Paul Isaacs' Blog

Autism from the inside


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Hemiplegia & Autism

                                                                                                                                                                                                        10338674_881821881831690_7870309102355592004_o

RIGHT SIDE – (LEFT HEMISPHERE INJURY)                                           

HEMIPLEGIA DEFINITION 

Hemiplegia is caused by damage to the brain. The damage can occur before or during birth, which is called congenital hemiplegia. No one knows what causes the damage in these cases.

Hemiplegia can also be acquired. This is caused by damage to the brain, such as a stroke, in childhood.

Sometimes the condition will only become clear as the baby gets older, such as having trouble walking.

An injury to the right side of the brain will cause the left side of the body to be paralysed. An injury to the left side of the brain will cause the right side of the body to be paralysed.

The condition can affect any child, but it is slightly more common in premature babies. It is quite a common condition, affecting one in 1000 births.

LEFT HEMISPHERE BRAIN INJURY & RIGHT SIDE DISCONNECT

A Personal Account

As you can see from the picture above there are visible signs of hemplegia (due to difficult birthing, placental abruption and “silent” stroke within the womb) such as – notice how the mouth is lop-sided and has a stretched appearance as a smile (the side the that is “blind” is not matching) also the eyebrows are not matching either. As a child my Mum thought I was deaf and blind due to sensory perceptual and language processing issues the left side of brain is where language comes from (receptive and expressive) so I have an aphasia as well as visual perceptual disorders, motor cordination, under-processing on my blind side both visual (Homonymous hemianopsia) and motor perception (Hemispatial neglect).

WHAT HELPED?

  • Walking
  • Swimming
  • Bicycling
  • Rough & Tumble Play (as a child)
  • Painting
  • Drawing (sketches, doodles, drawing by route)
  • Practical Living Skills (cooking, cleaning etc)
  • Tinted Lenses

Paul Isaacs 2015

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Autism – Visual Perception, Language, “Self” & “Other” & Connecting

Note – This is from a personal perspective of how autism affects me

Wedding Photos 19861CONNECTING WITH PARENTS

In the early years I remember my parents by parts their being, my Mum would be through the feel of her hair and my Dad through sculpting his face and getting a sense of connectivity through tactile stimulus – the system of “sensing” and “energy” that filled the house was care and love.

FAMILY PETS

We had a dog and that was my first experiences of having an animal I liked him very much and could us me tactile system to “piece together all the dots” through stroking him, in affect he was as much “family” as a had through the lenses of my “parents” the energy was good and safe on both counts I didn’t need to understand why? internalise? It just was at in this point of my development that was fine. I knew they loved me but it was “sensing the love” and that was shown back.

Quinn and I

AWARENESS OF OTHER PEOPLE

Today I was asked when I was aware of other people – I had to think about this it was at school in Year 4 that on basic level I was aware of others this may have been due to gaining functional speech (that was developmentally of a 3 year old) and the connects I was trying to make in a body that was just about obeying my commands, a mind swilling with words but finding it hard to grasp them like sand through my fingers or as ethereal as trying to connect touch-wise with a ghost and endless mirage of sounds, hums and tones which I struggled to into words – living before the literal can be just as much a confusing place as being (language wise) a literal person

A SENSE OF “SELF AND OTHER”

Developmentally from a receptive language perspective am stuck in projecting “self” or “receiving” other, but ( struggle still in real-time to have a conversation in the moment, before I gained functional speech I had “patterned” and/or “sensing” speech/language creating my own words for feelings and I also used to sense “good” and “bad” energy this was living in world before the literal and/or significant. I still use this system today despite being able to speak verbally. A “sense of self” is a complex thing I have garnered the basics a few years ago which to me is good. I still can “tune out” but I hope to get there we are all on a journey. 🙂

Paul Isaacs 2015


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Visual Perceptual Disorders, Visual Agnosias, Motion Perception & Tinted Lenses

Me Looking to SidePlease note – this is from a personal perspective of visual perceptual issues 

Eye Tracking 

I met a lady at an autism conference this year who has expertise in sensory integration I described to her how I “see” the world and access it – she said there is a simple test it involves a pen at the midline of your focus and vision as she moves the pen she asks me to track the pen my eyes darted and had to “re-focus” as I could not follow the movement properly and process the visuals either.

Visual Perception Disorders 

This would also make sense of why I see things in pieces (simultagnosia), problems processing faces (prosopagnosia), integrating visual information, visual semantic recognition (semantic agnosia). I found this revelation very interesting and informative.

