Paul Isaacs' Blog

Autism from the inside


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There Are Two Types of “Social Emotional Agnosia” in Autism

abstract background close up construction

 

“Typical” Social Emotional Agnosia

Social emotional agnosia is the inability to see and/or perceive body language, facial expression and tone of voice, this mean that the person is only “seeing” factual information this rides along side an secondary factors such as a language processing disorder, alexithymia, mood, compulsive and anxiety disorders for example.

This tends to be found in people with a diagnosis of Asperger’ syndrome and is related the right hemisphere for the brain up to 30% also have faceblindness and sensory hypersensitivities.

“Perceptual” Social Emotional Agnosia

If we think of visual information up to 70% of is visual so what if a person simultagnosia? The inability to perceive more than one thing in their visual field rendering the ability to take in “social” information difficult, perceiving faces, objects and surroundings as “pieces”. What if the person has a receptive aphasia, auditory verbal agnosia and cannot retain information secondary to oral apraxia, verbal agnosias, exposure anxiety , mood, compulsive and anxiety disorders for example.

This tends to be found in people with a diagnosis of Autism and is related to the left hemisphere of the brain and the occiptal lobes and sensory perceptual disorders.

Image result for shoes paired Image result for shoes paired

You can have two pairs of shoes that “look” the same but once you look inside them you realise they are different in terms of “mechanics” that would mean differing styles of learning, communication and mentalising will come into play.

Paul Isaacs 2018


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The Journey To Functional Language

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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! 😉 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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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.

“Blindisms” 

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”

Shorts

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
object
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.

Conclusion

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.

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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

 

autism-pyramid-updated-2017

 

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”.

 

Conclusion 

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.

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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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. 🙂

Paul Isaacs 2016