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Autism from the inside

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Asperger’s Syndrome & Classic Autism? Or Left Brain, Right Brain Autism “Fruit Salads”?

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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


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



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:

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
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.

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.

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 effected.

What I am not saying (and never will say) is that I am speaking for all that would be disservice to many peoples 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 2017


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Future Diagnosis’ – A Further look Autism and Asperger “Fruit Salads” & The Inner Mechanics

The Changing Landscape of Autism Diagnosis

Looking how the scope of how the autism diagnosis has changed over the decades here is an overview

  • 1940s and 1950s – Autism was considered a form of attachment disorder
  • 1960s – Autism was considered a form of “childhood psychosis”
  • 1970s and 1980s – Autism was considered a form of mental retardation
  • 1990s – Asperger’s syndrome was added as a diagnostic criteria
  • 2000s to now – Autism and the impact of sensory integration issues

The truth is autism is has different trajectories and components it is best to look at autism as 3 dimensional a stacking of pre-existing syndromes/conditions/disorders that are person-specific.

So let’s look at the breakdown between “Autism” and “Aspergers” Fruit Salad looking at through the lenses of Donna Williams’ analogy.



Autism “Fruit Salad”



Aspergers “Fruit Salad”





On the surface “Autism” and “Aspergers” may appear the “same” but digging deeper and looking at the profile differences and what makes up the differing profiles surely means that the wants, needs and interventions will be specific to the person in question and what they need will not be the same. Autism is not a generic “one size fits all” condition it is made up of many different elements specific to the person.

It is my wish that in the future when some is diagnosed with autism they will look a the full package this would include potentially different professionals being involved if differing diagnosis are willing to be made such as –

  • Speech and Language Therapists
  • Neurology Specialists
  • Dietary Specialists
  • Genetic Counselling
  • Gut, Immune and Metabolic Specialists
  • Mental Health Psychologists & Psychiatrists
  • & Other Empowering Interventions


Paul Isaacs 2017


Minor Facial Anomalies (Dysmorphisms) in Some People With Autism

Note This is from personal observation and doesn’t represent all people on the autism spectrum and facial anomalies affect a percentage of people with autism these are from personal, parental observations as well as a contribution by Dr. Emily Casanova and would need to see a dysmorphologist  but just from general observations certainly my eyes, philtrum, nasal bridge have particularities.

Looking back at some of the pictures in my youth and reading the studies it is interesting draw conclusions of these variants in facial structureReception. Here is some text from the article in a study on the subject in 2012.

 The study found children with autism had wider eyes, and a “broader upper face
,” compared with typically developing children. According to the study, children with autism also had a shorter middle region of the face – including the nose and cheeks – as well as a wider mouth and philtrum, the divot above the lip and below the nose.

The study also found that children with more severe autism traits such as behavioral problems, language difficulties, and repetitive behaviors had distinct facial differences from other children with milder autism.




Baby Pictures High Chair

Broader Upper Facial Region (Forehead & Shallow Nasal Bridge) 1

Baby Pictures Deck Chair I Year Old

Broader Upper Facial Region (Forehead) 2

Paul 1996 - 7 1

Wider Upper Face (Wider Set Eyes) – Looking at some pictures in my early years I do have a wider mouth, wider set eyes and also a broader upper facial region (notice in this picture right eye is slightly misaligned and the left is looking straight ahead). This photo was taken in 1996.

Me Toddler

Shorter Mid-Face Region 1 (Nose, Cheeks & Philtrum) I also have a shorter middle region of the face this includes the cheeks and nose region as well as the neurological effects of mild brain injury and visual perceptual disorders (notice the left eye is misaligned and inverting outwards while my right eye is looking straight ahead). This photo was taken in 1990.

Toddler 1

Shorter Mid-Face Region 2 (Nose, Checks & Philrum)  My philtrum I would say is somewhat wider (but not overtly noticeable) and shallow you can see a shorter mid face region (nose and cheeks) giving my face a “squashed” appearance. (notice eyebrow misalignment)  This photo was taken in 1990.

