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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Bucks Autism Conference Video 2015

Note – These are from personal and obervational perspectives

Sensory Issues in the context of Autism Bucks Autism Conference

This video is about covers these topics

 

Paul Isaacs 2015

 

 

 


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An Accessible Look At My Autism Profile

Reception

This is a laymen’s terms/accessible version of my autism profile – although I have written previous blogs with technical information about the “mechanics” of my autism here is an “easy read” version of my autism which is broken down into a heading and paragraphs and/or sentences with hyperlinks attached for further information.

As always this is from a personal perspective.

Alexithymia (Emotional Processing)

Not understanding, processing or receiving my own emotions in “real time” this also affects how I understand bodily messages such as thirst and hunger. Poetry, painting , drawing and music help me process my emotions contextually.

Aphasia (Language Processing)

I have processing delay with language this means I struggle to find words, lose them, find them again and lose them again etc – I live before literal and struggle to find significance in language – however music, beats, rhythm and gesture help me access meaningful language.

Speech Delay (Developmental Milestone)

The developmental milestone of speech was delayed noticeably during my early years (please checkout other blogs for further information).

Language Delay (Developmental Milestone)

The developmental language milestone was delayed even when speech was acquired.

Speech Apraxia (Verbal Dyspraxia) (Body Disconnection/Mouth Coordination )

I had a disconnect between my body and brain so my brain would have words but my body (mouth, jaws, tongue and lips) didn’t seem to want to “join up” this lead to feeling of heightened frustration to total indifference.

Selective Mutism – (once functional speech was acquired) (Co-condition secondary to Exposure Anxiety)

In times of anxiety and/or dissociation I would become mute.

Tic Disorder & Globus Pharyngis (Co-condition/Mental Health) – 8 Years old – was called a “Nervous Throat”

This was due to an invasive sensation of something being within my throat, this would cause me to throat clear in an abrupt and idiosyncratic (odd) fashion.

Echophenomena (Developmental Milestones – Speech, Movement, Body Language)

  1. Echolalia – Echoing of words (delayed and instant)
  2. Echopraxia Echoing of movements (delayed)
  3. Echomimia Echoing of facial expressions (delayed)
  4. Palilalia Echoing of one’s own words (instant/delayed)
  • Visual Agnosias (Visual Perceptual Disorders/”Seeing” without meaning and/or “Seeing” but not piecing the “wholes” together)

    Semantic Agnosia (Meaning Blindness)

    Not retaining associative meaning with what is being seen, so I would tap, sniff, lick, rub, mouth and tongue to gain a reality and an experience of my surrounding environments.

    Simultagnosia (Object Blindness)

    Not seeing in wholes – so seeing “fragments” and not seeing the “whole visual picture” of one’s environment.

    Prosopagnosia (Face Blindness)

    Not perceiving faces and/or recognising people by their faces.

    Visual – Verbal Agnosia (Comprehension Blindness)

    Reading without internalising/retaining meaning this is related to mentalising.

    Colour Agnosia

    Seeing colours but not processing/understanding or recognising differentiation between them by name. (in my case I recognise red but struggle to sometimes name other colours).

    Mirror Agnosia (Visual Processing)

    Not understanding nor processing “other” or “self” in mirrors for example I would and still get fooled by mirrors and when I was younger and used to think that was behind me was in front of me (foreground and background distortion).

    I didnot associate that the person in the mirror was “me” until my mid-teens. (associated with visual perceptual disorders).

    Form Agnosia (Visual/Cognitive/Auditory & Contextual)

    Not configuring the contextual “whole”.

    Pure Auditory Agnosia (Auditory Perception)

    Not processing/understanding the “origins” of sounds and associating them when I next “hear” them.

    Language Auditory Agnosia (Meaning Deafness)

    A type of aphasia (Language processing disorder).

    Tonal Agnosia (Atonia) (Language Processing/Related to Aphasia)

    I “hear” tone but sometimes do not associate with meaning.

    Pain Agnosia (Body Disconnection)

    I do not perceive pain at all and/or there is a significant delay in recognition.

    Visualspatial Dysgnosia (Body Blindness)

    I do not recognise my body in space so I wear tight clothes, bracelets, tight shoes to get a “reference” of my body.

