Paul Isaacs' Blog

Autism from the inside

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So What is Simultagnosia & Semantic Agnosia? In The Context Of Autism?

Image result for occipital lobes and simultagnosia

Note: This is from a personal perspective

Simultagnosia is a condition that effects the occiptal lobes of the brain this is where visual perception and processing is connected, it also can have an impact on visual association, language perception/processing and overall navigation of the visual world around you.


For me it meant not being able to access the visual world with coherence rendering me unable to access with my “eyes” and having to build up the visual world in a “non-visual” way such as.

  • Smelling
  • Touching 
  • Sculpting
  • Licking
  • Tapping
  • Moving

This started early in my development with my Mum’s observations thinking I was both deaf and blind (which is a common observation with people with visual agnosias) I was imprinting through EXTERNAL stimulus to build up a representation and connecting through other sensory modulations to make sense of the experience around me.

“Mapping” A System

As I have got older and with more awareness of the condition I have system in place where I do not hide anything from my view and placement of objects are important in relation to their context.

Context & Relevance

I still have a level of context blindness which means that things that are not being used “lose there relevance” (what they are, their use and function in relation to the environment) I may mistake objects for other things entirely and/or be caught up in how they make me feel rather than what they are.

Paul Isaacs 2018




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Autism, Semantic Agnosia & “The Eyes That Don’t See”


The Eyes Are Deceptive?

Think about it a person who eye’s are organically “normal” and the ability “see” from an psychical perspective is there but the brain is not able to process visual information that is coherent and meaningful.

Sensory Explorer 2

Reality vs. Context? The Hidden Link

As a child association was created through my body this could be through objects and or people. Touch gave me a reality and context that my eyes could not the contours of what touched beamed into my inner world as a way of saying “hello” to the outside from inside and secret bridge that was being made every time.

Quinn and I

Movement, Mapping and Tactile Association

I was eager to be bare foot and “mapped” out my surroundings, movements, twists and turns around the “dead space” that enveloped in was both my enemy and my friend all at once. Touching, licking, sniffing, tapping and rubbing gave “life” to everything around me on an unconscious level of was working out world.

• This is the most studied type: easier to detect.
• Stimuli misrecognized visually, can be recognized:
– through tactile manipulation
– from verbal description
– based on its characteristic sound or noise
early visual processing
image viewer-dependent
object-centered (3D)
(2 and 1/2 D)
episodic structural description
structural description system
semantic system
output phonological lexicon
object naming
AGNOSIAS & SEMANTIC DEFICITS Raffaella Ida Rumiati, Cognitive Neuroscience Sector Scuola Internazionale Superiore di Studi Avanzati Trieste, Italy
A Blindism

One could call this a “blindism” a state in which visual perception is not giving the associative signals and/or visual association of what an object “is” regardless of where you find it, what angle you see and so forth. This could lead problems with context and a distortion of memory.


As an adult I still rely more on my movements that what I am “seeing” this means that can still get lost in my surroundings but with my tinted lenses this is able to keep my conscious mind on track with meaning.

Paul Isaacs 2017


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Managing Grief and Loss with Visual Perceptual Disorders

Note this is from a personal perspective

Grief is a normal state to be in when you lose someone you love and have connected to and I know that this feeling or more accurately abundance of differing feelings that accompany it are part of the process.


Visual Agnosias – Deficits In Memory Perception & Visual Association? 

I have no pictures of my Gramp none that “spring to mind” I cannot “visualise” or have pictures in my mind my “meta-reality” (a person’s inner world/consciousness)  is not made of pictures or movies as a form of association. It is made of of smells and textures I made a point when I said goodbye to my Gramp at the chapel of rest to stroke his face and hair so would have a physical association of the firstly the bond we had and secondly my way of saying goodbye to him and his body.

Paul Isaacs communication profile 2017

Bereavement Counselor 

I went to see a bereavement counselor today and I was thankful that he was able to assist me not only in the human element of my grief but also adapt his way of describing different interventions and explanations to me.

