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Growing up
    meaning
 deaf, meaning
     blind, &
 disconnected
   from body

        by

  Donna
  Williams
www.donnawilliams.net
Sensory & perceptual disorders in the context of
     Donna Williams ‘Fruit Salad’ model of ‘Autism’

      Psychiatric             Info Processing:
      Co Morbids                Health Issues
                                  Dyspraxias            Personality traits
         Mood                      Aphasias
                                   Agnosias            and their associated
                            Emotional dysregulation     disorder extremes
Psychosis        Anxiety



  Impulse                                                Environment
                Attention
   Control      Deficits                              Learned Helplessness
                                                           Cat vs Dog
                                                            Mourning
                                                         Social Isolation
       Attachment
        Disorders
Sensory versus Sensory Perceptual
        (not always even related)
         SENSORY                       SENSORY
                                      PERCEPTUAL
   Sensory integration
    (incl Dyspraxia)             Agnosias (meaning
   Hypersensitivities            deafness, meaning
                                  blindness, body
   Nutrition & sensitivity       disconnectedness
   Personality &traits          Gut/immune/metabolic
    sensitivity                   disorders
•   People are
Faceblindness       interchangeable
                •   People known by
                    situation/placement
                •   People known by
                    hair, clothes or objects
                •   People known by smell
                •   Difficulty in the
                    playground
                •   Lost in groups
                •   Bonds with
                    wallpaper, objects, textur
                    es
                •   Happier with
                    objects/textures etc
                •   May avoid faces or
                    deeply study own face
                •   Mirror may be best friend
•   Get yourself a 'signature' – a hat, jacket, song, name
    tag.
•   Name yourself upon arrival and when you might be
    out of your usual place.
•   Show your 'signature' object (ie keyring, watch).
•   Offer to be smelled
•   Find ways of bonding unrelated to facial recogniation
•   Don't take lack of recognition personally.
•   Don't take face recognition as a reflection of
    inteligence or empathy.
•   Teach self advocacy re faceblindness instructions
    (even if on a card).
•   Find the person a playground buddy who'll find them.
•   Create activities where friends are easier to visually
    keep recognisable.
•   Be aware people may become strangers when in
    bathing costumes, when wet etc.
•   Language sounds like blah       Meaning
    (people sharing sound
    patterns).                      Deafness
•   Often worse with other
    external sounds (ie fans).
•   Common in those with
    Semantic Pragmatic
    Language Disorder
•   Echolalia is common
•   Tendency to play with
    sounds/words, later
    avoidance of verbal
    situations
•   Make cover
    ears/hum/run/spin to tune
    out blah
•   Preferance for
    objects, nature, animals, mir
    ror (non-verbal things)
•   Use slowed, bullet point, telegraphic speech with
    processing breaks.
•   Gestural signing (showing the use/movements/3D
    form associated with words).
•   Use representational objects to track speech and
    context shifts.
•   Provide social opportunities which don't rely on
    conversing.
•   Provide means of self advocacy about percentages
    and fluctuations in meaning deafness.
•   Provide learning opportunities through:
    maps/lists/categories/systems, music/rhythm.pattern
    s, movement/hands on learning.
•   Many with meaning deafness are also meaning blind
    so DO NOT assume picture thinking or learning by
    pictures.
•   Ensure visuals involve observable movement/action.
•   Use means other than speech to bond.
Meaning     •   Sees the part, loses the whole.
            •   Plays with parts of things.
Blindness   •   Struggles to learn board, group or
                interpersonal games.
            •   Appears to only recognise specific
                attachment objects.
            •   Smells, rubs, taps, flicks, mouths
                objects.
            •   Will go without until seeing
                someone else use an item.
            •   Can't imagine others recognise
                things/may not seek help.
            •   Can't process visual context.
            •   May fear being taught visually or
                flap/chew/tear pictures.
            •   Hands on learner. Must DO in
                order to learn.
            •   May have serial memory but can't
                visualise something novel.
            •   Struggles to learn flexible word-
                meaning through looking.
•   Hands on, discovery learning
•   Hand over hand learning                     ideas
•   Rote learning still intact
•   Recognition through tapping/smelling/handling.
•   Categorise parts
•   Choose games/activities which don't rest on visual
    processing
•   Provide means of self advocacy about meaning blindness.
•   Use physical tracing to link visual parts to a 'whole'.
•   Tinted lenses or peripheral vision may be employed to filter
    incoming information leaving more time to process what's
    left.
•   Flitting glances and finger movement at the side of the
    eyes may each be used to re-set visual processing.
•   Ensure inteligence/empathy is not judged by meaning
    blindness.
•   Use music, systems, movement for bonding
Social Emotional
•   May have little use of       Agnosia
    facial expression/body
    language or as
    characatures.
•   May not respond to
    non-verbal
    communications.
•   May stick to non-
    human interactions.
•   May be more likely to
    be bullied/left out.
•   May not know how to
    initiate or continue
    friendships.
ideas