    Finger Agnosia (Digit Blindness)

    As a child I had trouble reference that I had fingers and “where they were” this was due to body disconnection.

    Paul Isaacs 2015


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    Strategies For The “Pieces” of My Autism Using Donna Williams’ Fruit Salad Analogy

    Fruit Salad Analogy Donna Williams

    Note – That this is from a personal perspective of my profile and what makes up “my autism”

    Here are all the pieces of my Autism broken down into bits and chucks with a personal perspective on each bit and personal strategies that have helped me over the years.

    Expressive Agnosias

    Alexithymia

    This is an issue with processing one’s own emotions it affects about 85 percent of people on the autism spectrum and is experienced on different levels depending on how one is affected and what moods create the issue.

    Personal Perspective

    For me emotions come outside in and not inside out they are an invasion a wave of energy that is uncontrollable, invisible and scary – negative emotions take longer to process and configure as well – for example it took my 3 whole years to process (emotionally) that I was being bullied at work everybody else knew I didn’t. I a wave of energy hit me that night as I cried uncontrollably with the realisation of what happened again it took 3 years. As a teenager I would tense my face up and self-harm in the form of knuckling my cheeks, slapping my legs and hitting my arms in confusion and disconnect.

    Strategies

    • Paul what are the origins of your feelings (helping me find a starting point)
    • Paul are these feelings environmental (situational) or is this not
    • Use objects of reference and gestural language and representation to explain

    Receptive/Expressive Language & Movement Issues (Speech & Communication)

    Aphasia

    There are many different forms of aphasia which affect both expressive and receptive communication

    Personal Perspective

    Sounds and language intermingled and became indisputable I would react with glee and find these “sounds” that people made and tilt my head in wonderment, perplexed and even intrigued by these “sounds” this was at pre-school – event now receptive language is difficult for me (words process back into sounds meaning deafness)

    Strategies

    • Clipped telegraphic language
    • Tone and overt melody
    • Gestural language – creating movements which connect with the words like a play
    • Allowing processing time

    Speech Delay

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    Personal Perspective

    Swirling sounds and words in my head – I had problems with expressive speech for about the first five years I had no functional language in head for many years – I would have moments of clarity, moments of language which slowly progressed but no one saw because of my external behaviours I had limited words within my head which progressed – no one should be written off if they don’t have expressive speech, I heard things in the playground and slowly processed them and because of how I appeared it looked like I didn’t hear/understand.

    Strategies

    • Word and sound play
    • Movement
    • Not presumed incompetence

    Language Delay

    Personal Perspective

    At around the ages of 7/8 years old I gained functional expressive speech of (from a developmental perspective a 3 year old) – with the receptive and expressive language disconnect I had issues with understanding to express and equally expressing to understand. This lead to confusion with not only myself but others around me Speech Apraxia (Verbal Dyspraxia) also compacted the issue (coordination of the mouth and tongue and jaw muscles to extract speech) this was prevalent until late infancy in my CAMHS (Child & Adolescent Mental Health Services) notes speech production was at times heard to understand.

    Strategies

    • Clipped Telegraphic Language
    • Gestural language (both from myself and speaker)
    • Word, Sentence & Language play (use of syntax, meaning, word production, sentence connections)
    • Contextualisation of words

    Selective Mutism (once functional speech was acquired)

    During late infancy and early teenage-hood I had bouts of mutism (having the ability to speak but because of anxiety would not) this included – people who I sensed were non genuine, too much expressive language from speaker (meaning deafness) so unable to give an answer that was contextually correct.

    Strategies

    • Understanding the origins of the mutism (social anxiety, exposure anxiety, OCD obsessive compulsive disorder, language processing disorder, social phobia etc)
    • Boosting self-confidence – such as in my cases drawings and exercise
    • Understanding the receptive and expressive communication profile

    Tic Disorder & Globus Pharyngis – 8 Years old – was called a “Nervous Throat”

    Personal Perspective

    In mid to late infancy I had what was termed a nervous throat this was to do with the “feeling” or an obstruction in my throat causing me to in a tic-like fashion make a loud “Hum!” and “ahem!” sound.

