Paul Isaacs' Blog

Autism from the inside


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Autism, Meaning Blindness and The Phantom Rainbow Flask

Related image

Note This was from a personal perspective

There are times when I even question my own perception visual and/or otherwise and got the the point wonder of how I cam to this conclusion.

Noticing An Object With No Context? 

I was presenting a workshop around a week ago and in the room something every so often was catching my eye and intriguing me, its was shiny and rainbow coloured in presentation however I ignored for a while.

Interpretive Meaning vs. Non-Interpretive Experience? 

I was then talking about experiences of being object blind (simultagnosia) and meaning blind (semantic agnosia) and turned the the object of intrigue and held it and proclaimed and questioned  “what is this?” in about 5 seconds or more the audience explained that it was a hip flask!

It just goes to show that even on a residual level my visual perceptual challenges take me by surprise this were I made an effort to remember the object by touching the its smooth and bobbled surface.

Paul Isaacs 2019

 


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Asperger’s Syndrome & “Classic” Autism – Left Brain Autism & Right Brain Autism “Fruit Salads”

The late Polly Samuel’s (Donna Williams) through her career had pointed out that firstly autism was adjective a describer of an experience rather than a definer of a person, she also pointed out through her books and blogs that “autism” is different for each person a clustering and multifaceted condition made of different conditions in both neurology  and biology  and contributing psycho-social factors, identity, mental health and environmental factors

Asperger’s Syndrome – Left Brain Autism

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When noting and observing people with Asperger’s Syndrome the part of the brain which is being used to compensate for a disconnect right is the left, people with Asperger’s Syndrome have a condition called social emotional agnosia this means that the person cannot perceive facial expression, body language and tone of voice. Even thought sensory issues may present themselves it would to do with modulation and integration rather than sensory perceptual issues that effect different areas of the brain, faceblindness (prosopagnosia) has a high co-morbidity as well as dyspraxia, alexithymia and literal perception of language. So other words people with AS have to intellectualise in order to compensate for the disconnect in the right.

Characteristics of Right Hemisphere Syndrome: 

– Left visual neglect – an individual may neglect words on the left side of the page or not realize that there are objects on the left side 
– Difficulty with facial recognition 
– Poor awareness of deficits 
– Poor self-monitoring 
– Impulsive behavior
– Poor initiation and motivation 
– Disorientation 
– Impaired attention/memory 
– Difficulty with organization and reasoning/problem – solving 
– Difficulty with social aspects of language (e.g., poor turn taking skills, providing too much information) 
– Difficulty understanding humor 
– Difficulty with word retrieval 

© By Beata Klarowska, M.S. CCC-SLP Monday, July 25, 2011

Classic Autism – Right Brain Autism

When looking at “classic” autism one makes the impression that the person has (and wrongly) a “lower functioning”variant of AS, this could not be further from the truth people with classic  autism tend to to have receptive and expressive aphasia, verbal agnosia, speech/oral apraxia, and a higher rate of visual perceptual disorders such as simultagnosia and semantic agnosia. However introspection is in tact and just look at the poetry and art.

What if my brain injury or stroke is on the LEFT SIDE of my brain?

Injury to the left side of the brain may result in right-sided weakness and the following communication problems:

  • Receptive Language: Problems with understanding spoken or written language (listening and reading)
  • Expressive Language: Problems with expressing spoken or written language
  • Apraxia of Speech: Problems with programming and coordinating the motor movements for speaking
  • Dysarthria: Aspects of the speech system is impacted, which may result in slurred speech or a change in how your voice sounds
  • Computation: Problems with number and math skills
  • Analyzing: Problems with solving complex problems

© 2016 CONSTANT THERAPY

Right Brain Left Brain Autism Fruit Salads Image 2017

Differences between Aspergers and Autism ‘fruit salads’?

