Paul Isaacs' Blog

Autism from the inside


Leave a comment

A Lesson in Time – Mental Health Assessment Pre-Diagnosis

Paul 7 Years Old

Family Assessment

Tuesday 11th February 1997

Presenting Problems

Mr. Isaacs was unable to attend today as he is a shift worker and since accordingly this date he has been changed to day work. My initial impression of Paul was of a much younger lad (he is eleven in May) physically and psychologically.

Paul was eager to explain his concerns to me and at times was very insistent on not letting his mother give a more comprehensible explanation of the situations that had occurred.

Paul’s major sense of unhappiness and the reason for his referral is that he feels he is verbally bullied at school. he gave examples of being taunted primarily about 1.) The way walks. 2.) Shuffling his feet. 3.) He wears glasses – and he has been called “four eyes”. However, he feels that the teaching staff are against him . In year 4 he had an unhappy relationship with his form teacher. It does seem one particular occasion he was humiliated – but to the infants so they could show him how to behave.

Mrs Isaacs also incited another incident which seemed to have upset her more than Paul. It became apparent that when Paul was explaining his situation at school his explanations tented to be repetitions of his parents points of view.

Paul after became muddled and it seemed there gaps in connecting and associating. It was also significant that when Paul referred to “she!”- his pronunciation was really that of “he” – I did check several times, but it appears that both Paul and his mother were unaware of this – which was marked. (receptive hearing problem? speech difficulties?).

Mrs Isaacs pointed out that Paul always had difficulties “concentrating” and settling down to work – she remembers this as steaming as far back as three year of age – When he attended play-group. she also recalls at this age and ever since that has had problems with “interacting with others” (her words). Paul has not many friends and it was brought to Mrs Isaacs’ attention by the teaching staff that he was a “solitary figure” in the playground. His mother also pointed out that they lived close of approx ten houses and that there were other children of Paul’s age, but he tended to say in.

Her explanation for this was that he felt safe and secure behind closed doors. Paul did mention some of his friends, but found it hard to articulate what he felt about his friendships with them. He did admit to hitting out at people at times is was significant that he mentioned his father hit him when he was angry. Mrs Isaacs denied this. Paul’s response was “I suppose Mum must embarrassed that I said that.”

Paul’s self-perception is that his “fairly sensible” , however he admits to being influenced by others into “being silly”, but he feels other children are being “sillier” the than him – “going over the top”. He feels he doesn’t go over “the top”. Paul has recently had to go back to the very basics in Maths with one other pupil. Mrs Isaacs conveyed concern and irritation that the teaching staff had not picked up on Paul’s severe difficulties with Maths; especially in view of him starting upper school at Lord Williams East in the new academic year (Sept 1997). Paul’s reading age is estimated as that of a nine year old. it appears the only positive subject that could of was Paul’ art. Mrs Isaacs believes and feels the teaching staff convey negative messages surround Paul’s overall performance. Mrs Isaacs explained that Paul gets very “worked up” over homework assignments, Paul also stated that he cries very easily hence his vulnerability at school in being bullied. It appears Paul suffers from anticipatory anxiety and expressed his fear of commencing upper school as he has heard he will get “beaten up”. Is is of significance that Mrs Isaacs was unhappy at ‘Long Crendon Primary School’ and suffered “bullying” at ‘Lord Williams’ East’. Mr Isaacs is also being scapegoated at work – he is being ‘verbally bullied’ (Mrs Isaacs’ words) and harassed and feels under a lot of pressure.

Family History

When referring to the history of the pregnancy Mrs Isaacs requested to speak separately – she explained she told no one of the pregnancy – only her partner (whom she is married to). She had been rushed into the JR as Paul “was distressed” – he was a month premature and was in SBCU post birth. She was unable to breast -feed Paul remarking they had said “she was too big”. Transition to weening had been unproblematic. Had been slow in walking – 18 months? He was sleepy baby and had to be woken up for feeds – He had been a “good baby”. However Mrs Isaacs had fond toddlerhood difficult – his “boisterousness”. Paul has had three operations 1.) Circumcision at 2 years 2.) Grommets 3.) Adenoidectomy at 4 years – at the JR and Radcliffe. Tonsillitis – query – Tonsillectomy otherwise healthy. Mother with Paul for all operations – no significant complications

Paul would like help with “the teasing” – he said it although it had been easier recently he wants to be able to cope with it better if it worsens again. He also says he is very sensitive and works himself into a state easily. There is also much anticipatory anxiety regarding this move to Lord Williams’ East in the Autumn. In ascertaining his mood he expresses no helplessness or hopeless feeling and denies suicidal ideation or such thoughts. He does covey and sense of confusion and bewilderment over the treating of staff’s “rude words” (his words) about his self-presentation. (percistanty anxiety).

