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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 Hemishpere (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 moods, easily 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 perctupaul 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 Journey To Functional Language

IMAG0083

 

Note this is from a personal percpetive

There is a percentage of people on the autism spectrum who overcome a level of severe language processing disorder. I have been diagnosed with autism in 2010 at the age of 24. My trajectory was a wobbly one part of my autism was brain damage at birth (left hemisphere) which meant receptive and expressive language was impaired this was a RECEPTIVE & EXRPRESSIVE APHASIA, I was sleepy baby and my Mum notices differences at about 6 months old. My language impaction was a mixture of neurological and in early infancy environmental.

I had speech and language DELAYS as part of my language journey this included missing MILESTONES, and then I had TRAUMA which was do with having adenoidectomy and circumcision. I had ORAL APRAXIA which meant that words at times expressively where a jumbled mess. I was echolalic, echopraxia and echomimic TV shows; VHS you name was stored phrases, movements and sequences. I had roughly between 80- 90% meaning deafness up till the age of 7/8 years old. When a level of functional speech which “my own” it felt stilted, “alien” and non-fluent and garnered from my perspective a lot of unwanted attention so I went into bouts of SELECTIVE MUTISM through my late infancy. Visual perception had an impact of PICTURE/WORD association meaning I was largely kinaesthetic due to by object and meaning blind – SIMULTAGNOSIA and SEMANTIC AGNOSIA.

Now as an adult I would say I am residual being about 30-40 % meaning deaf, tinted lenses have helped my make simple but dramatic visual associative contexts although I still struggle to know the difference between a toaster and a bread bin! 😉 I someone speaks to quickly, background noise, doesn’t use gesture and/or objects of reference I may well pick up the words but not glue the “meaning” to them.

I have functional speech but it can still tumble and become laboured due to fatigue and residual aspects of ORAL APRAXIA and my social emotional world is tapped into INTROSPECTIVELY through art and poetry. I still live in a system of SENSING the unknown “KNOWNINGNESS” which means that I perceive far more than I know until it is “out there” on paper form then feed it back to myself and understand what is going on! My mind is like confetti but I have overcome many obstacles due to autism, developmental delay, language processing and visual perception.

Paul Isaacs 2018


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Autism & Living With The Fallout of Language Processing Disorder

Note – This is a from a personal perspective

Early Years & Its Relation To Language Development

I was born in 1986 and with the impact of a premature nervous system, brain injury due to complications of a placental abruption, cerebral asphyxia/hypoxia, fetal distress which caused in turn issues with visual perceptual disorders – rendering me object, meaning and context blind and due to the left hemisphere injury receptive and expressive language processing disorder. The picture below is on me not long after I was born signs of being premature are evident by the colour of my skin which is jaundice, fisted hands are sign of the nervous system being impaired. My Mum also noted that I was sleepy baby a common factor in babies who have the sort of start to life which I did.

Premature 1

Overall I started to speak (with no build up and “missing milestones” look above) and non-verbal until 1989 saying three words, then from 1990 onwards I regressed and lost skills in verbal language this persisted in me being non-verbal so from pre-school onwards slowly I made monolithic sounds and was saying “loo-loo” (meaning “water”) I was non-verbal from birth 1986 until 1989 then from 1990 until 1992. I then gained functional speech between the ages of 7/8 1993/94 (of a 3 year old developmentally).  – Paul Isaacs’ website 

 

A “Language” Of My Own?

My first three words where included “nan” which I used say in big long streams over and over again I liked the sound of it rather than making the “connection” that the word had and associate relevance with regards to a title of a family member. The words was “f**k” which was used for the same purposes as above however the social emotional aspects for both my parents in terms of embarrassment and parental judgement was high. The next has a level of context it was “loo-loo” which was going to toilets and flushing them – I was addicted to my own chemical highs when looking at the water as it flushed flicking my fingers.

Paul 1995 - 1

Inner Words

Words and sounds swilled around my head but nothing was tangible nor meaningful with anything the additional problems I faced meant that I had problems with processing speech but also at using it at at functional level of understanding or comprehension. Looking back I was trapped in a body that wouldn’t obey my commands my verbal wants or needs at the same time (the conception of “knowingness” wasn’t there in many respects) so not only did I have speech delay but severe language deficits that ran well into late infancy. Living a world before typical meaning was in itself a cage I didn’t have  language in head for many years it was kaleidoscopic, fragmented, ethereal and non-descript. In mid infancy I felt a frustration when words were expressively produced in manner which was clipped, stunted and not correct I remember feeling frustrated and detached. I believe words were within me but they the grip to get them is really beyond words to describe, but my parents always knew that they were within me. Paul Isaacs’ Website

Fast Forward To Now

Although I have gained a level of functional speech and many aspects of my “autism” would be in the residual range in terms of trajectory I still have challenges in these areas

  • Receptive language when people are speaking for larger lengths of time and/or people speaking in the background along with and/or including environmental noise.
  • I “sense” more than I consciously “interpret“.
  • I mentalise through “remembering” through placement, movement, texture and smell etc
  • I learn through being shown rather than being told.
  • Expressive language can become tiring when I begin to “lose words”.
  • Tinted lenses have helped me bring my visual world together but my “visual receptivity” is still in its infancy when it comes to a social-emotional context.
  • I type “feeling speak” far better and introspectively than I can verbally.

