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Autism from the inside


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Donna Williams’ Autism Fruit Salad – Bridging the Medical and Social Model of Disability

When Donna published “Autism: The Inside Out Approach” in 1996 it was the beginning of a trail-blazing analogy which would look at autism from the factual, compassionate and directional angle.

Looking Outside The Box

It would ditch rhetoric, confirmation bias and group think it would challenge people views (rightly or wrongly) about autism as a singular condition but look at it through the lens as a multi-faceted condition in which the person has their own unique “pieces” which would present differently from person to person.

Setting A Fluid Framework

She quite rightly humanised medical conditions that present themselves as apart of someones autism such as visual perceptual disorders such as faceblindness, simultagnosia and semantic agnosia and expand on the themes of context blindness in pragmatic but emotionally binding way.

Breaking The “Status Quo”

She would advocate for people who had severe apraxia and aphasia as a part of their autism and would need facilitated communication and assisted communication tools. She would advocate for people who struggled with ABA programs which triggered exposure anxiety. She would challenge the status quo of “all people with autism think in pictures” or “all people with autism are logical literal thinkers”. She would advocate for people with health conditions as a part of their autism.

Equalism

She would quite rightfully not tolerate internalisd bigotry within the autism world and would promote a heart warming and expanding message of egalitarianism which in means equality for all which is not just said but put into practice in a person’s daily life.

Let her videos, blogs and books inform you and empower you for in the end what she wanted out of you was to the be the best version of yourself.

Paul Isaacs 2019


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Autism, Meaning Blindness and The Phantom Rainbow Flask

Related image

Note This was from a personal perspective

There are times when I even question my own perception visual and/or otherwise and got the the point wonder of how I cam to this conclusion.

Noticing An Object With No Context? 

I was presenting a workshop around a week ago and in the room something every so often was catching my eye and intriguing me, its was shiny and rainbow coloured in presentation however I ignored for a while.

Interpretive Meaning vs. Non-Interpretive Experience? 

I was then talking about experiences of being object blind (simultagnosia) and meaning blind (semantic agnosia) and turned the the object of intrigue and held it and proclaimed and questioned  “what is this?” in about 5 seconds or more the audience explained that it was a hip flask!

It just goes to show that even on a residual level my visual perceptual challenges take me by surprise this were I made an effort to remember the object by touching the its smooth and bobbled surface.

Paul Isaacs 2019

 


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Asperger’s Syndrome & “Classic” Autism – Left Brain Autism & Right Brain Autism “Fruit Salads”

The late Polly Samuel’s (Donna Williams) through her career had pointed out that firstly autism was adjective a describer of an experience rather than a definer of a person, she also pointed out through her books and blogs that “autism” is different for each person a clustering and multifaceted condition made of different conditions in both neurology  and biology  and contributing psycho-social factors, identity, mental health and environmental factors

Asperger’s Syndrome – Left Brain Autism

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When noting and observing people with Asperger’s Syndrome the part of the brain which is being used to compensate for a disconnect right is the left, people with Asperger’s Syndrome have a condition called social emotional agnosia this means that the person cannot perceive facial expression, body language and tone of voice. Even thought sensory issues may present themselves it would to do with modulation and integration rather than sensory perceptual issues that effect different areas of the brain, faceblindness (prosopagnosia) has a high co-morbidity as well as dyspraxia, alexithymia and literal perception of language. So other words people with AS have to intellectualise in order to compensate for the disconnect in the right.

