Paul Isaacs' Blog

Autism from the inside


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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 clamed 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 2018

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Autism & Living With The Fallout of Language Processing Disorder

Note – This is a from a personal perspective

Early Years & Its Relation To Language Development

I was born in 1986 and with the impact of a premature nervous system, brain injury due to complications of a placental abruption, cerebral asphyxia/hypoxia, fetal distress which caused in turn issues with visual perceptual disorders – rendering me object, meaning and context blind and due to the left hemisphere injury receptive and expressive language processing disorder. The picture below is on me not long after I was born signs of being premature are evident by the colour of my skin which is jaundice, fisted hands are sign of the nervous system being impaired. My Mum also noted that I was sleepy baby a common factor in babies who have the sort of start to life which I did.

Premature 1

Overall I started to speak (with no build up and “missing milestones” look above) and non-verbal until 1989 saying three words, then from 1990 onwards I regressed and lost skills in verbal language this persisted in me being non-verbal so from pre-school onwards slowly I made monolithic sounds and was saying “loo-loo” (meaning “water”) I was non-verbal from birth 1986 until 1989 then from 1990 until 1992. I then gained functional speech between the ages of 7/8 1993/94 (of a 3 year old developmentally).  – Paul Isaacs’ website 

 

A “Language” Of My Own?

My first three words where included “nan” which I used say in big long streams over and over again I liked the sound of it rather than making the “connection” that the word had and associate relevance with regards to a title of a family member. The words was “f**k” which was used for the same purposes as above however the social emotional aspects for both my parents in terms of embarrassment and parental judgement was high. The next has a level of context it was “loo-loo” which was going to toilets and flushing them – I was addicted to my own chemical highs when looking at the water as it flushed flicking my fingers.

Paul 1995 - 1

Inner Words

Words and sounds swilled around my head but nothing was tangible nor meaningful with anything the additional problems I faced meant that I had problems with processing speech but also at using it at at functional level of understanding or comprehension. Looking back I was trapped in a body that wouldn’t obey my commands my verbal wants or needs at the same time (the conception of “knowingness” wasn’t there in many respects) so not only did I have speech delay but severe language deficits that ran well into late infancy. Living a world before typical meaning was in itself a cage I didn’t have  language in head for many years it was kaleidoscopic, fragmented, ethereal and non-descript. In mid infancy I felt a frustration when words were expressively produced in manner which was clipped, stunted and not correct I remember feeling frustrated and detached. I believe words were within me but they the grip to get them is really beyond words to describe, but my parents always knew that they were within me. Paul Isaacs’ Website

Fast Forward To Now

Although I have gained a level of functional speech and many aspects of my “autism” would be in the residual range in terms of trajectory I still have challenges in these areas

  • Receptive language when people are speaking for larger lengths of time and/or people speaking in the background along with and/or including environmental noise.
  • I “sense” more than I consciously “interpret“.
  • I mentalise through “remembering” through placement, movement, texture and smell etc
  • I learn through being shown rather than being told.
  • Expressive language can become tiring when I begin to “lose words”.
  • Tinted lenses have helped me bring my visual world together but my “visual receptivity” is still in its infancy when it comes to a social-emotional context.
  • I type “feeling speak” far better and introspectively than I can verbally.

Paul Isaacs 2018


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“Idiosyncratic Language” & “Stored Language Responses” in Autism

Interpreative Languuage 2017 2.png

Note this is from a personal perspective

Sometimes language in terms of interpretation can be difficult to “use” and “explore” however it may not be a true representation of the “inner world” the person is living in.

Words could come out stilted, mixed up and not in order and if the order is there it may take a lot time to form and lead into a strand of information. When my language was in its earliest “fruits” it was mixture of echolalia which I got from movies, sounds, movements, pitches and dominated my mind but trying to learn “interpretive language” was  “forced” and came from a  “stilted “place”.

  • Give the person time to process the information if the person has a level of Aphasia, and/or Verbal Agnosia
  • Allow time if the person has a level of motor coordination issues such as Oral Apraxia, Body Apraxia and/or Body Agnosias
  • Try using Gesture, Tone, Inflection and Objects of Reference
  • Understand were the stored language is coming from – Exposure Anxiety, Problems with Integration “self and other” in conversation, Body Related “Highs”, Mood, Anxiety, Impulse Control, Selective Mutism and/or Emotional Regulation 
  • See the Person First and Presume Competence

Before functional speech it a swill of verbal and visual information that I could not grasp nor mentalising in a fashion which was tangible my “inner world” was very much there but is was struggle to get it out I didn’t have a lot words to use in my mind as it was endlessly swirling and as I got older (before my later infant years) I was slowly building a firm repertoire of words and has a lot I want to say but couldn’t.