    Strategies

    • What are the places of anxiety in one’s life that has caused this
    • Making me aware of when I was doing this sound

    Echophenomena

    Personal Perspective

    Sounds, patterns, themes, feeling, movement and experiencing this world, people and place. I don’t use elaborate constructions but do and sense in order to perceive, understand an process I don’t live in a world of literalism nor logic as basis of “concrete” understanding – even now that form of and basis of understanding things, people, environments etc.

    Strategies

    • Movies (focusing on the sounds, movements and expressions)
    • Music (tone, melody and rhyming)
    • Observing surroundings and contextualisation

    Visual Agnosias

    Personal Experience

    I see faces (face blindness), bodies and visual environment as fragmented (object blindness) which also meant I could not see body language or facial expression , flat tursh and without depth or meaning (meaning blindness) not understanding self and other of what is around me for example it took me until 16 years old to understand that when I looked in the mirror firstly I was looking at myself (although I still get a level of disconnect) and that what “seems to be in front of me” is in reality behind me. My visual perceptual systems have layered effect on what I see and interpret.

    Strategies

    • Sculpting objects in my space this would including licking, sniffing, mouthing as a way to externalise the object making it real for me this help me map out my space
    • Preference for having no shoes of socks on in my youth and around the house (patterning movements)
    • Sculpting faces remembering and connecting with someone by touching their face (I have only done that to 7 people in my lifetime to date)
    • Having objects on display not “hidden” because I don’t have visual memory so placement is important
    • Recognising people by sensing their patterns of movement and their voice
    • Tinted lenses help with sensory integration, moving in visual space, depth perception, body language, posture and confidence

    Auditory Agnosias/Aphasia

    Personal Perspective

    Hearing sounds environmental with no on origin (auditory agnosias) hearing words as “sounds” (verbal auditory agnosia/receptive aphasia) missing tone, sarcasm, idioms not because of literalism but because of how much language I can process before I “hear” nothing.

    Strategies

    • Telegraphic language and clipped words for the origins of environmental sounds (auditory agnosias)
    • Telegraphic and gestural language – being overt, pantomime like in expression, tone and melody
    • Music, rhythmic beats and movement help my brain “work”

    Body Disconnection

    Personal Perspective

    Not being connected to my body means that pain is not recognised as well as a sense of my own body its inter-connectivity and its connection (as a whole form) around the world around me, I appeared odd to bouts of trauma having a tooth almost knocked out (an elbow to the mouth) was me with indifference to pain but shock and sadness at the blood (this element coming out of me) and a dislocated arm was met with anger and confusion because of the lack of movement not the pain. During times of mental illness I self-harmed both my arms not “knowing when to stop” and as a child I didn’t have knowledge of my fingers (my limbs also rolled into one another as if they didn’t exist).

    Strategies

    • Pressure points around my body – bracelets on wrists, tight shoes, belt, jacket and/or shirt and long hair tied back (adding pressure getting a sense of my head)
    • As a young child smearing paint, moulding play dough and sifting sand (to get a sense of my “foreign fingers”)
    • Messy play as a child
    • Dental appointments (for me this is form of sensory integration and very relaxing) 🙂

    Dissociative Disorders – Recognised in 2012/Revised 2014

    Personal Perspective

    In late infancy I started to dissociate as coping mechanism during these years and for many after taking myself away from both the situation and environment, persistent bullying during my educational and work years didn’t help the issue and I “created” personas (with strong reactionary personality profiles) to deal with this. I developed PTSD some years ago reliving an abusive incident that happened in my mid teenager years.

    Strategies

    • Understanding that dissociation is on a spectrum from daydreaming to higher frequencies and detachment of you the person and/or the environment you are in.
    • Therapy that includes mapping memory, incidents, personas and coping mechanisms
    • Understanding trigger responses
    • Personal origins of dissociation

    Mental Health

    Personal Perspective

    I started to develop OCD in my early teenager years this was persistent and would resulted in hand washing, placement moving and plug and switch checking, door-slamming and checking. Exposure anxiety was to do with an involuntary response to direct exposure interaction this would lead me to run away literally (or in my mind). Like many people on the spectrum I advocate the personhood first in the late 2000s I developed two distinct personality disorders (extreme versions of my “normalised” personality traits.)