Characteristics of Right Hemisphere Syndrome: 

– Left visual neglect – an individual may neglect words on the left side of the page or not realize that there are objects on the left side 
– Difficulty with facial recognition 
– Poor awareness of deficits 
– Poor self-monitoring 
– Impulsive behavior
– Poor initiation and motivation 
– Disorientation 
– Impaired attention/memory 
– Difficulty with organization and reasoning/problem – solving 
– Difficulty with social aspects of language (e.g., poor turn taking skills, providing too much information) 
– Difficulty understanding humor 
– Difficulty with word retrieval 

© By Beata Klarowska, M.S. CCC-SLP Monday, July 25, 2011

Classic Autism – Right Brain Autism

When looking at “classic” autism one makes the impression that the person has (and wrongly) a “lower functioning”variant of AS, this could not be further from the truth people with classic  autism tend to to have receptive and expressive aphasia, verbal agnosia, speech/oral apraxia, and a higher rate of visual perceptual disorders such as simultagnosia and semantic agnosia. However introspection is in tact and just look at the poetry and art.

What if my brain injury or stroke is on the LEFT SIDE of my brain?

Injury to the left side of the brain may result in right-sided weakness and the following communication problems:

  • Receptive Language: Problems with understanding spoken or written language (listening and reading)
  • Expressive Language: Problems with expressing spoken or written language
  • Apraxia of Speech: Problems with programming and coordinating the motor movements for speaking
  • Dysarthria: Aspects of the speech system is impacted, which may result in slurred speech or a change in how your voice sounds
  • Computation: Problems with number and math skills
  • Analyzing: Problems with solving complex problems

© 2016 CONSTANT THERAPY

Right Brain Left Brain Autism Fruit Salads Image 2017

Differences between Aspergers and Autism ‘fruit salads’?

 In one of my books, The Jumbled Jigsaw, I presented a range of conditions commonly collectively occurring in those with autism and Aspergers. I was asked about the differences between an Aspergers (AS) ‘fruit salad’ and an Autism ‘fruit salad’As an autism consultant since 1996 and having worked with over 1000 people diagnosed on the autism spectrum there are areas that overlap, areas where similar can easily be mistaken for same, and areas that are commonly quite different. Some with AS can present far more autistically in childhood but function very successfully in adulthood. Some with Autism can have abilities and tendencies commonly found in Aspies and some will grow up to function far more successfully than they could in childhood but, nevertheless, when together with adults with Aspergers they each notice that the differences may commonly outweigh the similarities. Generally the more common differences are:

ASPERGERS
originally called ‘Autistic Psychopathy‘(now outdated)
commonly not diagnosed until mid, even late childhood.
lesser degrees of gut, immune, metabolic disorders, epilepsy and genetic anomalies impacting health systems
dyspraxia
mood, anxiety, compulsive disorders commonly onset from late childhood/teens/early adulthood as a result of bullying, secondary to social skills problems, secondary to progressive self isolation and lack of interpersonal challenge/involvement/occupation.
scotopic sensitivity/light sensitivity more than simultagnosia
most have social emotional agnosia & around 30% have faceblindness but usually not due to simultagnosia
literal but not meaning deaf
social communication impairments, sometimes selective mutism secondary to Avoidant Personality Disorder (AvPD)
sensory hypersensitivities more than sensory perceptual disorders
higher IQ scores due to less impaired visual-verbal processing
tendency toward Obsessive Compulsive Personality Disorder (OCPD), Schizoid rather than Schizotypal Personality Disorder and commonly Dependent Personality Disorder to some level.
higher tendency to AvPD rather than Exposure Anxiety
Alexithymia is common
ADHD common co-occurance but may be less marked than in those with autism.

AUTISM
Once known as Childhood Psychosis (now outdated)
generally there is always some diagnosis before age 3 (those born before 1980 were still usually diagnosed before age 3, although commonly with now outdated terms like ‘psychotic children’, ‘disturbed’, ‘mentally retarded’, ‘brain damaged’.
higher degrees and severity of gut, immune, metabolic disorders, epilepsy and genetic anomalies impacting health systems
mood, anxiety, compulsive disorders commonly observed since infancy
commonly amazing balance but commonly hypotonia
simultagnosia/meaning blindness rather than just scotopic sensitivity
verbal agnosia/meaning deafness
verbal communication impairments (aphasia, oral dyspraxia, verbal agnosia and associated echolalia and commonly secondary Selective Mutism)
lower IQ scores associated with higher severity of LD/Dyslexia/agnosias
tendency toward OCD/Tourettes, also higher rate of Schizotypal PD, DPD is common and tends to be more severe
higher tendency to Exposure Anxiety more than AvPD
higher tendency toward dissociative states (dissociation, derealisation, depersonalisation)
poetry by those with autism as opposed to AS commonly indicates those with autism can have high levels of introspection, insight
ADHD extremely common co-occurrence

