Paul Isaacs' Blog

Autism from the inside


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NAS Lambeth/A2ndVoice Workshop – Autism & Language Processing Disorders Workshop

This workshop is about language processing disorders in the context of autism. Hosted by Venessa Bobb.

Further Information & Reading

Autism and Language A Journey To Functional Speech – Donna Williams

Wretches & Jabberers DVD Trailer

Paul Isaacs 2021


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Autism, Information Processing and Coronavirus

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Note – This is from a personal perspective 

Alexithymia & Emotional Processing 

Not knowing one’s own emotional states means that I struggle to connect my conscious and unconscious mind, incoming information doesn’t filter into a connected thought, feeling and inner response which is marrying up with my inner states.

Visual Perceptual Disorders, Aphantasia & Mentalising 

Aphantasia is a condition where one does not possess a functioning mind’s eye and cannot voluntarily visualize imagery.[1] The phenomenon was first described by Francis Galton in 1880[2] but has since remained largely unstudied. Interest in the phenomenon renewed after the publication of a study in 2015 conducted by a team led by Professor Adam Zeman of the University of Exeter,[3] which also coined the term aphantasia.[4] Research on the condition is still scarce.[5][6]

Visual learning is the most common form of accessing the information around you, I cannot  retrieve visual information and I do not have a “visual mind’s eye” this is called aphantasia. The aspects that I struggle with are visual fragmentation and simultagnosia (object blindness) and a residual level of semantic agnosia (meaning blindness). So watching the news and making visual-verbal connections takes time for me to access and apply meaning with my system which is largely kinesthetic in nature.

Tactile – Associative Synesthesia & Building Frameworks

There are many different types of synesthesia, but they may be categorized as falling into one of two groups: associative synesthesia and projective synesthesia. An associate feels a connection between a stimulus and a sense, while a projector actually sees, hears, feels, smells, or tastes a stimulation. For example, an associator might hear a violin and strongly associate it with the color blue, while a projector might hear a violin and see the color blue projected in space as if it were a physical object.

The way in which I build up frameworks is always on an emotive level I am unaware of my feelings from moment to moment, so I have to EXTERNALISE unconsciously in to text which can be creative in content, emotive and introspective and/or art work which can be abstract an metaphorical in representation. I am not a literal, logical processor of information and I do not have social emotional agnosia  that comes from disconnection of right hemisphere. So INTERNALISATION  comes from the marriage creative process as opposed to overtly factual and linear ones.

Aphasia & Language Processing 

Currently I am around 30 percent meaning deaf which means I can take in large amounts of information for a a short period of time, however I may begin to be flooded with a vast a array of language in which my mind cannot keep up with, it becomes distorted and slowly meaningless, so managing my time and input is crucial.

Conclusion

It is best for people to understand their own autism “fruit salad” and what works for them during times of great uncertainty and distress, build up a level of self-awareness or have someone around you that healthily acknowledges your challenges but still retains the autonomy and respect of seeing you as person.

Paul Isaacs 2020

 


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There Are Two Types of “Social Emotional Agnosia” in Autism

abstract background close up construction

“Typical” Social Emotional Agnosia

Social emotional agnosia is the inability to see and/or perceive body language, facial expression and tone of voice, this mean that the person is only “seeing” factual information this rides along side an secondary factors such as a language processing disorder, alexithymia, mood, compulsive and anxiety disorders for example.

This tends to be found in people with a diagnosis of Asperger’ syndrome and is related the right hemisphere for the brain up to 30% also have faceblindness and sensory hypersensitivities.

“Perceptual” Social Emotional Agnosia

If we think of visual information up to 70% of is visual so what if a person simultagnosia? The inability to perceive more than one thing in their visual field rendering the ability to take in “social” information difficult, perceiving faces, objects and surroundings as “pieces”. What if the person has a receptive aphasia, auditory verbal agnosia and cannot retain information secondary to oral apraxia, verbal agnosias, exposure anxiety , mood, compulsive and anxiety disorders for example.

This tends to be found in people with a diagnosis of Autism and is related to the left hemisphere of the brain and the occiptal lobes and sensory perceptual disorders.

Image result for shoes paired

Image result for shoes paired

You can have two pairs of shoes that “look” the same but once you look inside them you realise they are different in terms of “mechanics” that would mean differing styles of learning, communication and mentalising will come into play.

Paul Isaacs 2018


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The Journey To Functional Language

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Note this is from a personal perspective 

Language Processing Disorder & Autism

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 & EXPRESSIVE 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.

Oral Apraxia, Language Retrieval, Trauma & Mutism

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, echopraxic and echomimic TV shows and VHS’ you name it which consisted 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”, 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 in Association to Language 

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! 😉 If 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.

Residual Information Processing Challenges 

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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Tinted Lenses, Visual Perceptual Disorders and Bridging The Gap Between “Non-Visual and Visual Worlds”

Visual Agnosia Image 2017

Note – This is from a personal perspective

Visual Perception & Autism

Some people on the autism spectrum have problems with filtering visual information which in turn distorts perception and what one is seeing, interpretation what someone takes out of what is being seen in terms of context and association and mentalisation that ability to internalise and integrate the visual memory in the form of a coherent, connected and retrievable memory.

What Tints Can Be Used For?

