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Autism from the inside


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Autism – Communication Beyond Speech? Sensing A System Before Interpretation With Sharon King

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Sharon King Speech is only the tip of the iceberg. There are many more ways to communicate

Paul Isaacs I have had many a good conversation about Sharon with regards to the “system” of “sensing” a world before “you”, “I”, “self”, “ego” etc. All human beings go through this developmental phase some people on the autism spectrum stay (to varying and differing degrees) in this framework. A world before cladding and concepts that build on to some degree intellectual understanding vs. introspection. If someone is still in this system they may well pick up on things/situations/emotions that are raw, they may see other functions for things rather than its “interpretive use”. 🙂

Paul Isaacs For example I would use the toilet an its flush system as a “toy” a place to contextualise, a place to feel and get “sensory/chemical highs”, I used shaving foam, litres of bubble bath to create patterns on the tiled surfaces for hours and hours, would/do take in the smells of nature around, its textures, its feeling. I have learnt that some people want to know how you are feeling this moment, at this time and in which order that doesn’t make their system wrong as it is system they are using just as much I am using mine so I think there are more degrees of humanity between people who are on and off the autism spectrum than people actually think. Boxes only muddy the issue. I also think there are many people off the spectrum who live in this system of sensing as well.

My World = One’s Own World. This is our first world. Before all of its later cladding and contortions, it is at first a place of sensing, beingness, the preconscious mind and unknown knowing. It is the place where we understand self in others and others in self through the skill of mergence.

The External World = The physical world known through our sensory experiences as processed through our bodies/brains and experienced as sensations, thoughts, emotions, connections. This is a directly hands on world where sensing and beingness may be relatively strongly intact.

The Interpretive World = the world of applied meaning to incoming experiences that progressively builds mental structures and frameworks that ultimately filter our direct sensed experiences of the physical world and develops conscious mind as the primary guide.

Ego World = Ego contortion that further clads, alters and filters the logical meaning we get from experiences of the physical world and further buries our original capacity for sensing and beingness. This can be indoctrination, culture, economics, identifications, rewards, honed addictions and competition for social, economic, cultural ‘currency’.

Donna Williams

Sharon King Sometimes I wonder if feelings are more real than the external reality as they are our first point of contact being ‘within’ and everything else is ‘without’ to be filtered through our senses.

Paul Isaacs I FEEL before I interpret so its almost like a translation with knowing on a conscious level translating. The main difference I see between auties and aspies is the the system of sensing (to some degree) is far more “there” this also is taking into account the information processing blockages that come with that.

For example my Father is very much OPPOSITE he build up frameworks first, concepts first and then feeling and reflections come second. Its in the end a differing system of understanding information around you.

Paul Isaacs 2018


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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

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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 clamed 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 2018


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Most Common “Pieces” in People’s Autism “Fruit Salad”

Autism Most Common Image

Donna Williams’ (Polly Samuel) set a legacy in what the adjective “autism” meant it was like a bowl of fruit and different pieces of fruit mean different things in this overview she covered in the image above the most common aspects of someone autism “fruit salad.”

 

 

Social Emotional Agnosia – Not perceiving body language, tone of voice and facial experiences means that person only “sees” and “hears” facts that means that the person maybe socially anxious and may need information shared to them (including emotional supply) in factual/pragmatic way.

Faceblindness – A person who doesn’t recognise people by their faces this means the person may connect more with the what the person is wearing, hairstyles, jewellery, voice patterns, walking gait. context is also an issue such as meeting people and/or getting used to seeing someone one context may not translate to another. You may need to ask them is they struggle with faces.

Simultagnosia – (Object Blindness) – A person who only see’s pieces of a their visual field and not wholes this could mean that the person finds certain environments difficult to navigate, people, places, objects may be hard to track causing anxiety, overload and on the opposite end euphoria and “sensory highs” that is person who is addicted to their own “chemical highs”. Lightening, colours, patterns, colours, stairs (surface changes), shadows will all have an impact on perception.

Alexithymia – A person who does not process and/or perceive their emotions in “real-time” this can cause a reactionary delay meaning the person is always “trailing behind” to some degree and may give surface “responses” rather than “connected” responses. Give the person time to respond.