 In one of my books, The Jumbled Jigsaw, I presented a range of conditions commonly collectively occurring in those with autism and Aspergers. I was asked about the differences between an Aspergers (AS) ‘fruit salad’ and an Autism ‘fruit salad’As an autism consultant since 1996 and having worked with over 1000 people diagnosed on the autism spectrum there are areas that overlap, areas where similar can easily be mistaken for same, and areas that are commonly quite different. Some with AS can present far more autistically in childhood but function very successfully in adulthood. Some with Autism can have abilities and tendencies commonly found in Aspies and some will grow up to function far more successfully than they could in childhood but, nevertheless, when together with adults with Aspergers they each notice that the differences may commonly outweigh the similarities. Generally the more common differences are:

ASPERGERS
originally called ‘Autistic Psychopathy‘(now outdated)
commonly not diagnosed until mid, even late childhood.
lesser degrees of gut, immune, metabolic disorders, epilepsy and genetic anomalies impacting health systems
dyspraxia
mood, anxiety, compulsive disorders commonly onset from late childhood/teens/early adulthood as a result of bullying, secondary to social skills problems, secondary to progressive self isolation and lack of interpersonal challenge/involvement/occupation.
scotopic sensitivity/light sensitivity more than simultagnosia
most have social emotional agnosia & around 30% have faceblindness but usually not due to simultagnosia
literal but not meaning deaf
social communication impairments, sometimes selective mutism secondary to Avoidant Personality Disorder (AvPD)
sensory hypersensitivities more than sensory perceptual disorders
higher IQ scores due to less impaired visual-verbal processing
tendency toward Obsessive Compulsive Personality Disorder (OCPD), Schizoid rather than Schizotypal Personality Disorder and commonly Dependent Personality Disorder to some level.
higher tendency to AvPD rather than Exposure Anxiety
Alexithymia is common
ADHD common co-occurance but may be less marked than in those with autism.

AUTISM
Once known as Childhood Psychosis (now outdated)
generally there is always some diagnosis before age 3 (those born before 1980 were still usually diagnosed before age 3, although commonly with now outdated terms like ‘psychotic children’, ‘disturbed’, ‘mentally retarded’, ‘brain damaged’.
higher degrees and severity of gut, immune, metabolic disorders, epilepsy and genetic anomalies impacting health systems
mood, anxiety, compulsive disorders commonly observed since infancy
commonly amazing balance but commonly hypotonia
simultagnosia/meaning blindness rather than just scotopic sensitivity
verbal agnosia/meaning deafness
verbal communication impairments (aphasia, oral dyspraxia, verbal agnosia and associated echolalia and commonly secondary Selective Mutism)
lower IQ scores associated with higher severity of LD/Dyslexia/agnosias
tendency toward OCD/Tourettes, also higher rate of Schizotypal PD, DPD is common and tends to be more severe
higher tendency to Exposure Anxiety more than AvPD
higher tendency toward dissociative states (dissociation, derealisation, depersonalisation)
poetry by those with autism as opposed to AS commonly indicates those with autism can have high levels of introspection, insight
ADHD extremely common co-occurrence

Donna Williams, BA Hons, Dip Ed.
Author, artist, singer-songwriter, screenwriter.
Autism consultant and public speaker.
http://www.donnawilliams.net

Reflective Conclusion

It is simple people need to start looking at the functioning of the brain and how these different systems work for different people. This will in turn create advocacy which is not only meaningful and beneficial but character building and the correct information will give a broader foundation and palette to work from. I have autism (as opposed to AS) not because I am just “saying it” but because of what part of my brain affected.

What I am not saying (and never will say) is that I am speaking for all that would be disservice to many people’s realities. I am fully aware that this may challenge people me saying there are differences however looking at the neurology behind it and Polly’s observations I think there is room for healthy discussion.

Paul Isaacs 2019


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Asperger’s Syndrome and Autism? – Doing vs. Being?

When we some people look at Asperger’s Syndrome and Autism it can be used interchangeably as the “same thing” but a “different presentation” between the two. If we look a little (or a lot) deeper you can actually find that the differences lie in brain hemisphere dominance and neglect and all that comes with it.

Autistic’

Reliant on the mapping of pattern/theme/feel known as ’Sensing’, with intermittent use
of interpretative processing at the level of the literal
Mono tracked processing with moderate to severe information processing delay.
Indirectly Confrontational, self in relation to self

The struggle here is the use of switching between “being” and “doing” states this means that the person is going from a “sensing” state to an interpretive state.