When functional speech came at the around the ages 7/8 the it was expressively of a three year old (in developmental, content and constructional presentation) however this “voice” that seemed to be more “fluid” scared me and frustrated me at the same time as it still didn’t represent my “inner world” I was torn between complex stored responses the basics of “interpretive speech” and wanting to cut off from verbal speech altogether not being able to “hold” mental images of words also delay many aspect of my language but painting and drawing in many ways we’re a creative and communicative effort it created a bridge.

I certainly did not have a Asperger trajectory when it came to expressive and receptive language and getting the point of verbal and contextual significance so when I get tired and my language processing goes down. 

  • Speech will become slower and fragmented
  • I will have consciously find “interpretive speak” words
  • Sentence construction and word placement will be mixed
  • I will get “stuck” on a word and/or sentence focusing on how it sounds

I still type more words than I verbally “speak” however I am grateful that I can and I try and use it to the best of my efforts in fact typing has allowed me to express my emotions with much more clarity, cadence and deepness.

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

paul-amber-2002-3Note 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 and it effects me with I tired my words get stuck like a “blockage” and I have to consciously “find” the words which seem almost on “there” but disappear leaving 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 and mentalising (organising) and 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


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My Language Development – Receptive & Expressive Aphasia & Visual Agnosias

IMAG0083Note this is from a personal perspective

Overview 

Yesterday I presented a speech on my life with autism afterwards I had an interesting conversation with a lady who specialises in aphasia and language development so I thought I would go through my language trajectory.

Speech & Language Delay

I had both delays in speech and language acquisition this means that I was missing milestones on both these areas of language development – this was noted by my parents during those early years of development and I didn’t a level of functionality to my speech until late infancy.

Receptive Aphasia

This meant the the language of “the world around me” was a garbled tumbling mess that was feel of noises, inflections but not “meaning” in the typical sense at times I would be interested in these “noises” perplexed, intrigued even but it was very much a swirling bottle neck with the words being at the deepest part of ocean within the sea-back grasping yet not.

Expressive Aphasia

When expressive language did present itself it was not at the level firstly of my chronological  age and secondly what coming did not reflect what I wanted to say to people around me so there was quite rightfully and frustration there as words would “drop” both receptively and expressibly sentence construction, “word-finding” and neologisms which came in the form of echolalia was present and having created my “own language” (pattern, them and feel) before typical  interpretative language and unpicking that was difficult. As I have said I had before I had “words” within my head but grasping them, finding them and using them was being “blocked” by other factors.

Conclusion

Looking at my overall trajectory would say that I had global anomic aphasia coupled with additional difficulties created by the visual perceptual disorders and oral apraxia.

OVERVIEW OF APHASIAS 

Visual Agnosias, Simultagnosia & Semantic Agnosia – Related to Anomia

The word finding aspects I can split into two aspects firstly the nature of aphasia itself and not being able to use word retrieval and secondly the perceptual disorders (visual fragmentation, visual semantic problems) and not having “visuals” for words meant that making tangible and “concrete” associations was difficult.

I had to use a lot of tactile-associative strategies sniffing, rubbing, mouthing and sculpting my “external reality” in order to get a aspect of meaning I still very much “live in a world” before the literal so significance and bridging the gaps are important to me.

This meant that perceiving objects, people, faces was one aspect verbally being able to name them was another aspect of language which I found difficult.

Oral Apraxia 

I had this which layered the impact of speech production the use of my tongue, mouth, jaw and having a level of “disconnect” between the “words”, the “mind” and “body” not acting as team and going on there own path this caused difficulties in expression this carried on for many years and was notable present in observations of me at a CAMHS assessment in 1996 for at that time clinical depression.

Residual Issues Still Present? 

I would say the are in particular when I am tired this is something I have become more aware of as I have researched and got older so this means that sometimes my expressive speech can become laboured, slow and I can miss out words in sentences and struggle with “word-finding” etc. What helps me is music, gesture, tone, placement, telegraphic language and objects of reference to gain the firstly and foundation and then secondly meaningful association. However as always I continue to live life, experience life and enjoy life as much as possible with new experiences, friends and creativity 😉

Paul Isaacs 2016