Paul Isaacs' Blog

Autism from the inside


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Most Common “Pieces” in People’s Autism “Fruit Salad”

Autism Most Common Image

Donna Williams’ (Polly Samuel) set a legacy in what the adjective “autism” meant it was like a bowl of fruit and different pieces of fruit mean different things in this overview she covered in the image above the most common aspects of someone autism “fruit salad.”

 

 

Social Emotional Agnosia – Not perceiving body language, tone of voice and facial experiences means that person only “sees” and “hears” facts that means that the person maybe socially anxious and may need information shared to them (including emotional supply) in factual/pragmatic way.

Faceblindness – A person who doesn’t recognise people by their faces this means the person may connect more with the what the person is wearing, hairstyles, jewellery, voice patterns, walking gait. context is also an issue such as meeting people and/or getting used to seeing someone one context may not translate to another. You may need to ask them is they struggle with faces.

Simultagnosia – (Object Blindness) – A person who only see’s pieces of a their visual field and not wholes this could mean that the person finds certain environments difficult to navigate, people, places, objects may be hard to track causing anxiety, overload and on the opposite end euphoria and “sensory highs” that is person who is addicted to their own “chemical highs”. Lightening, colours, patterns, colours, stairs (surface changes), shadows will all have an impact on perception.

Alexithymia – A person who does not process and/or perceive their emotions in “real-time” this can cause a reactionary delay meaning the person is always “trailing behind” to some degree and may give surface “responses” rather than “connected” responses. Give the person time to respond.

Dyspraxia & Overload – A person is struggles to motor-ordination issues, the movement of their body and limbs in and around their environment being prone to overload could be due to the brain and bodies movement not being in tandem causing/triggering chemical imbalances.

Lack of Simultaneous – Self and Other – A person who can do either “all self no other” and/or “all other no self” this means the a shared sense of “social” may be delayed and the mono-tracked way of conversing may have to be adapted to allow time between “switching”.

Language Processing Disorder – A language processing disorder can come in many forms and presentations the ability to find words (anomia), the ability to construct sentences (pragmatics) and the ability to receive and express meaning with interpretation some people may be “meaning deaf” (aphasia, verbal auditory agnosia) and need for example object of references gesture and tone and other who are literal in their perception and have atonia may need facts and to limit body language.

Communication Disorders – Some people may get tongue tied, stammer, are “tone-deaf”, have tourette’s, have verbal agnosia and talk through echolalia (TV shows, Jingles, DVDs and TV shows), some people have oral apraxia (the ability to use their tongue and facial muscles) having visual perceptual issues and associated personality types which in turn have an impact on style and/presentation.

Exposure Anxiety – A person who is triggered by direct communication and “exposure” triggering compulsive, avoidance, retaliation and diversion responses meaning that “direct communication” you may need to use a “indirectly confrontational response” such as focusing on the object, situation not the person, humanising objects.

Lack Of Mentalising – The inability to “juggle” information with a level of coherence this could be to do with information processing delays, sensory perceptual disorders, social perception and/or language processing this means that you need to work out the person’s “system” of integrating information with associated meaning.

Personality, Identity and Attachment – This is how the person sees themselves, differing personality types will colour a person’s interpersonal wants and needs and communication styles, sexuality and gender

Mental Health – These associated conditions will have an impact on presentation such as mood, impulse control, anxiety, dissociation and attachment disorders.

Physical Issues – They may have auto-immune disorders, disorders of metabolism, dietary disabilities, genetic anomalies which have an impact on overall functioning.

Paul Isaacs 2018

 

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The Journey To Functional Language

IMAG0083

 

Note this is from a personal percpetive

There is a percentage of people on the autism spectrum who overcome a level of severe language processing disorder. I have been diagnosed with autism in 2010 at the age of 24. My trajectory was a wobbly one part of my autism was brain damage at birth (left hemisphere) which meant receptive and expressive language was impaired this was a RECEPTIVE & EXRPRESSIVE APHASIA, I was sleepy baby and my Mum notices differences at about 6 months old. My language impaction was a mixture of neurological and in early infancy environmental.

