Paul Isaacs' Blog

Autism from the inside

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Placental Abruption – Part of My Autism Profile

Premature 1

Placental Abruption 

This a personal account of these issues, my development and my autism profile.

My mother and I where both in distress during her pregnancy – I was born premature and was born via cesarean section  and my Mother suffered heavy bleeding as a result of what is called placental abruption.

“Placental abruption happens when there is bleeding behind the placenta, between the placenta and the wall of the uterus (womb). This may be just a small amount of bleeding. But if you have a large amount of bleeding, the placenta may partially or completely separate from the lining of your uterus before your baby is born.”

Left Hemisphere Brain Injury & Oxygen Deprivation (Hypoxia) 

“25% of babies who experience hypoxic/anoxic injuries at the time of labor will have permanent neurological problems.”

© 2014 Birth Injury by Becker Law Firm, L.P.A. All rights reserved.

Aspects Of My Birth 

My Autism profile consists of many speech, language, perceptual and developmental delays  which includes

  • Speech Delay (non-verbal 5 year approx with speech regression)
  • Motor Coordination Delays (crawled with one arm and didn’t start walking until 18 months old)
  • Language Delay (gained functional speech between the ages 7/8 years is that of a 3 year old developmentally)
  • Learning Difficulties (dyslexia, dyscalculia, dysgraphia)
  • “Mild” Learning Disability
  • Visual Agnosias (simultagnosia, semantic agnosia, prosopagnosia, visual-verbal agnosia)
  • Auditory Agnosias (pure auditory agnosia, verbal auditory agnosia, receptive and expressive aphasia)
  • Body Agnosias (finger agnosia and visual-spatial dysgnosia)
  • Hemispatial Neglect (related to brain injury, left-handedness, left-right confusion related to Gerstmann Syndrome)


They also come into play because there are such things as genetic based agnosias, processing issues and learning difficulties which can be passed down from generations to generation (although the fashion in which this is done is highly variable) the cross over with other profiles seems to be there and commonalities are present in some of the conditions such as.

This However Doesn’t Affect My Character or Personhood

Every person is on a journey of self discovery and revelation this doesn’t make me feel sad nor isolated in anyway quite the opposite I’m still “Paul” and all that in entails these aspects of discovery are the trajectory of my development, my learning, my language, my visual processing etc. They are apart of me but don’t ultimately define – I’m still creative, eager to learn, eager to live and with the set of cards I have been dealt I will use them ultimately to the best of my abilities. Hope springs eternal. 🙂

Special Thanks to Donna Williams & Dr Manuel Casanova

Paul Isaacs 2014

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Why I Didn’t Point as A Child Finger Agnosia & Autism

Dad and I Butlins 1991OVERVIEW

About Josef Gertsmann

As I child even in my early development I didn’t point and one of the reasons for this was Finger Agnosia (which also part of Gertsmann Syndrome which I have as apart of my Autism Fruit Salad). I had no idea that on the end of my palms where digits which I could use as a from of communication because I was “blind” to them so what helped me “recognise them”.

This is a personal overview and from my experiences

  1. Sensory Exploration (scrunching leaves, touching environment, painting with my hands)
  2. Sensory Play with Dad
  3. Pens and Pencils (giving me an awareness of through grip/pressure)
  4. Riding a bike
  5. Learning to get dressed
  6. Swimming

Paul Isaacs 2014

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A Syndrome Within My Autism “Fruit Salad” – Gertsmann Syndrome, Visual Agnosias & Premature Birth

Me at 6 Months Old With My Teddy

Me at 6 Months Old With My Teddy

Note this a personal perspective of Gertsmann Syndrome in the context of Autism

“Paul was the product of a premature delivery and was considered a very small baby when born. Some physicians would consider the fact that he is left handed a possible sign of brain damage from his premature delivery. As other autistic individuals, Paul had delayed language acquisition, an atrocious handwriting, and a possible learning deficit. The commonality of all of his signs and symptoms is what both Paul and Donna Williams call a “fruit salad”.” 


This is part of Dr Manuel Casanova‘s wonderful review of my book this takes into account which part for my brain were affected left hempshire neglect right brain dominance that is where the Visual agnosias occipital and temporal & lobes are Simultanagnosia,Semantic AgnosiaAuditory verbal agnosiaAphasiaAuditory agnosia the left side of the brain the semantics of auditory, visual information is as well as communication (expressive and receptive).