Donna Williams, BA Hons, Dip Ed.
Author, artist, singer-songwriter, screenwriter.
Autism consultant and public speaker.
http://www.donnawilliams.net

Reflective Conclusion

It is simple people need to start looking at the functioning of the brain and how these different systems work for different people. This will in turn create advocacy which is not only meaningful and beneficial but character building and the correct information will give a broader foundation and palette to work from. I have autism (as opposed to AS) not because I am just “saying it” but because of what part of my brain affected.

What I am not saying (and never will say) is that I am speaking for all that would be disservice to many people’s realities. I am fully aware that this may challenge people me saying there are differences however looking at the neurology behind it and Polly’s observations I think there is room for healthy discussion.

Paul Isaacs 2019


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Asperger’s Syndrome and Autism? – Doing vs. Being?

When we some people look at Asperger’s Syndrome and Autism it can be used interchangeably as the “same thing” but a “different presentation” between the two. If we look a little (or a lot) deeper you can actually find that the differences lie in brain hemisphere dominance and neglect and all that comes with it.

Autistic’

Reliant on the mapping of pattern/theme/feel known as ’Sensing’, with intermittent use
of interpretative processing at the level of the literal
Mono tracked processing with moderate to severe information processing delay.
Indirectly Confrontational, self in relation to self

The struggle here is the use of switching between “being” and “doing” states this means that the person is going from a “sensing” state to an interpretive state.

Asperger’s’

Interpretative processing at the level of the literal intermittent processing
beyond the literal to the ’significant’,
Generally Mono tracked processing with mild information processing delay

Those with Exposure Anxiety are indirectly-confrontational and self in relation to
self. Others are able to manage directly confrontational other-initiated social
interaction but generally lack a simultaneous sense of self and other

The struggle here is the opposite the use switching between “doing” and “being” this means that although the person gets a level of “significance”  they may get “stuck” in a state of over thinking.

Exposure Anxiety is one of the three faces of “Autism”
Notes from a presentation by Donna Williams
At Flinders University, Friday Jan 16th 2004

Autism Doesn’t Run On”One” System

There is not one “system” in autism and that is part of the larger issue, by promoting tired stereotypes and linear 2D presentations of “collective autism” in which the person is assumed to think, act, react and behave in the same manner is rather passe and potentially dangerous.

Looking deeper, being objective and opened minded to the varying presentations that both “Autism” and “Asperger” fruit salads supply as an adjective and a description can lead down to meaningful roads of empowerment.

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Paul Isaacs 2019


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A Journey With Exposure Anxiety

 

Exposure Anxiety comes in 3 levels:

  • Specific: Targets only specific environments, activities and interaction with particular individuals.
  • Generalized and other-directed: Effects all areas of life which directly involves others.
  • Generalized and both self and other directed: Effects all areas of life which directly involves others but is also present when alone.

Copyright Donna Williams 1991, 2003, 2008

Image result for exposure anxiety

 

Residual “Exposure Anxiety?

If we think about exposure in a residual (non syndromic sense) those moments of embarrassment, aware of being aware, aware of your own self-awareness of the situation meant that you froze clammed up or even ran away meant that this “feeling” you wanted to escape, remove, and disappear.