Scarf and Braids

As my face has grown some of the characteristics are still “there” just not as noticeable and would certainly consider them minor anomalies  in that context. I do notice in this picture a shorter mid-face region between eyes and upper lip, wide mouth and philtrum to some degree, residual effect of mild brain injury with asymmetrical smile. This photo was taken as adult in 2010s.

Eye 1

Eye 2

Shallow Philtrum

Profile Shot 2016

Premature Birth & Left-Handedness

In the book the “Left-Hander Syndrome” by Stanley Coren he concludes that potential birth difficulties such as trauma, foetal distress, c-section section (to name but a few) can contribute to people being left handed also rare physical characteristics such my case two ears noticeably  different heights on the head. This conclusion in my case is clear that a part of my “autism fruit salad” and that the complications of brain injury and handedness (such as language aphasia, simultagnosia, semantic agnosia etc) has had an overall impact on my development as well as psychological mood, anxiety disorders as well as depression.


“The findings of that paper only seem to apply to a minority. I wouldn’t necessarily say you fit the results. However, just at a cursory glance, your childhood pictures do seem to be mildly dysmorphic. Shallow bridge to the nose, epicanthal folds (which are due to underdevelopment of the bridge of the nose), mildly downslanted palpebral fissures, possibly a shallow philtrum but hard to tell just from photos. You would have needed to have measurements done. The spacing of the eyes would need to be measured, because the appearance of the bridge of the nose can give the illusion of different spacing of the eyes. Have you ever been genetically tested? It’s not a bad idea.”

Observations of pictures by Dr. Emily Cananova which have been noted by my parents I certainly have larger “doe eyes”, a wider mouth, smoother philtrum – still a human though! 😉

Other Blog Pages On The Subject

Autistic Facial Characteristics Identified

FASD, Autism and neurological challenges

Paul Isaacs 2016


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“Autism” – It Is Different For Everybody

“Autism” what is it?

Fruit Salad Analogy Copyright D.Williams

Fruit Salad Analogy Copyright D.Williams

Autism is word for a clustering of different co-conditions that come together to create the “presentation” and therefore when one uses the word “Autism” it should be specific it what that means for the person themselves and what the “mechanics” are no one is the same so why should one condition mean that everybody has the same viewpoints? Profiles? Processing issues? and outlook – realities and perceptions.

Stereotypes – Are They Damaging?

If a “one size fits all” perception of autism then yes – it will affect outlooks, mental health, interventions, motivations, opinions (created and/or forced) not all people on the autism spectrum are logical, literal thinkers/processors, not all are visual thinkers/processors and everyone on the spectrum has their own unique wants, needs and aspirations it not about setting someone up for a fall or failing to recognise a person because they don’t “fit in”.

Lines Culture or Created Culture?

Anybody can create a culture it can start off with an ideal and/or ethos that then becomes reality – I don’t believe that autism is a different culture and never have done. What I do see is a culture being created around autism. Which is a different thing altogether.I am all  and firmly for equality, humanity, humility and happiness. And for people on the spectrum (like everyone else in the world) to have an equal shot at life and have opportunities.

What I am not for is false prophets, venomous politics,  militancy (from culturists and curists) – I prefer to be neutral and through that you can see both sides in balances democratic manner, selfishness and so forth all voices have a right to heard, acknowledged and recognised – disagreement is fine but at what point does one go too far? I have made this point in previous blogs that I think that the autism world will eventually implode on itself and how many people on and off the spectrum suffer as result? Just because they didn’t “tow the line” or “say the right things” Will it be just the same sycophancy? Or will all (people on and off the spectrum’s) view’s be heard? I wonder? Let’s stop the man-made barriers and start listening to ALL peoples views.

I am not angry but I am upset – not really for me but for the others who will be affected.