Dyspraxia & Overload – A person is struggles to motor-ordination issues, the movement of their body and limbs in and around their environment being prone to overload could be due to the brain and bodies movement not being in tandem causing/triggering chemical imbalances.

Lack of Simultaneous – Self and Other – A person who can do either “all self no other” and/or “all other no self” this means the a shared sense of “social” may be delayed and the mono-tracked way of conversing may have to be adapted to allow time between “switching”.

Language Processing Disorder – A language processing disorder can come in many forms and presentations the ability to find words (anomia), the ability to construct sentences (pragmatics) and the ability to receive and express meaning with interpretation some people may be “meaning deaf” (aphasia, verbal auditory agnosia) and need for example object of references gesture and tone and other who are literal in their perception and have atonia may need facts and to limit body language.

Communication Disorders – Some people may get tongue tied, stammer, are “tone-deaf”, have tourette’s, have verbal agnosia and talk through echolalia (TV shows, Jingles, DVDs and TV shows), some people have oral apraxia (the ability to use their tongue and facial muscles) having visual perceptual issues and associated personality types which in turn have an impact on style and/presentation.

Exposure Anxiety – A person who is triggered by direct communication and “exposure” triggering compulsive, avoidance, retaliation and diversion responses meaning that “direct communication” you may need to use a “indirectly confrontational response” such as focusing on the object, situation not the person, humanising objects.

Lack Of Mentalising – The inability to “juggle” information with a level of coherence this could be to do with information processing delays, sensory perceptual disorders, social perception and/or language processing this means that you need to work out the person’s “system” of integrating information with associated meaning.

Personality, Identity and Attachment – This is how the person sees themselves, differing personality types will colour a person’s interpersonal wants and needs and communication styles, sexuality and gender

Mental Health – These associated conditions will have an impact on presentation such as mood, impulse control, anxiety, dissociation and attachment disorders.

Physical Issues – They may have auto-immune disorders, disorders of metabolism, dietary disabilities, genetic anomalies which have an impact on overall functioning.

Paul Isaacs 2018

 


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Autism & Personality Types – They Do Exist

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Personality Types & Autism 

When we look at “autism” looking at personality types is just as important as any other factors. We could look at these aspects of a human being they are very much the “soul” of the person they pepper one’s temperament, personal outlook, emotional regulation, friendships, relationships and aspects of social and emotional interaction.

Identity Crisis

For people who are on the autism spectrum not all their “being” is dictated by the diagnosis that they have. This of course will vary from person to person depending on what part of their “fruit salad” are impacting and how they view their personhood within that. Is it hidden by language processing disorder? Is it being tempered and challenged by health issues? Or are there underlying mental health issues that are being called “the autism” when they are not?

Autism Isn’t a “Collective” 

Some people see their autism as “ego-syntonic” that is all their person and they feel it all of the time, others like myself see their autism as part of their “being” this means that other factors come into it such as environmental factors, mental health, identity and learning style all human being are made of up these things . For me it seems to over simplified and reductive to suggest that people on the spectrum share common goals, values and outlooks as a collective experience.

The “Sameness” Machine

“We” do not all come from the same place, we do not have a carbon copy autism “fruit salad” that is  shared from person to person. That means that one should be seen as an individual not just a sausage machine of traits. People are born with no labels what so ever and no one person is defined by “one word”.

Paul Isaacs 2018

 

 


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Altered Developmental Trajectories In Autism Are Not Mutually Exclusive

Note this from a personal perspective reflecting on aspects of development

Donna Williams’ wrote a blog which I have included in mine about the connection between “autism and trauma” now these two things are not mutually exclusive. She was very much a person who thought outside of the box and did not her confine her views to rhetoric or fads making for refreshing and reflective reading.

Early Experience “Nature vs. Nurture” 

Many things part of my autism are to do with early birthing issues such as placental abruption, brain injury, c-section, circumcision due to phimosis in 1991 age 5 and ear infections which lead to grommets and adenoidectomy age 4 in 1990. Many of these factors had an impact on my developmental trajectory some of them are to do with altered states of development which then in turn create a person who nervous system reacts.

Premature 1

What “Makes Up” My Autism?

For me my autism is due to birthing complications placental abruption, prematurity hemiplegia, language processing disorder and visual perceptual disorders making up about 70% of my autism.