    Strategies

    • Origins of OCD – in my case this was fear of the house being burned down, burglary, germs and confirmation, and invasive illness that would lead to pain and/or death
    • Indirect confrontation for exposure anxiety talking away from me, talking about me but allowing me to hear it and integrate it without being in the mix
    • Knowing personality its traits and extremes (disordered versions of “normalised” versions/traits)

    Learning Difficulties

    Personal Perspective

    Words swilling in my head I found them hard to process and strand together as words formed in my head over time I found it hard to translate them onto the page, the same with numbers which don’t swill in my head I found it hard to grasp numbers their meaning and their interpretation and their overall function.

    Strategies

    • Clipped sentences – one stage at a time
    • Pens with extra grip (fine motor movements)
    • Alternate ways of writing
    • Function and context of what number “mean”

    Auto-Immune

    Candida Albicans

    Personal Perspective

    Many foods would make me fill ill both in body and mind causing me to have brain fog, lack concentration and further hinder my processing and integration of information from my surroundings, language and sounds.

    Strategies

    • Understand foods, their content and what ingredients they have in them
    • Piecing together what foods are making you ill, unwell and have brain fog
    • Piecing together what foods you can have that don’t make you ill

    Other

    Personal Perspective

    This can be related to anxiety it is the slow stripping of enamel making them look “smooth” and/or “chipped” in appearance I have this with many teeth on one side of mouth

    Strategies

    • For me regular checks at the dentist and a gum guard at night has helped with issue

    Dr Casanova

    Dr Casanova

    Genetics – Developmental Agnosias & Minicolumns

    Some agnosias, sensory hypersensitivity, sensory integration disorders and many other conditions and syndrome can be passed down and can be seen as congenital in nature how the brain has grown with genetic encoding – Neurologist Dr Manuel Casanova calls this Minicolumns please take a look at this blog about his research and findings

    AUTISM & MINICOLUMNS

    PERSONAL WEBSITE

    PERSONAL BLOG SITE

    Donna Williams 2011

    Donna Williams

    Donna Williams – Autism as a “Fruit Salad”

    Donna is quite correct in letting the world know that autism is a “clustering” of different conditions (both neurological and metabolic systems), syndromes, personhood and personality extremes, environment, mental health and learning styles. No one person with autism is the same and that means there is a high level of diversity to their which is good.

    WHAT IS AUTISM? BLOG

    AUTISM & ASPERGERS “FRUIT SALADS”

    PERSONAL WEBSITE

    Premature 1

    Me Premature

    Brain Injury Relates To My Autism Profile

    Having brain injury at both has also had an impact on my autism presentation I was born premature and through placental abruption, cerebral hypoxia, silent stroke and damage the left hemisphere of the brain (which is related to aphasia, language processing, visual agnosias, simultagnosia, apraxias and visual spatial functioning).

    HYPOXIA & BRAIN INJURY

    I would say that these added factors has made my autism “Fruit Salad” more complex in nature and presentation – there are clearly other members of my are on the on the autism spectrum who have been diagnosed but their profiles are very different from mine in terms of presentation the mechanics.

    Having an Autie Profile

    Having an Autie profile in terms of presentation means I live in world (from a processing perspective) that is less literal, less logical and I use my sensory systems to work out the world I live in and I think it is important to know the mechanical differences between Autism and Asperger’s Syndrome and the people in between profiles of the two “Aspinauts” .

    Every profile is unique in presentation so interventions, learning and communications will have to be person centred.

    Personhood First? Why?

    For all what is said and done I want to be known for my personhood first my autism comes along with me wherever I go, however it doesn’t define my being, it doesn’t make me what I am in totality (it affects how I perceive and processing the world). I love art, poetry, music, movies, fashion, drawing, being silly, bad jokes, dogs and want to know for those things first.

    I hope this helps others. 🙂

    Paul Isaacs 2014


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    Speech/Language Delay, Visual/Auditory Processing & Body Disconnection in Autism

    Paul Year 1

    Note this is my own personal experiences of Autism

    PATTERN, THEME & FEEL (D.WILLIAMS) – A WORLD BEFORE “KNOWINGNESS”

    I was non-verbal for 5 years or more (I had a lot of words in my head) I had speech and language delay Aphasia,Apraxia of speechAuditory verbal agnosia) – (expressive and receptive) my Mum thought I was deaf and blind (this was due to Visual agnosias and Auditory agnosias), I used movements, clicks, sounds to convey information to others (I still use this when happy, excited and/or distressed) I consider this my “primary language” and interpretive language a second language I learned), pre-verbal than functional expressive speech at around 7/8 years old (1993/1994) that was of a 3 year old expressively. 