Paul Isaacs 2015



There Is No Collective “Sameness” In Autism The Profiles Are Person Specific

Lindsay Meetup 2014 Hi-Def4Autism & Identity 

Autism is a developmental disability which has an effect has and effect on a person’s functioning in various different areas of functioning. It is a diverse in its presentations, profiles and most in importantly the “mechanics” in other words what is different parts of the “clustering”.

Identity could be to to with the politics and culture that has been created around the Autism & Asperger’s Syndrome they are words for an overview of specific profiles and presentations. I don’t believe that autism is a culture at all. We are all human and cultures are created around “things”.

Autism & Asperger’s Syndrome – Profile Differences

Observations and studies 

Observations from autism consultant Donna Williams and also a recent study in 2011 shows structural differences from a neurodevelopmental perspective within different areas and regions within the brain. This I feel is important not only for people on the the spectrum but family members, teachers and other forms of support for the individual in question.

It is about personalising the support. There are of course people within who have both an Aspie and Autie in terms of mechanics which shows have fluid presentations are.

Autism Rather Than Asperger’s? Why? 

This isn’t specifically to with with my identity (I see myself as a person first( at all and isn’t said the intent to annoy or aggravate people neither. When I say “I have Autism rather than Asperger’s” I am talking about mechanics (what makes up my autism) and my formal diagnosis and differences which are apparent to me and how important it is to know them from this perspective. I have written many blogs on the subjects.

Why I have Autism Not Asperger’s Syndrome  

Why I Have Autism (Rather Than Asperger’s Syndrome) And The Importance In The Differences

Autism – No One Person Is The Same 

Autism is a clustering of pre-existing conditions that build up the person’s profile’s and presentation’s –  there is no “sameness” in that everyone on the spectrum is the same or share identical characteristics. I destian from using “us” and “we” language (single representation) and also “them” and “us” language. (people with autism and people without) Firstly because it is inaccurate to do so, secondly the only perspective I have is my own that is it and thirdly as an autism advocate that is a professional responsibility that I take very seriously I will not adorn to the status quo just because “that’s what is people want to hear”. I cannot speak for everyone that would not be right and potentially damaging.

Lets start being person-specific about profiles not generic, generalised and batting out stereotypes that can make people feel isolated or worse.

Toddler 1The Lost Voices – More Inclusion Needed

Everybody deserves and has a right to talk about their experiences – one could argue it is human right what has concerned me is the political militancy that I have observed on social media. I wonder how many more people are going to be hurt? I hope that is stops and people start listen – because sadly voices (valued perspectives) are going to be lost through bullying and silencing.

I have written this before but I feel inclusion is for everybody 

  • People with Autism and Learning Disabilities
  • People who Are Functionally Non-Verbal
  • Views and Perspectives From The Whole Spectrum (Different Cultures & Backgrounds)
  • Parents, Carers & Guardians
  • Autism Specialists
  • & More

Paul Isaacs 2015


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Neurodiversity – Sometimes Things Have To Be Questioned

Dr Casanova

Dr Casanova

I have a lot of respect for Dr Manuel Casanova and this a very revealing blog about the subject of neurodiversity and what it means – it is my opinion that no one person can “represent” autism just because they themselves are on the autism spectrum.

I Can Only Speak About My Reality With Autism

I make professional and moral judgement to say this is my profile and that is the ONLY place it is coming from (I can’t speak for others on the spectrum) – I say “I” and “me” not “us” and “we” in speeches (again I cannot speak for everyone on the spectrum that doesn’t make sense).

I don’t believe autism is a “culture” either (I am apart of the human race) and I think we need think about what is projected and who is losing out? Is it people who don’t tow the line, fit the “stereotypes” are not seen as good advocates because of their “functioning”. I wonder? I know we all have a story to tell? But is it right for someone to tell their story on everyone else’s behalf?

Empowerment & Acknowledgment Of Multiple Realities Of Autism 

Autism is a “Fruit Salad” it is not one thing, it isn’t one syndrome and it affects people in different ways so what Manuel is advocating is that the more realities we acknowledge and listen to the more understanding we have – their should be no single representation because the voices get lost, realities can form into assumptions and they are both dangerous and can make people feel isolated and alone in their struggles.