If people live in a world of being object blind and meaning blind and ultimately context blind this can have an impact on socialising, bounding, learning and having the ability to retrieve multiple forms of incoming visual information at once. Tints work for people in different ways (if they are needed at all) – for some its sensory integration disorder, for some it is a level of dyspraxia, information overload and coordination, for some it is building up a visual context because of simultagnosia and/or semantic agnosia, for some its processing faces, for some its recognising and building upon and reading social cues, for some it is getting a sense of “self and other”, for some it is visual learning difficulties such as dyslexia, dyscalculia and being able to read and write with coherence, for some its aphasia and/or verbal agnosia and gaining a better grasp of language.

Donna Williams 2011

Personal Perspectives

70% of incoming information is visual and we take that information in as light waves – essentially as color. Tinted lenses are filters. They filter out different light waves. This reduces the level of incoming information which leaves a person more processing time. This can have different effects in different people. For some it may just help them relax more or feel more comfortable looking at faces or making eye contact, help them handle places with bright lights or being outside. For some it will allow them to read comfortably and with meaning or improve depth perception. For others it may help them better process language and ultimately speak more fluently. For some it may help them see things as a whole and recognise objects, faces, places, and begin to read context and social cues or have a better processing of a simultaneous sense of self and other.

Donna Williams

Tinted lenses have helped me glue together a world which was largely bits and pieces that seemed shattered and unendurable, people shatter into fragments, objects floating with no clear base, foreground and background interchangeable, familiar voices with no face that seemed to match the warmth of familiarity. My language was also impacted to a certain degree with no internalisation of the visuals around me. Now I have tints they have made able to see faces with a level of coherence, looking at faces now I see a “whole” rather than “pieces” I am able to focus on their movements, body language and words, I can walk down the street and look at faces, places and people with a level with a level of coherence, I am able to better gauge “self and other” in conversations. I still have visual perceptual disorders however the tints have opened up and bridged my “non-visual to visual” world greatly.

Paul Isaacs

Paul Isaacs 2017


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Autism, “Stored Responses”, Language, Processing Delay & Unconscious Thought

Language Processing Delay 2017

Note This from a personal perspective

Conscious and Unconscious Processing

The problem even though I have progressed in many areas is switching between conscious and unconscious patterns of thinking. This in turn has an impact on my ability to keep up with incoming information (in this case verbal) and the ability to think consciously about what and how to answer and also gauge it’s emotional significance.

“Stored Responses” & Unknown Knowing

I have come to realise that have rapporteur of “stored verbal responses” which come out at moments when I cannot process information in real-time these can look sometimes stilted, disinterested or “vacant” this is because I have level of social-emotional agnosia due to visual perceptual disorders and receptive/expressive language disorders as a result of aphasia. This jutting between a conscious response and conscious acknowledgment when most of my thought process’ that are “connected” in unconscious states means I now looking at ways of trying to marry my thoughts in a more connected manner. This comes through typing in which the information I type hasn’t consciously gone in and unconsciously comes out as Donna puts comes as a surprise to the person in question as it may do to the people around them.

“Being” and “Sensing”

Donna Williams explains how the senses of a person with autism work, suggesting that they are ‘stuck’ at an early development stage common to everyone. She calls this the system of sensing, claiming that most people move on to the system of interpretation which enables them to make sense of the world. In doing so, as well as gaining the means of coping with the world, they lose various abilities which people with autism retain.

I can exist in state of being for hours on end that is were my process’s lie I observe without a conscious “knowing” or “interpretation” of what is going on around me however on an introspective level I connect far more broadly and deeply through touch and texture. I am primarily a kinesthetic thinker/processor.

Being A Silent Observer

I have observed the world “silently” however I wasn’t really “silent” in the literal sense speech was not only delayed but late to be functionally meaningful, words swilled in my mind however grasping them for context and meaning was a struggle to say the least, as I grew into later infanthood my verbal speech impinged on my jutting my conscious thought with “sounds” that did not represent the “inner world” I resided in.

I am solitary and idiosyncratic and that has no doubt coloured my perceptions as much as the other part of my “autism fruit salad”.

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

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Note 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, it effects me when I’m tired. My words get stuck like a “blockage” and I have to consciously “find” the words which seem almost on “there” but disappear leading 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, mentalising (organising) and the 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


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Autism: A Very Sensory Christmas

family-christmas-early-90s

 

Note: This is from a personal perspective

One of the amusing observations from my parents was my indifference to Christmas in the my early infant years, this would be noted as they would wait eagerly excited on the day while I would still be fast asleep in my bedroom coming down later in the day.

OBSERVATIONS

Another observation was my facial indifference to the event at hand the lack of excitement as each present was opened. My Mum can remember one year they bought me a bike which was perched on the fireplace (not lit of course) she seemed bemused that I didn’t go to the biggest first opening the presents scattered around the tree, when it came to the bike being opened she can remember me staring indifferently at the bike with no seemingly no acknowledgement of what it was or the significance of what it meant.

Looking a back at these two observations I can see many different aspects of what was going on from the inside and how observationally they caused confusion with my parents.

WHAT COULD BEEN  SEEN MAY NOT REFLECT “INSIDE”

One of the conditions I have noted about is simultagnosia and seeing things in bits along side aphasia and language processing issues these hidden blockages no doubt would have an impact on how I physically expressed my emotions to the outside world, be it in this case contextually joy, excitement and love.

All these things I feel and felt but because of visual perceptual issues, language processing, alexithymia and information processing delays these were not seen by my parents however other aspects of Christmas did excite me such as the colourful wrapping paper, glittered tree decorations and the twinkling lights but it was much more instant for me to access how I felt about a present would take longer so time would be needed. As the years progressed so did my level of understanding of what was going on.

I was happy at Christmas. 🙂

Paul Isaacs 2016