The 30% remaining is genetic components such as a family history of dyslexia, mood, anxiety disorders and OCD on my Mother and Father’s side.

Auto-immune disorders of various types are on my Father’s & Mother’s side. Mum had chronic childhood Ezchema, My Nan on my Father’s side had Non-Hodgekin Lymphoma and My Father Chronic Lymphocytic Leukaemia.

A Broader Perspective Of “Autism” 

Looking at the broader palette of what is “autism”? What if people are becoming progressively distant and/or scared of different “Roads To Rome” when it comes to the different factors that come with an “autistic package”. What if things that “look like autism” can actually be apart of what makes someone “non-autistic” and vice versa? Maybe we need stop finding the magic “bullet” for what autism “looks like” and what it is made up of and start looking a specific realities and all that is within them?

People Who Don’t Have Autism?

People who don’t have autism can have things that can be apart of person’s “autism package” to varying degrees – developmental delays, personality types, mental health, environment and learning styles can have an impact on anybody in the end.

Lets Stop Calling it ‘the autism’: Autism and Trauma – what’s the connection?

Donna Williams’ Blog

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Recent studies in reputable medical journals have linked Autism to seemingly farfetched things like being born to mothers with pre eclampsia, being born prematurely, being born to older fathers, being born to smokers, being born by cesarean, being circumcised under the age of 5.

And as an autism consultant since 1996 I would say that of over 1000 families I saw as a consultant, that a rather strikingly significant number of them claimed to notice the onset of their child’s autism in the week following the child’s first birthday party (being posed for photos, candles, cake, room full of visitors, clown etc). And then of course are the plethora of families who swear their child began developing autism anywhere from 24 hours to 3 months after heavy vaccination schedules. Could these seemingly unrelated things have anything in common? Could it even be there is a cascade effect where the child’s autism is present (subclinical) but not showing following a cesarean birth, then becomes progressively more obvious if the same child gets circumcised, has a heavy vaccination schedule and is then thrown a full on first birthday party? It may sound utterly whacky, but is it possible?

“Children can develop a kind of ̳hard-wired‘ autonomic nervous system response to trauma and its triggers due to the ongoing need to utilise the circuitry to promote adaptive defence strategies. Over time they decrease their capacity to access their social engagement system (since this has not been used successfully in great amounts), and as more and more of the world is perceived as unsafe, they come to rely on their defensive states to negotiate their environments, making social engagement very difficult.

Porges research has revealed that how our nervous system interacts with our environment depends on not just the absence of threat, but the absence of nervous system perceived threat. He has developed the term ‘neuroception‘ to describe our perception of safety not just consciously but also – and often exclusively – at a below cognitive level (Porges 1998, 2001, 2003). It is this neurological response of safety that promotes the ability to utilise our newer system and circuits, whilst conversely, the lack of safety promotes a return to using older circuits to mobilise or immobilize in the face of neurologically perceived danger.

When our nervous system detects safety our system adjusts and makes it possible to enjoy closeness without fear, and keeps us from entering defensive physiological states of mobilised hyper arousal and immobilized hypo arousal, whilst still enable the use of these circuits in safe ways.”

Chronic ear infections have been linked to PTSD so why shouldn’t Upper Respiratory Tract Disorders or gut disorders, even chronic severe constipation in children with immune and autonomic dysfunction equally result in such entrapment with pain from their bodies that some children might develop a neurological developmental response akin to PTSD?

In mild brain injury could the brain similarly interpret as trauma things like chronic sensory confusion/overload, extreme emotional dysregulation, the CNS disorientation from untreated food allergies and intolerances, the entrapment of being non verbal in a verbal world or having a body you can’t make work for you. And as one reached age 2-3 when functioning demands of the environment dramatically increase, could inability to organise one’s senses, emotions, communication, self help contribute to a trauma related cascade that progressively derails development accordingly?

What of the trauma potential to an infant of relentless torment from hyperacusis, or the whooshing sounds of Pulsatile Tinnitus, or severe Tourette’s, even relentless ear popping tics nobody can see, the repeated disorientation, unpredictability and loss of control of constant seizures?