Autism As As “Fruit Salad” & Breaking Down “Stereotypes”

Fruit Salad Analogy Copyright D.Williams

Fruit Salad Analogy Copyright D.Williams

As Donna Williams analogy points out “Autism” is not “one thing” it is a clustering of different pieces that create the person’s on unique profile and presentation that means that logically no one person is the same on the autism spectrum, therefore realities within autism are different and people on the spectrum are not all the same, nor do they have same needs, desires or aspirations. I will take that one step further and say if someone got up on stage and talked about “non-autistic syndrome”  and made the assumption every one with this syndrome is the same we would be in big trouble.

The Whole Spectrum & Personhood 

I am for one agree and for empowerment, inclusion, diversity but that must be inclusive to the whole spectrum of “Fruit Salads” and the realities within them and seeing someone’s personhood is very empowering.

People With Classic Autism and/or Learning Disabilities & People Who Are Functionally Non-Verbal (Who Are Empowered By Different Forms Of Expressing Words 

Looking at the whole spectrum means looking at different profiles and presentations and the firm empowering inclusion of people with classic autism and/or learning disabilities and people who are functionally non-verbal. Sometimes I worry that people with these diagnosis’ (who are considered to have an “exotic” or “atypical” presentation) and profiles don’t get recognition or heard. They are competent folk who need support too and their realities should be explored and recognised. They deserve to have voice.

Parents Views

Parent’s views are very important too and explorations of different ways to empower, support and help their children is also needed.

Autism “Politics” 

I stay neutral and balanced like I point towards being a moderate in my views on autism accepting the diverse, different realities and people’s stories and what their own personal experiences are (be that a parent, guardian, person on the spectrum etc) all are valid.

I have said before that I’m not a “curist” and I’m not an “ableist” but a “neutral” because I believe everyone has a story to tell without going to unhealthy extremes if we listened with our hearts we would learn about each others experiences.

Other Blogs On The Subject

Please Include Everyone On The Autism Spectrum, Listening Is Positive & No One Person Can Speak For Everyone On the Autism Spectrum

Listening & Hearing Everyone’s Views In The Autism”World”

Paul Isaacs 2015


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What A World Before “Typical” Interpretation Means To Me

Note – This is from a personal and developmental perspective 

I have been writing for many many months now about my personhood and my developmental disability and how they interact – interjecting, unraveling and pinpointing different aspects of it hopefully helping anybody who connects with it. I world before meaning let’s start with that.

Sensory ExplorerWhat Is Meaning?

Visual, Language Processing & Auditory Information

That means for me when sounds what ever they are (words or in the environment) have limited and/or no origin and the origins are not there in an instant nor is the the association so it has to be found in a different way.

For me things have to be touched in order to have meaning (my visual field is far too fragmented to get make that sort of instant connection) experienced through tactile association. Information and words have to be brought to life through gesture, elevated and exaggerated tone, movement and objects of reference like sculpting a piece of art giving meaning and connectivity.

They Way I Process

I don’t live in a world of logic, practical semantics or pragmatics nor do I work out the world that way. I create but I don’t have a vast cognitive landscape things for me have to be more refined.  My emotions come more through my movements more than my words (although I can use both poetry to extract) I like things that don’t require any complicated reasoning or explanation.

Sensory Explorer 2Such as 

  • The roughness of bark
  • The texture of moss
  • The feeling of swimming colours
  • The movement of the water
  • Sounds and words that don’t have an origin but sound and feel nice
  • Sculpting faces
  • Patterning movements

Autism & Asperger’s Profiles

I have Autism and knowing to difference between an Autism profile and a Asperger’s is needed in order to understand the mechanics but never over invest or over define a person by their condition always remember personhood is something people all share. If people keep thinking and educating that autism has one profile, one look and one method of using interventions then we need to listen and be more inclusive. 🙂

Paul Isaacs 2014