Paul Isaacs' Blog

Autism from the inside


Leave a comment

Autism, Walking Gait & Hemiplegia

A Dreamscapter 2016

 

Note this is from a personal perspective

As I have documented before in previous posts hemiplegia is a part of my autism profile which in my case is associated with a traumatic birth, prematurity and brain injury due to a placental abruption.

This affects the right side of my body, which caused me to have problems with the following.

  • Left-right orientation
  • Turning on one side (regardless of where the noise, auditory or tactile stimulus is coming from)
  •  Using the dominant side of body for tasks that involve both sides of the body
  •  Having an unusual/abnormal  gait which involves the right leg stiffening with a lack of bending in the knee and the leg itself rotating away from the other leg

What are the effects of hemiplegia?

It is difficult to generalise: hemiplegia affects each child differently. The most obvious result is a varying degree of weakness, stiffness (spasticity) and lack of control in the affected side of the body, rather like the effects of a stroke. In one child this may be very obvious (he or she may have little use of one hand, may limp or have poor balance); in another child it will be so slight that it only shows when attempting specific physical activities.

Copyright © 2007-2014 HemiHelp

Gait refers to the controlled manner of walking or moving on foot.  The functioning of the nervous system and the musculoskeletal system determines the gait pattern. In children who have hemiplegia, this delicate system is out of balance and often results in different types of gait.

Gait in the Child with Hemiplegia

A child with hemiplegia may have a tendency to walk with the toes on the affected foot striking the ground first, instead of the usual heel strike. This “toe drop” often results in our kids taking quite a few falls and tumbles. In order to clear the toe while walking, the child may develop a variety of ways to compensate, which then result in problems with his hip and or knee.   Treatments may include gait analysis, physical therapy, orthotics, serial casting, botulinum toxin and surgery. The goal of treatment is not to “cure” the condition, but to enable the child to achieve her maximum potential.

© 2017 CHASA. All Rights Reserved.

What has helped me?

I still have residual hemiplegia in terms of its impact on my life and it tends to start when I walk for long periods with associated movements etc. What has empowered me over the years is that same thing that would help someone who has acquired brain injury, a stroke etc which is called “brain gym”.

As an Infant & Teenager

  • Walking in long fields, day-trips and other activities (with the family and school trips)
  • Swimming in the local pools and streams (when I was younger)
  • Cycling from an early age (first with stabilisers and moved on to independent cycling) 

As an Adult

  • I continue to to walk from place to place promoting movement to the side which is impacted
  • I continue to touch type promoting both sides of my body being used
  • I continue to create art

Personality Types & Styles Of Learning

  • Being idiosyncratic and solitary meant that I was empowered by trying to do do things in my own time, my own way  and with a small amount of people so I could get direction
  • Being serious and mercurial meant that I was able to things with a level of focus and with element of free-will and boundary making and making it fun and light-hearted
  • I have a kinesthetic style of learning with a mixture of solitary and social learning

Communication 

  • Exposure Anxiety – Meant that being indirectly confrontational was the best way for me to feel included without the “watching, waiting, expecting” nature of direct contact setting or “retaliation and diversion” responses
  • Aphasia/Language Processing and Visual Perceptional Issues – Breaking down communication into smaller chunks, using gesture, tone, inflection, objects of reference, one topic at a time and one context at a time

Conclusion

Through looking at the different pieces of one’s autism (or autisms) if hemiplegia is apart of the profile it may be worth thinking of different ways to empower the person, gaining confidence and trying out new activities without fear and/or anxiety about getting things wrong but focusing on the little steps as always communication, sensory integration, sensory perceptual, associated personality types and any other issues would have to be taken into account.

 

Paul Isaacs 2017

 


Leave a comment

Living In Half A World – Hemispatial Neglect In The Context Of Autism

Note this is from a personal perspective of having this clustering syndrome 

It was interesting looking at a video I was presenting at an Tony AttwoodAutism Oxford UK earlier this year being “blind” to my right side is certainly an odd/interesting life. 🙂

Definition of Hemispatial Neglect 

Hemispatial neglect, also called hemiagnosia, hemineglect, unilateral neglect, spatial neglect, contralateral neglect,unilateral visual inattentionhemi-inattention, neglect syndrome or contralateral hemispatialagnosia is a neuropsychological condition in which, after damage to one hemisphere of the brain is sustained, a deficit in attention to and awareness of one side of space is observed. It is defined by the inability of a person to process and perceive stimuli on one side of the body or environment that is not due to a lack of sensation. Hemispatial neglect is very commonly contralateral to the damaged hemisphere, but instances of ipsilesional neglect (on the same side as the lesion) have been reported.

Physical Observations

10338674_881821881831690_7870309102355592004_o (1)

The factors that can be picked up is when I speak the right side of my mouth doesn’t rise and fall (giving it a crooked appearance) this also can happen when I smile as well as the eyebrow on the right side not rising and muscles looking lax and frozen.

If look at the picture to your left (left and right are reversed) you can see the difference in brain activity.

Note – the mouth and eyebrow on the side I am “connected with”

Fruit Salad Analogy Copyright D.Williams

Fruit Salad Analogy Copyright D.Williams

Left Hemisphere Brain Injury

Part of my Autism Fruit Salad is brain injury this was no doubt in the womb and compacted by complications such as fetal distress, silent stroke, cerebral hypoxia and placental abruption this would also explain the fact that I am blind to the the right side of my body this also includes

What has helped?

  • Cycling and Riding Bicycles
  • Walking on Different Terrains
  • Swimming
  • Drawing & Creative Activities
  • Hand Writing
  • Tinted Lenses
  • Positive Attitude

Conclusion 

Integration of the the neglected hemisphere could certainly be a start and could help not only with learning and experiencing new skills but also assist in good mental health also. (of course strategies will be very much person-centred).

Paul Isaacs Adult with Autism 2014