Asperger’s’

Interpretative processing at the level of the literal intermittent processing
beyond the literal to the ’significant’,
Generally Mono tracked processing with mild information processing delay

Those with Exposure Anxiety are indirectly-confrontational and self in relation to
self. Others are able to manage directly confrontational other-initiated social
interaction but generally lack a simultaneous sense of self and other

The struggle here is the opposite the use switching between “doing” and “being” this means that although the person gets a level of “significance”  they may get “stuck” in a state of over thinking.

Exposure Anxiety is one of the three faces of “Autism”
Notes from a presentation by Donna Williams
At Flinders University, Friday Jan 16th 2004

Autism Doesn’t Run On”One” System

There is not one “system” in autism and that is part of the larger issue, by promoting tired stereotypes and linear 2D presentations of “collective autism” in which the person is assumed to think, act, react and behave in the same manner is rather passe and potentially dangerous.

Looking deeper, being objective and opened minded to the varying presentations that both “Autism” and “Asperger” fruit salads supply as an adjective and a description can lead down to meaningful roads of empowerment.

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Paul Isaacs 2019


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Left Hemisphere, Right Hemisphere & The “Mechanics” Of Autism “Fruit Salads”

 

Autism and Aspergers Hemishpere Image

When looking at autism “fruit salads” and function of both brain hemispheres it is interesting look at the difficulties in each area.

Looking at Donna Williams’ work on the subject of the differences between “Aspie” and “Autie” fruit salads was to do with hemisphere dominance and neglect a trade off between on or the other with “Aspinauts” being the “grey area” of in-between.

On a personal note I always thought she was on to something and looking at this simple table backs it up, consultancy observations, personal experiences and tireless effort to give people a better understanding of both DISablity and disABILITY with autism.

http://brain.web-us.com/brain/LRBrain.html

Left Right Brain Functions Aspergers Autism Image 2018

Right Hemisphere (Asperger’s) “Fruit Salad”

Extralinguistic Deficits

Again, RHD patients are unlikely to display the kinds of phonological, syntactic or semantic problems associated with aphasia. However, although they do not typically have many specific language problems, they definitely have difficulty communicating. This impairment seems to follow from an inability to integrate information; RHD patients apparently do not make adequate use of context in their interpretations of linguistic or nonlinguistic messages. They have difficulty distinguishing significant from unimportant information. For example a patient of mine when asked to describe the “Cookie Theft” picture card from the Boston focused on irrelevant features without describing the overall picture. Some aphasics with typical left hemisphere lesions present with executive function disturbance similar to right hemisphere syndrome.

Literal Interpretations

RHD patients may be able to comprehend only the literal meaning of language. Thus, they will often fail to understand many jokes, metaphors, irony, sarcasm, and common sayings that include figurative language. For example, if an RHD patient hears someone say that they are about to “hit the ceiling,” he might assume that the person is really about to begin striking the ceiling. Such a patient may also have trouble understanding indirect requests. For example, if he is asked if he “could open the window,” he may fail to identify this as a polite request and simply answer “yes” rather than opening the window.

These problems with figurative language may be viewed as one manifestation of the inability to base interpretations on context.

Difficulty identifying relevant information

When listening to a conversation or reading, an RHD patient may fail to abstract the main point contained in the information being shared. This happens in spite of the fact that, unlike an aphasic, the patient can understand all the individual words and grammatical structures used. For RHD patients, it appears that their comprehension of everyday language is impaired by a failure to distinguish important information from irrelevant detail and also by an inability to integrate According to Blake 2007, RH patients have difficulty comprehending non-literal language, humor, and multiple interpretations Furthermore, Blake says that their difficulty with language production includes: impulsivity, inefficiency, and egocentricity. She also says that the same problems are seen in traumatic brain injury.

Inability to interpret body language and facial expressions

In a conversation, RHD may miss out on important cues that should tell them about the emotional state and true intention of the person with whom they are interacting. This inability to interpret body language and facial expression may be related to an overall failure to use context in the interpretation of individual pieces of information. Problems with the interpretation of facial expression may also be due to the fact that RHD patients often fail to maintain eye contact with their conversation partners.