  1. Assessment from Psychologist (educational?) to check ot cognitive abilities and overall school performance.

  2. Social skills group at “The Park Hospital for Children”. (mother drives) for interaction with class.

  3. Possible Family Therapy – concerns regarding Paul;s parents and levels of depression. Re-enactment of mother’s unhappy school experience and father’s “bullying” at his workplace, especially regarding “authority figures”

Cognitive Abilities , Cognitive Impairment & “Mental Retardation”

“It became noticeable he had very slow speech”

There was a massive transition in 1993/1994 prior to this interaction before this I was echolalic, meaning deaf to large degree and unable to speak in a fluid manner. Having visual agnosias, oral apraxia and challenges around receptive language meant that getting an interpretive and expressive framework was slow, stilted and lengthy. I went through bouts of selective mutism hating my “connected” voice which then in turn triggered exposure anxiety.

there appeared to be a gap in connecting and association.

Still have complex visual and verbal blockages meant that my “cognitive abilities” were hidden and therefore not “seen” I have no doubt that the lady in question had her own frame of reference on how I was processing the information so thinking I was “retarded” was just the tip of the processing iceberg.

‘Bursting into tears quickly’ – Alexithymia, Body Agnosias and Trauma

There are many overlapping reasons why this was happening at this point – the reason in which I was at this assessment was the persistent verbal bullying from a senior member of staff at the primary school I attended. Having body agnosias meant that I couldn’t gauge or manage my own emotional states this would be related to alexithymia the inability to “know” your own states of emotion, the ability to “internalise” them and mentalise them on a “conscious” level however manner years later when I wrote my first book I came to realise that on a “unconscious” all my experiences were unlocked through typing.

(receptive hearing problem? speech difficulties?)

I was traumed from an early age by expressive language (but at times would be intermittently intrigued) due to a language processing disorder (aphasia), I was triggered by exposure anxiety, dissociated easily and would struggle to get incoming information with “meaning” living in the world of the system of “sensing” before awareness mind and the ability to make interpretive connections.

Battling Books & Formulas & Artism

He has severe difficulties in maths.

His reading age has been estimated at an average age of nine.

Not being able to mentalise in a visual – verbal way meant that I had challenges around comprehension and getting meaning from books, written words and maths. (dyslexia, dyscalculia and visual-verbal agnosias) found the process of writing very difficult the way in which I held the pencil, the ability to concentrate on letter and sentence formation. The same goes for maths.

My solace for extraction and distraction was art which was were my mind was freed and felt “at home” I started from a very young around 5 smearing paint on to a piece of paper and I was hooked from that point on then transitioning to drawing by route during this period of my development.

Prematurity & Height

“There is some evidence that babies who were born premature tend to be shorter in childhood, but they usually catch up with those born at term in late adolescence. But our study shows that women who were born very preterm fail to reach the stature you’d expect based on their parents’ and siblings’ heights.”12 Dec 2016

She noted that developmentally and that I seemed “younger” than my age from a psychological and psychical perspective there is a link between having a short stature and prematurity currently I am only about 5’8′ I do not think I will be growing vertically anytime soon.

Did I Have An Attachment Disorder?

I can assure you I was lucky that my parents gave me love, support and grounding even though they didn’t know that I was on the autism spectrum. Did they both have difficult childhoods and upbrings? Yes they did for many different reasons.

My Father had parents his whom were his primary caregivers who didn’t not show him love, affection, boundaries or a sense of meaningful inclusion both of the parents were cold and aloof and didn’t seem to understand (be it wanting or otherwise) the serious practicalities of what parenthood meant for a child’s development and emotional wellbeing.

My Mother was seen as a disappointment to her Mother who was constantly comparing my Mum to other people explaining that she needed to be more like other people as opposed to building up her own sense of self and identity, self-worth and autonomy.

The truth is I am and try to be a objective judge of character when it’s presented to me and the answer is no I did not have a attachment disorder and my parents were not to blame for anything.

My Mother fits the solitary, serious and self-sacrificing personality types she is giving, emotionally connective and generous.

My Dad fits the conscientious, mercurial and adventurous personality types he is assertive, pragmatic and forthright.

I love and value them as human beings because despite their own “shit” they didn’t fling it consciously or otherwise on to me.

Paul Isaacs 2019


Leave a comment

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

34411899_10209991586620146_7281455466490626048_o

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


Leave a comment

“Autism” what does it mean?

Note this is froDad and I Dancingm a personal perspective

When I was diagnosed with autism in 2010 one of the first things that I was told is that was still a “person” even if I didn’t the mechanics and/or “pieces” of my autism that nevertheless was a sage piece of advice that has stayed with me on a personal and professional level.