If being born to a carer who is in the grip of post natal depression would predispose a child to not having established that initial bonding, would this leave such a child more predisposed to PTSD than one born to a healthy mother? And what of infants who fail to develop normally whose carer then goes through years of mourning the loss of the ‘normal’ child they had expected? Is this also experienced by the child in a similar way to being born to a carer with post natal depression? And what of the maternal separation of premature babies too small to be held by their mothers?

What of immune deficient or other unwell infants left in the care of hospitalswhere they experienced the absolute vulnerability of and utter foreignness of significant medicalisation in the hands of a range of strangers? With a 45% higher incidence of autism associated with circumcision before age 5, could this be traumatising for those children already genetically predisposed to trauma? Could this be extended to children handed over to doctors for heavy vaccination schedules without any later autism having anything directly to do with the vaccinations themselves?

And what of the trauma of a birthday party? We all have different personality traits. Babies too. Some of us are simply not wired for full on, in your face sociable parties when we are one year old. If our personality traits would later make us an attention seeking, self confident, adventurous party animal there’d be no foreseeable problem. But what if our nature was sensitive, solitary, vigilant, idiosyncratic…

It seems predisposition to PTSD is genetically predisposed. Would there then be children already more at risk from a progressive cascade effect of accumulated perceived traumas that would leave other children unaffected? If the children of older dads are more prone to mental illness would this include a higher predisposition to PTSD?

Ehlers Danlos Syndrome is a genetic collagen disorder with overlap with autism. Collagen is the stuff of connective tissue throughout the body, including the vascular system and the brain and is also responsible for immune regulation and brain connectivity but those with EDS also have autonomic dysfunctionassociated with sudden fluctuations in blood pressure (ie floppy veins) due to faulty collagen. These sudden fluctuations commonly get interpreted by the brain as panic attacks. So a child experiencing continual panic attacks caused by autonomic dysfunction would logically also be predisposed to developing chronic fight flight states and associated compulsive involuntary avoidance, diversion and retaliation responses.

Being born c-section leaves the child with lower levels of the calming hormone Oxytocin which is essential to having resistance to heightened threat and anxiety. We also all begin life with a reflex for crawling out of the womb. After using this infantile reflex it becomes neurologically inhibited which leaves us ready for the use of other reflex responses, each essential in the developmental process. Being born c-section leaves this infantile reflex uninhibited.

“Normal performance of primitive reflexes in newborns can be linked to a greater likelihood of having higher Apgar scores, higher birth weight, shorter hospitalization time after birth, and a better overall mental state”.

>http://en.wikipedia.org/wiki/Primitive_reflexes

What about if the mother experienced trauma during the pregnancy? If a mother was living in an abusive relationship would the unborn child be experiencing her own trauma as its own? Is the baby awash with stress hormones? Does the baby also feel this same level of threat that the mother is feeling?

Pre-eclampsia and other pregnancy and birth related emergencies have left mothers acutely anxious and sometimes traumatised and pre-eclampsia in particular has been recently shown to have another high association with autism . In response to this blog article I heard from a commenter who drew my attention to the recent links between Paracetamol and both pre-eclampsia and autism.
They wrote:

I would suggest that the missing link is not trauma but the use of paracetamol (acetaminophen, Tylenol). Rebordosa found that paracetamol use during pregnancy increases the risk of pre-eclampsia. Paracetamol is often used in conjunction with vaccines,ear infections and viruses. We have been circumcising for centuries but autism is a new and escalating phenomenon. So how could circumcision increase the risk of autism? What has changed about circumcision in recent times? The use of PARACETAMOL (acetaminophen, Tylenol) with the procedure to treat pain. This practice began in the mid 1990’s, with recommendations by WHO and the American Academy of Pediatrics. It has been shown that infants have significant difficulties metabolizing paracetamol in the first days of life. Paracetamol is known to have a narrow threshold of toxicity under the best of circumstances.

Three studies investigating prenatal use of paracetamolhave found adverse neurodevelopment in the offspring- ADHD and autism phenotypes in 3 year olds. It is not such a stretch to think paracetamol given directly to the infant could also have deleterious effects. This study supports the paracetamol hypothesis set forth by Bauer and Kriebel and highly warrants further investigation.