 A Personal Look at Exposure Anxiety And Me

If you turned the “volume-up” on this condition you may find that it fits in the realms of being called “Exposure Anxiety” a feeling on a chronic level that falls into the three subtypes above. I would say that in my early years I had the 3rd one throughout my child and teenage hood as I grew into my twenties and was at the tail end of being employment in my mid teens I was thrust into a world of expectation from a social perspective that in many ways never let up. I never the less “kept going” and now at the age of thirty two I can say that the claws of this condition have shortened, nails smoothed and hands made smaller.

I would say it has an impact on me in specific areas so that is going from 80% to now at a more comfortable 30% and below I can show more of “myself”, be, share and talk in a more “connected manner” than I did even 10 years ago. Other things have changed to my environment, my purpose, life is but a rolling journey and that is the joy we can all celebrate and question at different stages in our lifetime.

My information processing being meaning deaf and meaning blind have changed, the tints have aided in those areas of visual perceptual challenges, and my meaning deafness is around 30% so I can keep a better track on conversation around me. My emotional processing and perception are still delayed that is a work in progress and I seek not to compare but to be the closest version of “me” I can be.

When we look at other people’s autism “fruit salads”, we begin to wonder what is the “driver” to what I am seeing? Is it sensory perceptual? Is it dietary disabilities? Is it seizure related? Is it emotional perception? Is it language processing? Etc. By looking at the person’s “systems” you are dealing into those areas of honest and humble questioning, what will you find and how will you adapt?

Common Threads Of Humanity?

Do people with autism have much more in common with those without? My answer is yes they do the only difference is the areas of that person’s “autism” that is challenging some to smaller more residual degrees others to more severe and/or profound degrees it is not the matter of it being a linear spectrum from “classic” autism to “asperger’s syndrome” but the also the palette of grey and what is specific to that person is what matters. All human beings have “system” it may be just that I have taken the time (which anybody could choose to do in my circumstance) and work out “what that is”.

Looking At People As People?

If one ignores the poison of the autism militancy which is political and unhelpful in its projection and reasoning one must look at the person and what “autism” is for them and means for them.

Paul Isaacs 2019


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So What is Simultagnosia & Semantic Agnosia? In The Context Of Autism?

Image result for occipital lobes and simultagnosia

Note: This is from a personal perspective

Simultagnosia is a condition that effects the occiptal lobes of the brain this is where visual perception and processing is connected, it also can have an impact on visual association, language perception/processing and overall navigation of the visual world around you.

“Blindisms” 

For me it meant not being able to access the visual world with coherence rendering me unable to access with my “eyes”and having to build up the visual world in a “non-visual” way such as.

  • Smelling
  • Touching 
  • Sculpting
  • Licking
  • Tapping
  • Moving

This started early in my development with my Mum’s observations thinking I was both deaf and blind (which is a common observation with people with visual agnosias) I was imprinting through EXTERNAL stimulus to build up a representation and connecting through other sensory modulations to make sense of the experience around me.

“Mapping” A System

As I have got older and with more awareness of the condition I have system in place where I do not hide anything from my view and placement of objects are important in relation to their context.

Context & Relevance

I still have a level of context blindness which means that things that are not being used “lose there relevance” (what they are, their use and function in relation to the environment) I may mistake objects for other things entirely and/or be caught up in how they make me feel rather than what they are.

Paul Isaacs 2019


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Autism and Anti- Bullying Week – Advocating & Acknowledging Different Autism “Fruit Salads”

Image result for bullying image

The word “autism” is a describing adjective of and “experience” and multi-layered condition of “conditions” a “fruit salad” as the late Donna Williams had noted from looking at her own autism and observation of others through her consultancy work.

So with that in mind what can bullying be down to? Many factors of course can be noted such as perceived vulnerability and/or threat, a noted and/or varied amount of insecurities within the bully themselves and of course any other contributing environmental factors that propel and/or ignore or not acknowledge that bullying is happening so what can be the contributing factors? Within in a person’s “autism fruit salad”?

