory integration disorders and many other conditions and syndrome can be passed down and can be seen as congenital in nature how the brain has grown with genetic encoding  – Neurologist  Dr Manuel Casanova calls this Minicolumns please take a look at this blog about his research and findings

AUTISM & MINICOLUMNS

PERSONAL WEBSITE

PERSONAL BLOG SITE

Donna Williams 2011

  Donna Williams

Donna Williams – Autism as a “Fruit Salad”

Donna is quite correct in letting the world know that autism is a “clustering” of different conditions (both neurological and metabolic systems), syndromes, personhood and personality extremes, environment, mental health and learning styles. No one person with autism is the same and that means there is a high level of diversity to their which is good.

WHAT IS AUTISM? BLOG

AUTISM & ASPERGERS “FRUIT SALADS”

PERSONAL WEBSITE

Premature 1

                         Me Premature

Brain Injury Relates To My Autism Profile

Having brain injury at both has also had an impact on my autism presentation I was born premature and through placental abruption, cerebral hypoxia, silent stroke and damage the left hemisphere of the brain (which is related to aphasia, language processing, visual agnosias, simultagnosia, apraxias and  visual spatial functioning)

HYPOXIA & BRAIN INJURY 

 I would say that these added factors has made my autism “Fruit Salad” more complex in nature and presentation – there are clearly other members of my are on the on the autism spectrum who have been diagnosed but their profiles are very different from mine in terms of presentation the mechanics.

 Having an Autie Profile

 Having an Autie profile in terms of presentation means I live in world (from a processing perspective) that is less literal, less logical and I use my sensory systems to work out the world I live in and I think it is important to know the mechanical differences between Autism and Asperger’s Syndrome and the people in between profiles “Aspinauts”. Every profile is unique in presentation so interventions, learning and communications will have to be person centred.

 Personhood First? Why?

For all what is said and done I want to be known for my personhood first my autism comes along with me wherever I go, however it doesn’t define my being, it doesn’t make me what I am in totality (it affects how I perceive and processing the world). I love art, poetry, music, movies, fashion, drawing, being silly, bad jokes, dogs and want to know for those things first.

I hope this helps others. :-)

Paul Isaacs Adult with Autism 2014


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Autism, Aphasia & Visual Agnosias – Telegraphic Language & Gestural Communication

Note – This is from a personal perspective of having Aphasia and Visual agnosias as apart of my Autism

BrocasAreaSmallAphasia

As a child I appeared “deaf” this was because of severe receptive and expressive language processing other words I have used in my blog are related – pure wordness, verbal auditory agnosia and meaning deafness. This is to do with the left hemisphere of the brain – even now words can tumble into “sounds” with no auditory or contextual origin I hear melody rise and fall but no meaning, nothing to grasp. The words are “dead” and not brought to life.

Visual Agnosias

I struggle to gain visual context, things are see are fragmented, distorted, tursh and flat with no depth no origins, foreign Street Scene Pixeledintriguing and amazing as well as bewildering and confusing. I don’t live in a world world with logical and literalism as a backup for my lack of visual understanding I must “feel” for  understanding and contextualisation.

Simultagnosia – Visual Fragmentation – Object Blindness

Inability to recognize multiple elements in a visual presentation, one object or some elements of a scene can be appreciated but not the display as a whole.

Semantic Agnosia – Meaning Blindness

An agnosia that is a loss of the ability to visually recognise an object while maintaining the use of non-visual sensory systems such as feeling, tapping, smelling, rocking or flicking the object to recognise the object.

Prosopagnosia – Faceblindness

inability to recognize the faces of other people or one’s own features in a mirror, due to damage to the underside of both occipital lobes.

Visual-Verbal Agnosia

visual-verbal agnosia (also referred to as pure word blindness or alexia without agraphia).Individuals with this disorder show a marked reduction in their ability to read the printed word, though their writing and other language modalities remain essentially intact.

Hemispatial Neglect 

Being “blind” to one side of my body and and visual field this includes motor coordination this also relates to visual spatial disorders and seeing things in 2D which can be related (at least in my case to visual object agnosia)

Homonymous hemianopsia 

Processing “half” my visual field.