“Autism” is different for each person so here is a breakdown of the “mechanics”

  • Emotional perception (alexithymia) problems with recognising and verbalising emotional states.
  • Visual perception (visual agnosias) problems with perceiving faces, objects, reading words, colour and “sorting out my visual field into a “whole”.
  • Language processing (receptive aphasia) problems with processing and interpreting “meaning” and “significance” from language.
  • Auditory processing (auditory agnosias) problems with organising the origins of sounds.
  • Body perception (body agnosias and hemiplegia) problems with processing and perception on the right side of my body which affects coordination, problems with recognising pain, hunger and thirst.
  • Body and Movement (visuospatial dysgnosia) left-right disorientation.
  • Light Sensitivity (sensory integration disorder and related learning difficulties) problems with light creating distortions as well as dyslexia and dyscalculia.
  • “self” and “other” processing simultaneous information which requires this can be difficult.
  • Mental health and personality disorders.

 

PERSONALITY TYPES

I have four main personality types which intermingle with each these are human in terms of presentation but will differ form person to person – human beings under stress may develop “disordered” versions of these types affecting social and personal perception, mood management and interpersonal relationships and friendships.

  1. Idiosyncratic
  2. Mercurial
  3. Self-Sacrificing
  4. Serious  

 

NOT RELATING TO “AUTISTIC IDENTITY/IDENTITY-FIRST LANGUAGE 

I do not see my whole being as “autism” nor define myself by it. I see it apart of me, in my case the pieces are emotional perception, visual perception, language perception, auditory perception,
body perception, light sensitivity, information processing and learning difficulties
 with associated mood disorders, exposure anxiety, somatisation disorder, dissociation and personality disorders but they are not a total nor finite definition of my being. I can only speak from my perspective and that is all.

I am “Paul” first with the all the positives and negatives that come with it the likes, dislikes, regrets, dreams and the sense of just “being”. I shall never adhere to the “club” there is to much militancy, over-investing and politics. I see myself as apart of the human race – no more, no less, no more worthy, no less worthy just a person like one of the billions of people on the planet everyone has a story to tell don’t they.  😉

Paul Isaacs 2016


2 Comments

Phoebe Caldwell – Intensive Interaction And Diverse Communication Profiles Within Autism

As a person on the spectrum I am a firm believer that whenever you are on the the spectrum you are on the spectrum you have a right to have a meaningful and productive life.

Phoebe Caldwell Copyright P.Caldwell

Phoebe Caldwell

Phoebe Caldwell

Tapping into the communication profile of the person is key and she looks at all aspects of the profile

  • Sensory Integration Disorder
  • Receptive and Expressive Language (Aphasia)
  • Telegraphic Speech
  • Gestural Language
  • Rhythm, Pitch and Voice Modulation
  • Touch (if a preference)
  • Exposure Anxiety & Emotional Regulation
  • Neurological Pain
  • Body Agnosias
  • Person’s Environment

Communication – Thinking Of The Person’s Sensory Perceptions

Phoebe looks into the diversity of these communication issues from person to person as the brain’s of these person’s has different things going on, making connections in ways of relevance to that person, ways of meaning to that person it brings results of happiness, lowering anxiety and integration which is both positive and hopeful. I believe that rigid “models of communication” that sold as the way of communicating with a person with autism are wrong because it’s all down to the uniqueness of the person’s profile in other words there is no one way.

Pattern, Theme & Feel – Donna Williams

A world before typical interpretive language could mean that person has created their own language to try and integrate with the world around them, I know my early years I did and it was seen as “gibberish”, “mutterings” but I was trying in a world of visual and auditory distortion to reach out.

  • “Eeeeee!!!” is “happy” which includes clapping and jumpingBubbles
    Low sounds “ugggg!!!” – Is Unhappy
  • And/or “clicking” sounds with my tongue – Represents Anxiety
    Head hitting – Processing problems
  • Chest thumping – I would like come back to this world please
    Head banging – I can’t cope I need some help
  • Sniffing, Licking, Tapping, Mouthing, Rubbing Surroundings – What are you?Sculpting Faces – Who are you?
  • Tilting Head – I Remember You! And I like your company

I still find language difficult but I try my best – a lot what Phoebe does in terms of gestural language and telegraphic speech are from a personal perspective with beneficial for me to get meaning.

Conclusion

Phoebe has an excellent presentation style and projects with passion her over 40 years experience with working with adults on the autism spectrum, she sees the people she works with as people and person’s first which is refreshing to hear and it shows in her work and the people she has helped of the many years.

Paul Isaacs 2014

PHOEBE’S WEBSITE

INTENSIVE INTERACTION