Social emotional agnosia

This is to do with social perception so if someone doesn’t read body language, tone of voice or facial expression all they have left is facts this could lead the person to being picked on, left out and struggle to integrate into conversations between their peers and/or left overwhelmed.

Simultagnosia (Object blindness) & Prosopagnosia (Faceblindness)

The person may perceive things in pieces and not wholes making visual tracking of the environment difficult to manage meaning they are “lost” and struggle to find connections and visual coherence.

They may also have faceblindness as well meaning blindness meaning that bounding with the peoples via their peers faces is difficult. Leading to errors in communication and not knowing who people are, this may lead to teasing and/or bullying by their peers.

Semantic Agnosia (Meaning blindness)

Seventy percent of information is visual so what if a person on the spectrum is only using thirty percent information to perceive? They may use their hands, feet, tongue and body to externalise their surroundings in order to internalise, this includes objects and people.

As this system may not be fully understood by their peers around them it may lead to social misunderstandings, fear and/or exclusion due to a person being highly tactile.

Integration of “Self and Other”

Some people with autism may struggle with a “shared” sense of “social” the developmental underpinnings are to do with development of language and possibly having a more multi-tracked system of bringing together multiple forms of information at once.

So the person may only be able to do “all self no other” meaning the person may seem to not listen to others and project, and/or not project and not answer when it’s the other way round “all self no other” this could lead to teasing because of the lack of fluency between the “switching” by peers.

Meaning Deafness

Differing levels of language processing means that the person may not be able to keep track of what is being said, its relevance and or significance. If the person is resorted to just hearing “sounds” and not bridging the sounds into “meaning” the person may struggle with interpretive language.

Exposure Anxiety

EA was first described by Donna Williams in her book “Nobody Nowhere” in 1991 and later and hand book on the condition in 2003. EA creates involuntary diversion and retaliation responses when a feeling of “exposure” is triggered the nervous system then reactions with such responses as echolalic litanies (that go nowhere), spitting, hitting (others and/or themselves), swearing, running away and/or freezing (mutism).

People are directly confrontational in their language to one another with EA the person may benefit from an indirectly confrontational approach. Peers may be baffled on/or even confused by the differing responses this may lead to being teased, left out and picked on.

Other Things To Consider

  • Personality Types
  • Learning Styles/Variations
  • Dietary Disabilities
  • Mental Health Co-Conditions

Conclusion

If we are looking at advocacy we must first look at all perspectives of what is being experienced by the person on the autism spectrum and their peers and bringing a hopeful inclusion tailored by

  • Information sharing
  • Perspective taking
  • Healthy validation 
  • Inclusion

Advocacy of Autism as a “Fruit Salad”

By looking at the multifaceted nature of the word “autism” one must look beyond the stereotypes, beyond the rhetoric and once people open up to being healthily challenged, empowered and acknowledged then we can look forward to the future.

Links

Books

Nobody Nowhere D.Williams 1991

Exposure Anxiety D.Williams  2003

Autism: An Inside Out Approach D.Williams 1996

The Jumbled Jigsaw D.Williams 2005

Living Through The Haze P.Isaacs 2nd Edition 2016

Understanding & Supporting Autistic Students In Specialised Schools P.Isaacs 2013

Blogs

What is Autism? D.Williams 2014

Differences Between Aspergers and Autism “Fruit Salads D.Williams 2012

There Are Two Types of “Social Emotional Agnosia P.lsaacs 2018

Visual Perceptual Disorders In Children With Autism D.Williams 2011

Tinted Lenses, Visual Perceptual Disorders and Bridging The Gap Between “Non-Visual and Visual Worlds P.Isaacs 2017

Was Michael Jackson autistic or one of the most famous people with Exposure Anxiety? D.Williams 2009 

Link to Original Article Anna Kennedy Online

Paul Isaacs 2018