Could it be that in some cases paracetemol (acetaminophen, Tylenol) derails neurodevelopment pre-nataly which in turn leaves the child neurologically less equipped to handle acute stress and so has an early trauma response to things someone else would not, then once an acute fight-flight states becomes a chronically triggered/regenerated pattern, that becomes the default social-emotional response to such a wide range of new experiences the person is then further developmentally derailed. Paracetemol is also given to babies following circumcision and after the MMR vaccination. Parents have systematically given Tylenol to their infants for teething, for nappy rash, even for trouble sleeping.

In adults, single doses above 10 grams or 200 mg/kg of bodyweight, whichever is lower, have a reasonable likelihood of causing toxicity.[4][5] Toxicity can also occur when multiple smaller doses within 24 hours exceed these levels.[5] In rare individuals, paracetamol toxicity can result from normal use.[11] This may be due to individual (“idiosyncratic”) differences in the expression and activity of certain enzymes in one of the metabolic pathways that handle paracetamol (see paracetamol’s metabolism).

US television adverts of this drug psychologically target carers to ‘care for their child’ by quickly reaching for the Tylenol. These advertisements do then rush through the disclaimer at the end, often so quickly it is hard to process and usually completely out of sync with the reassuring tones used in advertising the product moments before.

IF trauma is found to have the most significant impact on brain development, communication development, social and emotional development presenting as ‘autism’, then what is the future? Would it also mean that autism is both born and made? Would we have to accept that a more mildly autistic child could become progressively more autistic if progressively accumulating further retraumatisation through everything from a bad fitting form of intensive intervention to bullying at primary school, to actual abuse from a carer unequipped to healthily care for a challenged child?

Do we have then develop screening for genetic predisposition to PTSD before a child is put through the same approaches and treatments as those without such predispositions? Would the strategies used to turn around chronic fight-flightstates and involuntary diversion, avoidance and retaliation responses in Exposure Anxiety become the most important first interventions?

I could suggest a protocol something like this:

Possible protocol for turning around chronic fight flight states.

a) inform the carers/diagnosticians about the presentation features of ‘autistic post traumatic developmental disorder’ and that trauma and the sources of retraumatisation can have a range of quite unconventional causes.

b) where possible identify initial traumas in each case and ensure these are addressed

c) identify additional re-traumatisation triggers that keep this being reinforced

d) put in place a treatment plan to address any underlying gut/immune/metabolic disorders and associated pain, sensory perceptual disorders and associated sensory distress, communication disorders, movement disorders, chronic information overload as socially non invasively as is possible to stop feeding chronic fight-flight responses.

e) to bring in omega 3s as a natural mood leveller and L-Glutamine where suited to raise GABA in order to facilitate lower doses of mood levelling/anti anxiety medication necessary to give respite to an overreactive nervous system.

f) to start a program designed to raise Oxyitoxin levels to tame over active anxiety responses: start music, massage, body brushing, art and movement programs, animal therapy, singing, laughter yoga, non invasive touch, to help calm the nervous system, get dissociated people feeling safe back in their bodies.

g) to counsel and support families in retaining the approaches that will progressively turn around chronic fight-flight states and thereby facilitate freed up development of more adaptive information processing, communication, and interaction.

And finally what of identification with one’s autism? What if it turns out that we do in fact ‘all have a bit of autism’ and that traumatisation (and retraumatistion) makes the difference in how much we each end up with? Do all people with autism then have ‘autistic post-traumatisation developmental disorder’? A kind of ‘Traumatism’? And would they want treatment or be happy with how they adapted?

At the end of the day, stress may break some of us, but stress also makes us. Stress trains the brain, trains the body. The trick is to build that slowly, progressively, so it isn’t experienced as trauma followed by continual perceived retraumatisation:

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

I acknowledge Aboriginal and Torres Strait Islander people as the Traditional Owners of this country throughout Australia, and their connection to land and community.


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The Cognitive Aspects of Autism

Note This Is From a Personal Perspective

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 attunded to empathy I show this through art and poetry.

“Sensing” vs. Intellectual Procesing

I can see that this is to do with the residual aspects of being meaing deaf, context and meaning blind, information processing delays and langauge 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 knonwingness” that I cannot do when I am in a more concious state as contrdicatry as it sounds one gets less out of me.

Paul Isaacs 2018


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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 2018