Telegraphic Language 

This clipped form of language helps me if you want to get a point and also if you want to use emotive language etc.

Gestural Signing and Movements

In order to me to understand the words and where they are going (remember I am not literal and I am processing before typical interpretive language) externalise use your body, your hands and exaggerated gestures creating a play in front my eyes and also use melody in your voice (I am not tonal deaf either) to help my grasp the movements to give them meaning this also helps because I cannot internlise words because of the visual agnosias.

Kate Bush – Wuthering Heights 

Kate Bush – Bush Babooshka 

Think of how Kate tells the story in this video with melody and movement using her hands and body to tell the story.

ARTICLE ON APHASIA AND GESTURE

Differences in the communicative use of gesticulation and pantomime in a case of aphasia PDF (conclusion below)

Conclusion

This study has shown that both gesticulation and pantomime can be used communicatively in a person with aphasia.
Importantly however, this may differ per communicative setting. Furthermore, even though a gesture mode might be
impaired it can be useful still. In clinical practice each of these gesture modes should be assessed separately in
different types of communicative settings. In these assessments the emphasis should be on comprehensibility
rather than on the correct use of a representation technique

“Pseudo” Social Emotional Agnosia 

The reason why I miss tone (melody), sarcasm, idioms in language isn’t because I am literal and have a semantic pragmatic issue with language it is because words (all of them in some case)  tumble into sounds or I pick up on key words. The reason why I don’t “see” body language and facial expression is because of visual agnosias and visual fragmentation and that is an important difference to mention.

Objects Of Reference

Objects can create relaties in front of me I remember movements, patterns, themes and feels what you are saying – objects can create contextual realities for me as you move them and uses them as examples it grounds me with what you are saying and more importantly meaning.

I have an Autism profile not an Asperger’s Profile 

Fruit Salad Analogy Copyright D.Williams

Fruit Salad Analogy Copyright D.Williams

I think this is very important element to point out I see people with AS and their profiles as unique I am intrigued and amazed with how they use language, strong logical reasoning and literalism to decipher the social world and other elements of it.

Classic Autism 

Although I don’t fit the “typical presentation” of classic autism  that is what my presentation and what my processing and profile innards are (people would have to live with me for a week to experience my processing world).

I was diagnosed with high functioning autism in 2010 with my parents giving a diagnostic history by a clinical psychiatrist this was because of -

and scotopic sensitivity syndrome in 2012 by an Irlen specialist with a additional recognition of severe autism (on my diagnostic report) because of -

Profile Differences

I don’t fit the presentation of Asperger’s Syndrome and these differences are very important in terms of mythbusting what Autism “looks like”. It as diverse set of pre-existing conditions that are stacked that then create the unique profiles and presentations.

Learning and Likes

  • I love melody and movement and music, sound bites, “sounds” of words etc – I one of the reasons why I like certain TV shows and movies isn’t to do with being a visual processor or thinker
  • When I move I think when I think I move
  • The bigger the gestures (with language) the more context I get
  • I have melodies, jingles and sound bites in my head a lot of the time – Musical Ear Syndrome 
  • I don’t learn by pictures they don’t compute and words must be “brought alive”

Remember every profile is unique and different that includes personalities, co-conditions and what “pieces make up the persons Autism. :-) 

Paul Isaacs Adult With Autism 2014


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Life With Visual Perceptual Agnosias Within Autism

“Having Visual agnosias as apart of my autism means I rely on textures, sounds, movement and placement rather than logic or literalism. I know I live in a different world perceptually than other folks on the spectrum.”

Paul Isaacs Adult With Autism 2014


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The Personhood Club – Remembering I’m A Person First – Identities Come Afterwards

Premature 1“The greatest feeling I get is when I reminded that I am a person and all that entails it is beyond any rigid identity bestowed on me, I belong to no specific club unless you call it the personhood club which has about 7 billion members

Paul Isaacs Adult with Autism 2014


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The Journey Of Artism

Fancy Beret“I love art and journey that encompasses it – I have no visual memory so my artwork is a journey in real-time and I go along with the journey with no pre-formatting although some basic ideas maybe contextually applied. I like to create things on a whim and feel free in my drawings.”

Paul Isaacs Adult With Autism 2014

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