Premature birth and a silent stroke  & lack oxygen with genetic factors  contributed to acquiring Gertsmann Syndrome

Gerstmann syndrome is characterized by four primary symptoms:

  1. Dysgraphia/agraphia: deficiency in the ability to write
  2. Dyscalculia/acalculia: difficulty in learning or comprehending mathematics
  3. Finger agnosia: inability to distinguish the fingers on the hand
  4. Left-right disorientation


So do I have an Autism profile as to an opposed Aspergers? Yes. Are Autism and Asperger Profiles different? Yes.

Can people have mixture of Asperger and Autism Profiles meaning they can relate visual agnosias and literal processing of language (for example) Yes.  Donna Williams calls them Aspinauts.  Autism is a very diverse spectrum indeed. But one should never forget their personhood. 🙂 

Paul Isaacs 2014

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How Donna Williams’ Fruit Salad Analogy Has Helped Me – And It Can Help You To

Paul Baby Picture 1986



It is not very often that somebody comes along and gives you the tools of understanding the whats? and the why? But I can honestly say that Donna Williams has done that for me and so many others on the Autistic spectrum over many years, empowerment is to give someone the confidence and ability to take hold of their life, understand their abilities and disabilities. I first saw Donna in 2008 at a conference in Oxford and we have been friends on Facebook and she has on a personal level helped me understand the “mechanics” of my Autism which I shall be forever grateful for her help, kindness and assistance. She has taught me a lot of things about keeping it real and not forgetting that Autism is APART of you and not the WHOLE of you. 🙂 Thanks Donna.

This model is lateral and takes a holistic open-minded approach to autism what is, this model is person centred and is for empowerment and positivity. 🙂


Fruit Salad Analogy Copyright D.Wiliams

Fruit Salad Analogy Copyright D.Williams

The Fruit Salad takes in all aspects of the person’s profile this includes

  • Information Processing
  • Identity and Personality
  • Co-Morbids
  • Environment
  • Learning and Communication Profiles




Paul’s Autism Fruit Salad (Updated 2014)

 Expressive Agnosias

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


Visual Agnosias

Auditory Agnosias/Aphasia

Body Disconnection

Dissociative Disorders – Recognised  in 2012/Revised 2014

Mental Health

Learning Difficulties



  • Bruxism – Teeth Gnashing
  • Genetics – Developmental Agnosias

Syndromes – Which make up a large part of my “Fruit Salad”

Paul Isaacs 2014

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Autism Isn’t One Thing – Donna Williams “Fruit Salad” Analogy


Me at 6 Months Old With My Teddy

Me at 6 Months Old With My Teddy


Donna Williams and I have been sorting out the origins of our Autism Fruit Salad – and this is interesting I must say so here goes –

What Syndromes Make My Autism Fruit Salad? (Fruit Salad Analogy Created By Donna Williams 1995/2005)

My “Autism” is comprised of 5 separate “syndromes” and interrelating “cluster syndromes/conditions”.

Thank you Donna for all your help. 🙂

Donna’s Fruit Salad/Diagnostic History Link



I had a distressed birth and was premature this was due to these factors, Jaundice, Cerebral Hypoxia (lack of oxygen to the brain), Brain Injury (as a result of Hypoxia) and a what is termed a Silent Stroke – In my first book I talk about my mother’s concern as I used one arm to move around the sitting room floor this certainly is associated with not only developmental delays in motor functioning but associate brain injury/stroke.

Brain Injury Related Agnosias 

Auditory Agnosias 

Pure Auditory Agnosia
Language Auditory Agnosia (Meaning Deafness)

Body Disconnection

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


  • Echolalia
  • Echopraxia
  • Echomimia
  • Palilalia

Genetic Related Agnosias (From Family)


This is something that Dr Manuel Casanova recognised after reading my first book that I had left hemisphere neglect (I was was left handed), had problems with left-right, Dyslexia, Dyscalculia, Dysgraphia, and Aphasia and Finger agnosia.


Problems with depth perception, headaches, “mapping visual space”, visual fragmentation, overwhelmed (euphoria) by colours, textures and patterns – associated with Dyslexia, Dyscalculia and Dysgraphia.


Depression, Anxiety, Dissociative Disorders, Sleep Disorder, Synesthesia and Tic Disorder 



By Sorting out ones Autism “Fruit Salad” can give a sense of completion I believe these last 48 hours have done that.  By sorting all the bits, the whys and hows etc. You can adapt your learning style, communication style, body mapping style, integration style and more. This is truly a postive for me and it can be a positive for your you.  Once you know all this you can be one with your personhood.

Paul Isaacs 2014