I had speech and language DELAYS as part of my language journey this included missing MILESTONES, and then I had TRAUMA which was do with having adenoidectomy and circumcision. I had ORAL APRAXIA which meant that words at times expressively where a jumbled mess. I was echolalic, echopraxia and echomimic TV shows; VHS you name was stored phrases, movements and sequences. I had roughly between 80- 90% meaning deafness up till the age of 7/8 years old. When a level of functional speech which “my own” it felt stilted, “alien” and non-fluent and garnered from my perspective a lot of unwanted attention so I went into bouts of SELECTIVE MUTISM through my late infancy. Visual perception had an impact of PICTURE/WORD association meaning I was largely kinaesthetic due to by object and meaning blind – SIMULTAGNOSIA and SEMANTIC AGNOSIA.

Now as an adult I would say I am residual being about 30-40 % meaning deaf, tinted lenses have helped my make simple but dramatic visual associative contexts although I still struggle to know the difference between a toaster and a bread bin! ūüėČ I someone speaks to quickly, background noise, doesn’t use gesture and/or objects of reference I may well pick up the words but not glue the “meaning” to them.

I have functional speech but it can still tumble and become laboured due to fatigue and residual aspects of ORAL APRAXIA and my social emotional world is tapped into INTROSPECTIVELY through art and poetry. I still live in a system of SENSING the unknown “KNOWNINGNESS” which means that I perceive far more than I know until it is “out there” on paper form then feed it back to myself and understand what is going on! My mind is like confetti but I have overcome many obstacles due to autism, developmental delay, language processing and visual perception.

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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Autism, “Stored Responses”, Language, Processing Delay & Unconscious Thought

Language Processing Delay 2017

Note This from a personal perspective 

Conscious and Unconscious Processing 

The problem even though I have progressed in many areas is switching between conscious and unconscious patterns of thinking, this in term has an impact on my ability to keep with incoming information in this case verbal, the ability to think consciously about what how to answer and also gauge the emotional significance of it.

“Stored Responses” & Unknown Knowing

I have come to realise that have rapporteur of “stored verbal responses” which come out at moments when I cannot process information in real-time these can look sometimes stilted, disinterested or “vacant” this is because I have level of social-emotional agnosia due to visual perceptual disorders and receptive/expressive language disorders as a result of aphasia. ¬†This jutting between a conscious response and conscious¬†acknowledgment ¬†when most of my thought process’ that are “connected”¬†in unconscious states means I now looking at ways of trying to marry my thoughts in a more connected manner this comes through typing in which the information I type hasn’t consciously gone in and unconsciously comes out as Donna puts comes as a surprise to the person in question as it may do to the people around them.

“Being” and “Sensing”

Donna Williams explains how the senses of a person with autism work, suggesting that they are ‘stuck’ at an early development stage common to everyone. She calls this the system of sensing, claiming that most people move on to the system of interpretation which enables them to make sense of the world. In doing so, as well as gaining the means of coping with the world, they lose various abilities which people with autism retain.

I can exist in state of being for hours on end that is were my process’s lie I observe without a conscious “knowing” or “interpretation” of what is going on around me as the however on an introspective level it is being so. I connect far more broadly and deeply through touch and texture. I am primarily a kinesthetic thinker/processor.

Being A Silent Observer

I have observed the world “silently” however I wasn’t really “silent” in the literal sense speech was not only delayed but late to be functionally meaningful, words swilled in my mind however grasping them for context and meaning was a struggle to say the least as I grew into later infanthood my verbal speech impinged on my jutting my conscious thought with “sounds” that did not represent the “inner world” I resided in. ¬†I am solitary and idiosyncratic and that has no doubt coloured my perceptions as much as the other part of my “autism fruit salad”.

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  РVERBAL 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  РVISUAL 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  РANOMIA (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. ūüôā

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. ūüôā

Paul Isaacs 2016