    SILENT CONVERSATIONS

    I didn’t understand that conversations were between two people for a very long time used to look at two fragmented blobs making sounds at each other at pre-school and found it rather amusing but didn’t connect that it was an interaction.  I used to make noises/whispers at other children I sat next to in the playground with (that was my form of a conversation) some time also.

    BODY DISCONNECTION & VISUAL MEANING

    I was already putting my arm behind my back that was to do with trying to connect my body with myself (body disconnection), probably liking the feeling of the fur and not quite understanding contextually where I was.

    Paul Isaacs 2014


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    Autism – Auditory Agnosias/Aphasias & Oral Apraxia – Not “Processing” Environmental Sounds & Words With “Meaning”

    31472503_2320748941272303_5404334138553532416_o.jpg

    OVERVIEW

    Note – This is from a personal perspective

    As apart of my Autism Fruit Salad (Donna Williams 1995/2005) I have auditory agnosia, this means I cannot process “environmental sounds” with meaning, comprehension and not retaining the “sound” in context (so for example “hearing/processing” and ambulance and retaining it it). This is one of the reasons why my parents thought I was deaf, I was/am neurologically deaf but their is no specific impairment to my ears.

    AUDITORY AGNOSIA

    Discriminative

    This type of auditory agnosia is caused by lesions to the right hemisphere of the brain.

    Classical (or pure) auditory agnosia is an inability to process environmental sounds, such as animal noises, industrial noises, or the like. An airplane roaring overhead would not be understood to be related to the idea of “airplane”—indeed, the person would not even think to look up.

    So How Does This Work

    • I can “hear” the sound lose it’s “meaning” and not “hear/comprehend” in association to where it’s coming from
    • I can have a sound in my head but not “know” it’s origin – this would lead me to repeat the sound in an echolalic fashion
    • I can have sound in my head and flip flop between comprehending and losing comprehension
    • I ultimately lose meaning/comprehension of sounds on daily basis and have to be verbally reminded of basic sounds such as mobiles phones, trains, cars, lorries etc.

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    VERBAL AUDITORY AGNOSIA/APHASIA

    Semantic-associative

    This type of auditory agnosia is caused by lesions to the left hemisphere of the brain, specifically the temporal lobes and Wernicke’s area.

    Linguistic (or verbal information or Wernicke’s) agnosia indicates that the subject can’t comprehend words, although they can understand words using sign language and words from reading books, and are themselves capable of speech (and even of deriving meaning from non-linguistic communication e.g. body language) the particular sounds associated to each word are meaningless.

    So How Does This Work

    • I hear words but cannot process meaning/context this means that clipped language is better for processing and meaning
    • Like Donna Williams I like people to use gesture (like mime) to tell the story and use movements that match the words
    • If over processed I will gain no auditory meaning from the words being said
    • I like to touch to perceive (visual agnosias) which helps with language

    EXPRESSIVE APHASIA & ORAL APRAXIA

    So How Does This Work

    • As a child I had thoughts in my head but had problems using my mouth, tongue, muscles and jaw to convey “words”
    • My mouth felt disconnected from “me” and my “words”
    • I lost words within my “head” (expressive aphasia) so “created” I words/sounds for feelings and communication
    • I speak but I have a lot of bass to my voice, tone is unusual, pitch and rhythm also (oral apraxia)
    • I use “stock expressive language” to aid with expressive language

    CONCLUSION

    I believe that this is one of the reasons I still live in a Pattern, Theme & Feel world, I created my own language through the auditory and visual cluttering that I had (and still do) and I still find typical interpretative language difficult (I treat it as a second language) but I try and use it to the best of my abilities. 🙂

    Paul Isaacs 2014


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    What is That Sound? – Autism & Auditory Agnosia – Autism Fruit Salad D. Williams Explained Part 6

    OVERVIEW

    Personal Accounts of Auditory Agnosia. 🙂

    Enjoy 🙂

    Using Donna Williams Fruit Salad Analogy (1995/2005)

    Paul Isaacs Adult with Autism 2014