Flat affect

RHD patients may fail to display a wide range of facial expressions themselves. Also their speech is frequently aprosodic, or lacking variations in pitch and stress. Some patients will sound “robot-like,” and thus be unable to express emotion or changes in meaning via changes in intonation. These patients will no longer be able to vary pitch to signal the difference between a question and a statement or use word stress changes within a sentence to signal a difference in meaning.

Problems with Conversational Rules

RHD patients may fail to follow conversational rules, including those governing turn-taking, the initiation and closure of a conversation. RHD patients may tend to dominate conversations, as they are frequently verbose. They may also fail to properly estimate levels of shared knowledge, failing to give the listener enough background information to understand their statements. According to Myers and Mackisack (1990), RHD patients appear to not care about the needs of the listener. They, like children in an early developmental phase, may assume too much knowledge on the part of the listener; or not enough. They appear to answer without adequate search for the right answer. They also may fail to pick up on non verbal cues that signal listener’s reactions.

Impulsivity

RHD patients may exhibit poor judgment and problem solving abilities. They may require constant supervision due to a tendency to attempt tasks of which they are no longer physically capable. This may be related to anosognosia. They may also exhibit impulsivity in the sense of failing to censor the statements they make to other people.

Confabulation

RHD patients may make untrue statements. These do not usually seem to be deliberate lies. According to Brownwell et al. (1995), this may be the patient’s way of responding to his own confusion rather than attempts to mislead the listener

The Neuroscience on the Web Series:
CMSD 636 Neuropathologies of Language and Cognition

CSU, Chico, Patrick McCaffrey, Ph.D.

There tends to be a lower level of visual-verbal processing difficulties in this profile, social emotional agnosia, alexithymia, issues around a shared “sense” of social, self and other. Internal mentalising (to gain meaning)  would make sense.

Left Hemisphere (Autism)  “Fruit Salad”
  • Sensory disturbances, weakness or paralysis on the right side of the body. Read more.
  • Impaired vision on the right hand side of both eyes. (hemianopia)
  • Speech and language problems (aphasia).
  • Difficulties in recognizing objects (agnosia).
  • Problems with daily activities, routines that used to go well (apraxia).
  • Reduced memory for verbal (spoken) matters.
  • Decrease in analytical skills.
  • Problems with chronology (in order of time, cause and effect)
  • Reduced timing and speed of skills
  • Confusing left and right
  • Difficulty in dealing with numbers, understand numbers and dealing with money
  • Become slow
  • Exhibit insecure, anxious and withdrawn behavior
  • Risk of depression
  • Chance of changing moodseasily overwhelmed by emotions

© 2014 – 2018 Braininjury-explanation.com Foundation

There seems to be a higher level of visual-verbal processing difficulties, language processing disorder, sensory perceptual agnosias, problem with a sense of “self” and other.  External mentalising (to gain meaning) would make sense.

Paul Isaacs 2018


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The Cognitive Aspects of Autism

Image result for Donna Williams autism

I used to think I was stupid and there are many things which are a struggle. It’s hard for me to tell a garlic crusher from a can opener. I sometimes can’t visually recognise my own husband. I lose the meaning of things I’m not physically using so cooking and running water can be a problem. There is often no left or right in my world and up and down sometimes tumble too. I use objects to track my thought externally or have to type it out to experience it after it hits the screen. I often can’t tell if I like something, whether I’m hungry or whether I had a good day. But I can do so many things that people really struggle to understand how extremely uneven abilities can occur in the one person. But in fact, that is the cognitive definition of autism.

Donna Williams 2009

Cognition vs. Expression

I don’t know on a conscious level what I am always doing, thinking or feeling which means in responses that on the surface seem very “limited” or “surface” an action creates a response but not always a “connected” one.

I can however type long reams of introspective and emotional material on a unconscious level which seems paradoxically detached from what I can say verbally at times. My inner world is far more richer than at times what I can get out verbally. This lends to personality types which are more attuned to empathy I show this through art and poetry.

“Sensing” vs. Intellectual Processing

 

I can see that this is to do with the residual aspects of being meaning deaf, context and meaning blind, information processing delays and language processing issues. I have found over the years “pathways” of extraction such as art and poetic writings. I “be” and the puzzle seems to all come together with an “unknown knowingness” that I cannot do when I am in a more conscious state as contradictory as it sounds one gets less out of me.