Paul Isaacs 2018


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“Idiosyncratic Language” & “Stored Language Responses” in Autism

Interpreative Languuage 2017 2.png

Note this is from a personal perspective

Sometimes language in terms of interpretation can be difficult to “use” and “explore” however it may not be a true representation of the “inner world” the person is living in.

Words could come out stilted, mixed up and not in order and if the order is there it may take a lot time to form and lead into a strand of information. When my language was in its earliest “fruits” it was mixture of echolalia which I got from movies, sounds, movements, pitches and dominated my mind but trying to learn “interpretive language” was  “forced” and came from a  “stilted “place”.

  • Give the person time to process the information if the person has a level of Aphasia, and/or Verbal Agnosia
  • Allow time if the person has a level of motor coordination issues such as Oral Apraxia, Body Apraxia and/or Body Agnosias
  • Try using Gesture, Tone, Inflection and Objects of Reference
  • Understand were the stored language is coming from – Exposure Anxiety, Problems with Integration “self and other” in conversation, Body Related “Highs”, Mood, Anxiety, Impulse Control, Selective Mutism and/or Emotional Regulation 
  • See the Person First and Presume Competence

Before functional speech it a swill of verbal and visual information that I could not grasp nor mentalising in a fashion which was tangible my “inner world” was very much there but is was struggle to get it out I didn’t have a lot words to use in my mind as it was endlessly swirling and as I got older (before my later infant years) I was slowly building a firm repertoire of words and has a lot I want to say but couldn’t.

When functional speech came at the around the ages 7/8 the it was expressively of a three year old (in developmental, content and constructional presentation) however this “voice” that seemed to be more “fluid” scared me and frustrated me at the same time as it still didn’t represent my “inner world” I was torn between complex stored responses the basics of “interpretive speech” and wanting to cut off from verbal speech altogether not being able to “hold” mental images of words also delay many aspect of my language but painting and drawing in many ways we’re a creative and communicative effort it created a bridge.

I certainly did not have a Asperger trajectory when it came to expressive and receptive language and getting the point of verbal and contextual significance so when I get tired and my language processing goes down. 

  • Speech will become slower and fragmented
  • I will have consciously find “interpretive speak” words
  • Sentence construction and word placement will be mixed
  • I will get “stuck” on a word and/or sentence focusing on how it sounds

I still type more words than I verbally “speak” however I am grateful that I can and I try and use it to the best of my efforts in fact typing has allowed me to express my emotions with much more clarity, cadence and deepness.

Paul Isaacs 2017


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Managing Grief and Loss with Visual Perceptual Disorders

Note this is from a personal perspective

Grief is a normal state to be in when you lose someone you love and have connected to and I know that this feeling or more accurately abundance of differing feelings that accompany it are part of the process.

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Visual Agnosias – Deficits In Memory Perception & Visual Association? 

I have no pictures of my Gramp none that “spring to mind” I cannot “visualise” or have pictures in my mind my “meta-reality” (a person’s inner world/consciousness)  is not made of pictures or movies as a form of association. It is made of of smells and textures I made a point when I said goodbye to my Gramp at the chapel of rest to stroke his face and hair so would have a physical association of the firstly the bond we had and secondly my way of saying goodbye to him and his body.

Paul Isaacs communication profile 2017

Bereavement Counselor 

I went to see a bereavement counselor today and I was thankful that he was able to assist me not only in the human element of my grief but also adapt his way of describing different interventions and explanations to me.

 This is what he used in  the session 

  • Contextual telegraphic language “painting his words” with gesture and placement and meaning
  • Allowed time for me to do “all self no other” and “all other no self” in order for me to express and receive the information
  • Compartmentalised my  own emotional states giving them a reference point and also suggestions in how to manage my emotions
  • Understood I have a history of mood, compulsive and anxiety disorders associated with somatisation disorder
  • Allowed me to be creative in expressing my emotions through creative writing, poetry and art

 

autism-pyramid-updated-2017

 

Addressing The “Pieces” Of The Jigsaw

So what parts of my “autism” are being addressed?

  • I would say firstly his looking at a level of information processing delay and giving me time
  • The next would be that fact that because of visual perceptual disorders having a level of visual agnosia in the areas of meaning (semantic), object (simultagnosia) and faces (prosopagnosia) means that using gesture, placement and telegraphic language backed up with word emphasis in the right areas helps me internalise the words better assisting with the level of aphasia I have
  • Looking at my own emotional states is assisting with alexithymia and overall giving me time to integrate “self and other”.