 This is what he used in  the session 

  • Contextual telegraphic language “painting his words” with gesture and placement and meaning
  • Allowed time for me to do “all self no other” and “all other no self” in order for me to express and receive the information
  • Compartmentalised my  own emotional states giving them a reference point and also suggestions in how to manage my emotions
  • Understood I have a history of mood, compulsive and anxiety disorders associated with somatisation disorder
  • Allowed me to be creative in expressing my emotions through creative writing, poetry and art




Addressing The “Pieces” Of The Jigsaw

So what parts of my “autism” are being addressed?

  • I would say firstly his looking at a level of information processing delay and giving me time
  • The next would be that fact that because of visual perceptual disorders having a level of visual agnosia in the areas of meaning (semantic), object (simultagnosia) and faces (prosopagnosia) means that using gesture, placement and telegraphic language backed up with word emphasis in the right areas helps me internalise the words better assisting with the level of aphasia I have
  • Looking at my own emotional states is assisting with alexithymia and overall giving me time to integrate “self and other”.



I would say that my grief is human and that I will get through this with at times very basic but meaningful interventions I do however hope this helps people with similar issues to my myself regardless of being on the autism spectrum or not.


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.


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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Autism: A Very Sensory Christmas



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.


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.


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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Autism, Visual Distortion, Non-Visual Thinking & Image Break-up

There are many people on the spectrum such as Temple Grandin that have strong visual memories not only for fact retrieval but in her case she has used her visual way processing to help her with her career in animal slaughter.


Some people on the autism have problems with not only processing visuals in “real-time” but also accessing it, contextualising it and having what I call “image retrieval” this means the person in question may not only have problems processing and internalising what is around them (visually) they may well have issues with image retrieval this means they may not connect the image with word because they have no idea what the image is so there is no were for the “word” to or they may have an issue once they have processed the image to give it the correct word that is associated with it. For me words have to be associated with a “feeling” not emotional specifically but how the object for example “felt” as I am typing this will remember the typewriter by the “texture” of the keys that my fingers are touching.


This may sound and look odd for the onlooker and rightfully so – but is the person has so many sensory “blockages” touch in the context of “meaning” may well be one of the only ways in which they can access the “world” in way which is not only comforting (for some) but meaningful its relevance.


This may well not be just restricted to touch and feeling it may well also include licking, sniffing, mouthing too to objects, people and the physically surroundings. Visual break-up may look like the child is blind which in my case my Mum thought I was which would indicate I was showing behaviours of a blind person. (as well as a deaf person because of auditory processing).

Paul Isaacs 2016


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Autism, Visual Perception & Body Disconnection

20160829_172026.jpgNote this is from a personal perspective


For people with at times complex visual perceptual disorders within their autism profile the “visual” enviroment may well be foreboding, scary, intriguing or fantastic. The waxing and waning may come from other factors such as mental health conditions such as undiagnosed mood, compulsive or anxiety disorders within the mix which can heighten and project the issues for the person in question.


As a child I found misdirection confusing and alluring at the sametime being able to “sense” through my fingers, toes and body rather than “seeing” with my eyes was a comfort it was tangible and “real” for more real in reflection that what my “eyes” were showing me.

The complex nature of my visual perceptual disorders have been documented in other blog posts and my second book  with James Billett in which the world was faceless, fragmented and distorted clarity was found in the moments of touch (to gain meaning, context and placement). 


The level of body disconnection as the years go back was higher I had no idea of the “vessel” I was “living in” and that that meant I often wonder with that lack of groundedness made my an emotionally anxious child (amongst other environmental and  social factors). Legs, hands, fingers, toes, my trunk etc seemed to be in a world of their own with the realisation of their existence being triggered by an awareness of their movements and what that meant for me (rather than what other saw or reacted to how it looked).


I have mentioned about a lack awareness of trauma this included knocking a tooth, scraping my legs on barbed wire with next to now reaction to the the level of trauma itself and that a level of pain agnosia must have been present and still is to a certain degree.


I wonder if people in both educational, home and residential environments who have complex visual perceptual disorders (a level of face, object and meaning blindness), pain agnosia and body disconnectivity who self-harm because they do not have the internal “stopping point” thus causing secondary conditions that which is related to mental health which heightenings the presentation it is worth thinking about?

Paul Isaacs 2016