Paul Isaacs 2019


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A Journey With Exposure Anxiety

 

Exposure Anxiety comes in 3 levels:

  • Specific: Targets only specific environments, activities and interaction with particular individuals.
  • Generalized and other-directed: Effects all areas of life which directly involves others.
  • Generalized and both self and other directed: Effects all areas of life which directly involves others but is also present when alone.

Copyright Donna Williams 1991, 2003, 2008

Image result for exposure anxiety

 

Residual “Exposure Anxiety?

If we think about exposure in a residual (non syndromic sense) those moments of embarrassment, aware of being aware, aware of your own self-awareness of the situation meant that you froze clammed up or even ran away meant that this “feeling” you wanted to escape, remove, and disappear.

 A Personal Look at Exposure Anxiety And Me

If you turned the “volume-up” on this condition you may find that it fits in the realms of being called “Exposure Anxiety” a feeling on a chronic level that falls into the three subtypes above. I would say that in my early years I had the 3rd one throughout my child and teenage hood as I grew into my twenties and was at the tail end of being employment in my mid teens I was thrust into a world of expectation from a social perspective that in many ways never let up. I never the less “kept going” and now at the age of thirty two I can say that the claws of this condition have shortened, nails smoothed and hands made smaller.

I would say it has an impact on me in specific areas so that is going from 80% to now at a more comfortable 30% and below I can show more of “myself”, be, share and talk in a more “connected manner” than I did even 10 years ago. Other things have changed to my environment, my purpose, life is but a rolling journey and that is the joy we can all celebrate and question at different stages in our lifetime.

My information processing being meaning deaf and meaning blind have changed, the tints have aided in those areas of visual perceptual challenges, and my meaning deafness is around 30% so I can keep a better track on conversation around me. My emotional processing and perception are still delayed that is a work in progress and I seek not to compare but to be the closest version of “me” I can be.

When we look at other people’s autism “fruit salads”, we begin to wonder what is the “driver” to what I am seeing? Is it sensory perceptual? Is it dietary disabilities? Is it seizure related? Is it emotional perception? Is it language processing? Etc. By looking at the person’s “systems” you are dealing into those areas of honest and humble questioning, what will you find and how will you adapt?

Common Threads Of Humanity?

Do people with autism have much more in common with those without? My answer is yes they do the only difference is the areas of that person’s “autism” that is challenging some to smaller more residual degrees others to more severe and/or profound degrees it is not the matter of it being a linear spectrum from “classic” autism to “asperger’s syndrome” but the also the palette of grey and what is specific to that person is what matters. All human beings have “system” it may be just that I have taken the time (which anybody could choose to do in my circumstance) and work out “what that is”.

Looking At People As People?

If one ignores the poison of the autism militancy which is political and unhelpful in its projection and reasoning one must look at the person and what “autism” is for them and means for them.

Paul Isaacs 2019


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So What is Simultagnosia & Semantic Agnosia? In The Context Of Autism?

Image result for occipital lobes and simultagnosia

Note: This is from a personal perspective

Simultagnosia is a condition that effects the occiptal lobes of the brain this is where visual perception and processing is connected, it also can have an impact on visual association, language perception/processing and overall navigation of the visual world around you.

“Blindisms” 

For me it meant not being able to access the visual world with coherence rendering me unable to access with my “eyes”and having to build up the visual world in a “non-visual” way such as.

  • Smelling
  • Touching 
  • Sculpting
  • Licking
  • Tapping
  • Moving

This started early in my development with my Mum’s observations thinking I was both deaf and blind (which is a common observation with people with visual agnosias) I was imprinting through EXTERNAL stimulus to build up a representation and connecting through other sensory modulations to make sense of the experience around me.

“Mapping” A System

As I have got older and with more awareness of the condition I have system in place where I do not hide anything from my view and placement of objects are important in relation to their context.

Context & Relevance

I still have a level of context blindness which means that things that are not being used “lose there relevance” (what they are, their use and function in relation to the environment) I may mistake objects for other things entirely and/or be caught up in how they make me feel rather than what they are.

Paul Isaacs 2019