 

Conclusion 

I would say that my grief is human and that I will get through this with at times very basic but meaningful interventions I do however hope this helps people with similar issues to my myself regardless of being on the autism spectrum or not.

 

Paul Isaacs 2017

 

 


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Autism, Words, Aphasia, Body & Visual Agnosias

Sound Asleep

Note this is from a personal perspective

Aphasia and Words

Words in my mind felt ethereal, transient and distant the internal garbel of sounds, pitches, tones, hums and inflection as if my unconscious mind was trying so desperately to find the words, string the sentences anew to project and receive in “real-time” on some level I believe in my later years that is what I was trying to do. The jumble of a “salad of letters” in my mind could be found and then lost in equal measure.

Oral Apraxia and Word Finding and Formation

The functional element of my speech was delayed in both speech and language the aphasia was both receptive and expressive in nature with a high instance of anomia (word finding). The other element is oral apraxia which rendered me unable to form the words I would find leaving me disconnected and frustrated.

Receptive Aphasia, Body Agnosia & Associated Visual Agnosias

The receptive element of speech for example someone talking to me was the same external garbel as was in my mind a silent war between expresser and receiver trying to find clarity amongst the hidden mist of miscommunication.  The inability to perceive my own body meant a level of internal groundedness was  not their and context was missed time and time again. I relied on the touch, taste, smell, texture these feelings gave me a context to grab onto and create an association it is no surprise to me that my Mum through I was deaf and blind because that is exactly how I was behaving my language processing and sensory perceptual systems (visual agnosias) were so scrambled the credible and most importantly meaningful option was to “feel to think”, “feel to relate”, “feel to connect”, “feel to be”, “feel to extract” and the list goes on.

Creating My Own Language

Before interpretative language sets one could be creating their own language through association, things they have heard and seen on the television, jingles on the radio or other stands of information that bears relevance to an event and/or emotional meaningful response. In my case this was form of communication which looked meaningLESS to the listener but was meaningFUL to me as the expresser.

Memory and Internal Mentalising 

A memory with no associative images for words and no words for images meant my style of learning and integrating was not logical in nature nor literal this is secondary reason why my language and visual-verbal processing was delayed and slower, however as the years progressed I was building up a slow repertoire to words and my functional speech came around 7/8 years old this was expressively and developmentally in terms of content and formation of a 3 year old this new “voice” at times rendered me equally mute and frustrated.

Conclusion

Looking at the broader instance of different aspects that make up language processing difficulties in autism one needs to look at what is making the difficulties piece by piece, how that has an impact on the person and then work on positive and empowering and meaningful interventions.

Paul Isaacs 2017


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Living With Anomic Aphasia In The Context of Autism

paul-amber-2002-3Note that this is from a personal perspective 

Speaking to a speech and language therapist yesterday it got me thinking about my autism trajectory and what residual and very apparent markers of disability are still present and more importantly how they manifest and present themselves.

LOOKING BACK 

As a child it took me a long to time to speak and use language in a functional way this meant that both receptive and expressive language was hard to filter and decode into something that was connecting and meaningful.

LEFT HEMISPHERE & LANGUAGE

As I have stated in previous blogs part of my development was due to brain injury to the left hemisphere this part of brain is were human language is formed (although other aspects of the brain will connect with this).

THE PRESENTATION NOW 1  – VERBAL LANGUAGE 

As an adult  the type of a aphasia  (receptive and expressive) as apart of my autism would be considered residual in presentation and it effects me with I tired my words get stuck like a “blockage” and I have to consciously “find” the words which seem almost on “there” but disappear leaving me to have longer pauses or repeat “umm” for example.

THE PRESENTATION NOW 2  – VISUAL PERCEPTUAL DISORDERS & MENTALISING

Lacking visual internalisation means that I don not have a “meta-reality” which involves complex pictural referencing in other words I do not “store visual information in a coherent way” meaning that retrieval and word association when tired can be slowed down.

Having simultagnosia means I see things in pieces that has an effect on how I internalise visual information and mentalising (organising) and need to focus on movement, pattern and touch to externally map-out something rather than internally.

Anomic aphasia (also known as dysnomia, nominal aphasia, and amnesic aphasia) is a mild, fluent type of aphasia where an individual has word retrieval failures and cannot express the words they want to say (particularly nouns and verbs).[1] Anomia is a deficit of expressive language. The most pervasive deficit in the aphasias is anomia. Some level of anomia is seen in all of the aphasias.[2] Individuals with aphasia who display anomia can often describe an object in detail and maybe even use hand gestures to demonstrate how the object is used but cannot find the appropriate word to name the object. [3]

CONCLUSION THE PRESENTATION NOW 3  – ANOMIA (WORD FINDING)

It is completely understandable that not having an visual memory and having a long developmental history of language associated issues that word finding at times for me can be difficult but one much use what they have and accept what is going on. I’m glad I am in a position to understand what is going on and I hope this blog helps others who can relate to this. 🙂

Paul Isaacs 2017