Cortical Visual Impairment/Disorder Article 

Not all types of visual deficits caused by CVI will affect visual acuity. For example, in cortical visual dysfunction (CVD)16, the predominant visual deficit is not visual acuity loss, but rather disturbances in visual perception and integration. In higher-functioning children with CVI or CVD, specific visual disorders such as agnosias may be diagnosed. These include cerebral motion blindness or cerebral akinetopsia (the inability to perceive moving targets), simultanagnosia (the inability to focus on more than one visual object at a time), central achromatopsia16 (color desaturation), prosopagnosia (difficulty in recognizing faces), topographic agnosia (problems with orientation; see section on rehabilitation), and astereocognosis (difficulty with depth perception)17. Thus, although not all children with CVD have associated CVI, certain children with CVI (with loss of visual acuity) may show signs of CVD

“The most common cause of CVI is an hypoxic-ischemic injuryl-3,10,19,20. At least 60% of children with neonatal hypoxic-ischemic encephalopathy have cerebral visual impairment12. Hypoxia (lack of oxygen) or ischemia (tissue death due to loss of blood flow, and thus oxygen deprivation) in the preterm baby leads to a characteristic injury of the brain, namely periventricular leukomalacia (PVL)21,22, which can be detected by MRI.”

Originally appeared in Developmental Medicine & Child Neurology 2001, 43: 56-60

Smith-Kettlewell Eye Research Institute

Me & Teddy

Me a 6 Months Old

This would make sense of the the following visual perceptual issues I have

  • Akinetophsia (motion blindness) – I believe I could have this as a result of simultagnosia (a problem with visually processing integrating the whole picture) this can lead to a “juddering” effect with my vision
  • Simultagnosia (object blindness) – “seeing” things in “bits” and or “fragments” not being able to integrate the pieces into meaningful chunks this could also be considered a form of context blindness.
  • Prosopagnosia (face blindness) – Not being able to recognise a person by their face this can lead to the persons using other forms of “recognition” such as voice, patterns of movement, placement, touching, sniffing hair, name tags etc.

What Has Helped?

From a personal perspective tinted lenses have had a great impact on how I process visual information and integrate it. The lenses have also  helped with

  • Body posture
  • Movement of my legs (not so “heavy footed”)
  • Reading and writing (dyslexia and dyscalculia)
  • Light sensitivity (sensory integration disorder)
  • Eye contact
  • Concentration and focus
  • Integrating visual perceptual information (even if I don’t understand the semantics/meanings this still helps)

Remember All Autism “Fruit Salads” Are Different 

That also includes not only what the fruit salad is made up of but also the origins that made them.

What Is Autism? Blog Donna Williams 

Paul Isaacs 2014


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

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

BrocasAreaSmallAphasia

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

Visual Agnosias

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

Simultagnosia – Visual Fragmentation – Object Blindness

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

Semantic Agnosia – Meaning Blindness

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

Prosopagnosia – Faceblindness

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

Visual-Verbal Agnosia

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

Hemispatial Neglect 

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

Homonymous hemianopsia 

Processing “half” my visual field.

Telegraphic Language 

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

Gestural Signing and Movements

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

Kate Bush – Wuthering Heights 

Kate Bush – Bush Babooshka 

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

ARTICLE ON APHASIA AND GESTURE

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

Conclusion

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

“Pseudo” Social Emotional Agnosia 

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

Objects Of Reference

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

I have an Autism profile not an Asperger’s Profile 

Fruit Salad Analogy Copyright D.Williams

Fruit Salad Analogy Copyright D.Williams

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

Classic Autism 

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

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

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

Profile Differences

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

Learning and Likes

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

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

Paul Isaacs 2014


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Visual Perceptual Disorders In Autism & Not Thinking In Pictures

Me On My OwnUnderstanding, Processing Visuals & Typical Interpretive Language 

Note this is from a personal developmental perspective 

For someone like me who got diagnosed with Autism in 2010 and later in Scotopic sensitivity syndrome with Visual agnosias (object, meaning and face blindness) as well as Visual-Verbal agnosia (comprehension blindness) and associated learning difficulties this is what I can relate to – I had oral apraxia compacted by auditory and visual processing disorders I saw  (and still  in the present without my tinted lenses) shapes, movements, colours and blobs and couldn’t contextualise where I was in space and time what I was doing (learning by route was a system I learnt) – I had speech and language delay as well as significant motor delays, echolalia and late speech compacted on my ability to understand typical language

I had NO contextual words within my head for along time (even though the capacity was there and I would have gleaming moments of clarity which no one saw or noticed) but I recited jingles, sounds, hums and treated words like “sounds” nor could I visualise words either.

