Paul Isaacs' Blog

Autism from the inside


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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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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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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 ūüėČ

Paul Isaacs 2016

 

 


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Emotions, Words and Speech Production In The Context Of Autism

Paul 1996 - 7 2Note РThis is from a personal perspective 

The Landscape of Words

Speaking and going on and on for the one’s sake not knowing the beginning where it started nor where it ended or ¬†were it should end the internal cluttering coming from within me like a tidal wave of phonics being spurted out in a “scatter gun” approach the receptive sounds coming into my consciousness ¬†– I had a speech and language delay (I had no coherent words in my head until I was 7/8 years old) and the words are still whirling trying to pin point meaning, context, relevance, need, want, substance, creativity, what the other person wants, what I want it doesn’t always fit it at times is ¬†lack of coherence a kaleidoscope of feelings with no visual basis or formation. I will always try and have a go and feel by trying it is giving me more opportunities ¬†to integrate and connect.

Logorrhea

In psychology, logorrhea or logorrhoea (from Ancient Greek őĽŌĆő≥őŅŌā logos and ŠŅ•ő≠ŌČ rheo “to flow”) is a communication disorder, expressed by excessive wordiness with minor or sometimes incoherent talkativeness.

Sometimes I talk and talk but it doesn’t mean I understand or connect with what I am saying (the expressive function) and also the I don’t always process what the other person is saying (receptive function) this is in context is to do with with aphasia and the “cluttering” of language based auditory information. This is reflected in the content and the way in which I am expressing the information at the time.

Thought Disorder

In psychiatry, thought disorder (TD) or formal thought disorder (FTD) refers to disorganized thinking as evidenced by disorganized speech. Specific thought disorders include derailment, poverty of speech, tangentiality, illogicality, perseveration, neologism, and thought blocking.

Derailment

In psychiatry, derailment (also loosening of association, asyndesis, asyndetic thinking, knight’s move thinking, or entgleisen) is a thought disorder characterized by¬†discourse consisting of a sequence of unrelated or only remotely related ideas. The frame of reference often changes from one sentence to the next.

In the context of how I process words and my own emotions which is a condition called alexithymia (I connect with gesture, movement, tactile feeling, textures and tastes) my thoughts are buried beneath many hidden levels this can lead to thoughts ebbing and flowing from within me with multiple things being said from different areas. The irregular retrieval means that I always trying to find words for emotions and the emotions come first so it happens in reverse causing the issues stated above also.

Conclusion 

I will continue to try and find the things within me that connect with being human which make me feel inclusive, connected and integrated with the world around me using the tools i have learned to the best of my abilities. ūüôā Poetry from a personal perspective has helped me with these processes of word formation and emotions. ūüôā

Paul Isaacs 2014


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Visual Perceptual Disorders In Autism & Not Thinking In Pictures

Me On My OwnUnderstanding, Processing Visuals & Typical Interpretive Language 

Note this is from a personal developmental perspective 

For someone like me who got diagnosed with Autism in 2010 and later in Scotopic sensitivity syndrome with Visual agnosias (object, meaning and face blindness) as well as Visual-Verbal agnosia (comprehension blindness) and associated learning difficulties this is what I can relate to – I had oral apraxia compacted by auditory and visual processing disorders I saw ¬†(and still ¬†in the present without my tinted lenses) shapes, movements, colours and blobs and couldn’t contextualise where I was in space and time what I was doing (learning by route was a system I learnt) – I had speech and language delay as well as significant motor delays, echolalia and late speech compacted on my ability to understand typical language

I had NO contextual words within my head for along time (even though the capacity was there and I would have gleaming moments of clarity which no one saw or noticed) but I recited jingles, sounds, hums and treated words like “sounds” nor could I visualise words either.

I relate to Donna Williams in this way and it’s important to debunk the myth that all people on the spectrum are thinking in pictures when many clearly aren’t. I still find typical language difficult but I can but try to integrate as much as possible.

One must also differentiate and language processing disorder from mutism it was ironic though when I gained functional speech I had bouts of mutism so the two can interact.

I also have and Autie based profile as opposed to Aspie and this may certainly be one of the reasons why.

Paul Isaacs  2014


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Autism & “Route” Expressive Language & Pattern, Theme & Feel Language (D.Williams)

The Inside Story Milton Keynes 2011OVERVIEW

EXPRESSIVE LANGUAGE

I was non-verbal for about 5 years, I had speech delay and language delay, oral apraxia and then I was pre-verbal and I gained “functional” expressive speech (of a three year old) between the ages 7/8. Before that I lived in a pattern, theme and feel (Donna Williams) with language creating sounds, movements to convey my emotions and communicate as well as touching and sculpting.

TYPICAL FUNCTIONAL EXPRESSIVE SPEECH “IS NOT MY NATIVE LANGUAGE”

Typical/functional speech is to me still not my native language, my native language is before typical interpretation and meaning Рeven now this is still the case this is do with many factors.

CONCLUSION

I have learnt to use functional language as a route pathway and cross-over for people who process typical interpretive expressive ¬†and receptive language. much like refined echolalia. ūüôā I still live in a word before typical interpretation. ūüôā

Paul Isaacs 2014