I relate to Donna Williams in this way and it’s important to debunk the myth that all people on the spectrum are thinking in pictures when many clearly aren’t. I still find typical language difficult but I can but try to integrate as much as possible.

One must also differentiate and language processing disorder from mutism it was ironic though when I gained functional speech I had bouts of mutism so the two can interact.

I also have and Autie based profile as opposed to Aspie and this may certainly be one of the reasons why.

Paul Isaacs Adult With Autism 2014


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Speech & Language Processing -The Words Within Myself & How Precious Words Are

Me Holding Something 2OVERVIEW

This is a personal overview of my Autism “Fruit Salad”

For the first 5 years of my life I was functionally non-verbal (internal jumbles of sounds with words within myself but unable to come out) and there was a massive disconnect, words were sounds, sounds had no origin, language was internally and externally jumbled so I had no language with meaning in my head, people were fragmented blobs making “noises” to each other, when I had budding moments of connectivity I lost them due to a mouth and tongue not coordinating. Of course the capacity for words was within me  and words were within me but sensory perceptual issues and coordination issues played their part in this.

I did begin to piece things together I was aware of what others were saying about me in the playground at primary school for example, this is documented in my first book Living Through The Haze.

Parts of my Fruit Salad played apart in this such as

  • Simultagnosia – seeing things in bits and pieces, losing “wholes” and “connecting dots things where all fragmented.
  • Semantic Agnosia – I touched to perceive, to experience, to navigate, to sense, to connect, to understand my own self in relation to other and I also touched to communicate.
  • Aphasia – words were like sounds with no meaning, context or function other than it was a sound emitted from a fragmented blob as time progressed contextually words would come. and go however because of my outward behaviour I listened to some very ignorant things about myself without others connecting I was listening/processing.
  • Auditory Agnosia – I heard sounds and even now I wonder contextually where they come from sometimes sounds fill with wonder and confusion.
  • Visual-Verbal Agnosia – This along with Dyslexia made it hard for me to read with meaning and an understanding of what was on the page in front of me.
  • Oral Apraxia – One of the reasons I struggled to speak in the early years was the physically disconnect between my brain finding words and my body expressing them.
  • Echolalia/Echopraxia/Echomimia – These were used during my period of development where I was experimenting with words and movements and sounds – this was during the time I acquired functional speech

More info on my webpage about speech and language processing 

Sensory ExplorerTV Shows

I loved Mighty Morphin Power Rangers and Hook my gateway to movement and language – when functional expressive speech came at 7/8 years old, it was developmentally that of a 3 year old I have to admit I was scared of this new language and wanted to go back but I kept moving forward. I still rely on the sensing system and at home I use this language still, I am glad that had parents that didn’t write me off. 🙂

All Profiles Are Different & Other Forms Of Communication

Please realise that all different profiles are different and please also be aware the people who do not speak through their mouths have a  human right to be able communicate, this is something I feel strongly about and something that should be embraced and acknowledged.

Paul Isaacs 2014


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Olga Bogdashina & Donna Williams – The Link Between Agnosias, Sensory Perceptual Disorders & Autism Profiles

Olga-BogdashinaOlga Bogdashina

I have a lot of respect for her. A very lovely lady  I saw her last October at the National Autistic Society she spoke about Autism and Sensory Issues which includes Sensory Sensitivities but ALSO Sensory Perceptual Disorders which she calls Sensory Agnosias – Agnosias can be an important part of a persons’s Autism “Fruit Salad” (Donna Williams) She covers many of them including ProsopagnosiaVisuospatial dysgnosiaSemantic AgnosiaSimultanagnosia and many more.

OLGA’S BOOKS LINK

OLGA PROFILE LINK

OLGA’S PDF PRESENTATION

Donna Williams Copyright D.Williams and C. Samuel

Donna Williams Copyright D.Williams and C. Samuel

Donna Williams

I also have a lot of respect for, a lovely lady also. She has written extensively from personal and professional views on the inter-linkage of Agnosias and how they’re with a person’s Autism profile. From her own personal memoirs, books, blogs and presentations and many years as an Autism Consultant.

DONNA’S BOOKS

DONNA’S WEBSITE

Developmental Agnosia (n.) DEFINITION

1.(MeSH )Loss of the ability to comprehend the meaning or recognize the importance of various forms of stimulation that cannot be attributed to impairment of a primary sensory modality. Tactile agnosia is characterized by an inability to perceive the shape and nature of an object by touch alone, despite unimpaired sensation to light touch, position, and other primary sensory modalities.

Autism, sensory perception and agnosia by Donna Williams

Two Warrior Women Indeed 😉

Paul Isaacs 2014