• You Tube, DVD clips, drama classes to formally
  teach facial expression/body
  language/intonation.
• Provide social and employment opportunities not
  dependant on reading facial expression/body
  language/intonation.
• Provide means of self advocating about Social
  Emotional Agnosia.
• Don't take Social Emotional Agnosia as
  representative of disinterest or lack of empathy.
• Work with social anxiety associated with
  isolation/fear in not being able to process non-
  verbal messages.
Visual Verbal Agnosia
•   May chew, flick, rip
    books.
•   May read fluently
    without intonation or
    use it randomly.
•   Learns from doing, not
    from reading.
•   Prefers letters, lists or
    interesting sounding
    words (when read).
•   Loses interest when
    pictures are absent.
ideas
•   Gestural signing, representational objects and
    characterisations to bring written words to life
    with meaning.
•   Lists rather than long strings of 'embedded text'.
•   Tinted lenses or muted colored background
    may improve processing time.
•   Small encyclopedic entries.
•   One idea per sentence and one sentence per
    line.
•   Consider activities/jobs requiring limited ability
    to understand contracts, forms or written
    instructions.
•   Hands on experience or films rather than books.
Simultagnosia
•   May appear to ignore
    that others are            and self-other
    speaking.
•   Appears to have little
    self consciousness.
•   Appears to go blank
    when others are
    expressive/active.
•   Difficulty learning from
    being lectured.
•   Feels ignored (actually
    can't experience
    feedback whilst
    expressing).
• Representational objects to track self/other and
  topic without losing any of these three.
• Parallel interactions for social success.
• Sit alongside or to the side, not opposite.
• Focus on the object/issue, not the person.
• Advocacy skills re issue.
• Hand over hand teaching and rote physical
  patterning.
• Teaching may have to be sink or swim as may
  otherwise not learn actions through modelling.
• Singing, dance, music, arts, sharing nature, to
  improve sense of being in company.
Disconnected from Body (body agnosias)
•     Late with
      toiletting, washing, groomi
      ng.
•     More likely to self injure
      and stim.
•     May appear indifferent to
      pain.
•     May have poor sense of
      tiredness, need for the
      toilet, clothing, hunger, thir
      st or comfort from others.
•     May behave puppet like or
      distressed at being
      handled.
•     Exposure Anxiety may be
      more likely.
• Brain Gym.
• Body brushing, spinning, rolling, massage, tickling.
• Hand over hand rote learning for self
  help, toiletting, feeding etc.
• Visible times/lists of routines to replace dysfunctional body
  feedback.
• Rote hand over hand learning for sequencing actions.
• Don't expect self to be identified with/through the body.
• Physical patterning for skills and in following directions.
• An Indirectly Confrontational approach (for Exposure
  Anxiety) may be essential.
• Use hand over hand physical tracing and reflection to
  experience body as a whole.
• Tapping, rocking and vibration to re-ground in the body.
• Teach rote caretaking of plants/animals and transfer this
  to own body.
• O.T exercises for finding toiletting related pushing and
  holding muscles.
•   Difficulty telling body       Alexithymia
    messages from emotions.
•   Difficulty telling one body
    message or emotion from
    another.
•   Difficulty guaging the
    degree/volume of a
    sensation or feeling and
    how to react to it.
•   A detached relationship
    to body and emotions.
•   Poor ability to respond to
    the emotional needs of
    others in spite of
    empathy.
•   Alienation from the
    social-emotional world of
    others.
•   Preference for non-
    human company.
•   Emotional dysregulation
• Modulation games – strong, gentle, scratchy, smooth etc
• A visible scale to assess the 'volume levels' of a feeling.
• Use of representational objects to track competing/contrasting
  sensations/feelings and their contributing causes.
• Statements to trigger give away reactions instead of
  questions which draw a blank.
• Don't confuse Alexithymia for inability to love or empathise.
• Use real objects to assist in making felt (not rote learned)
  choices.
• Define differences of fear vs excitement, tiredness vs
  anger, happy vs scared, need for the toilet vs feeling cold etc.
• Advocate for the bluntness of those with Alexithymia
  particularly re their own feelings (these will commonly be
  dismissed if the person appears unemotional in expressing
  them).
• Create opportunities which play to the person's strengths.
•   Visual thinkers will not have    Learning Styles
    significant visual perceptual
    disorders.
•   Those who can fluently
    visualise speech will not have
    significant visual and verbal
    processing disorders.
•   Those with visual or verbal
    processing disorders may be
    unable to internally mentalise
    so this will need to be done
    externally – hands
    on, representational
    objects, gestures, characteris
    ations, mind
    maps, lists, rote, hand over
    hand patterning etc.
•   Those with body agnosias
    may be unable to transfer the
    visual to the physical and
    need to physically pattern
    new activities.
•   Addressing
    gut, immune, metabolic                Environmental
    disorders, poor nutrition, toxicity
    (ie eating fluoride toothpaste)         strategies
    may improve processing.
•   Reduce unnecessary sensory
    bombardment but don't pander.
•   Work to the person's strengths.
•   Don't take their perceptual
    deficits personally.
•   Use respectful strategies aimed
    specifically at each issue not
    one-size-fits all approaches
    thrown at 'the autism'.
•   Respectfully help them with self
    advocacy and build their sense
    of equality.
•   No matter how disabling the
    challenges appear, always see
    the person, not just the
    disability. Then they might too.
For more information
         see the books

Autism; An Inside Out Approach
               or
     The Jumbled Jigsaw

              and visit

   www.donnawilliams.net

         also more info at

http://www.autismhangout.com/e
   ducation/details.asp?id=32

 http://en.wikipedia.org/wiki/Agnosia

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MFA-Donna

  • 1. Growing up meaning deaf, meaning blind, & disconnected from body by Donna Williams www.donnawilliams.net
  • 2. Sensory & perceptual disorders in the context of Donna Williams ‘Fruit Salad’ model of ‘Autism’ Psychiatric Info Processing: Co Morbids Health Issues Dyspraxias Personality traits Mood Aphasias Agnosias and their associated Emotional dysregulation disorder extremes Psychosis Anxiety Impulse Environment Attention Control Deficits Learned Helplessness Cat vs Dog Mourning Social Isolation Attachment Disorders
  • 3. Sensory versus Sensory Perceptual (not always even related) SENSORY SENSORY PERCEPTUAL  Sensory integration (incl Dyspraxia)  Agnosias (meaning  Hypersensitivities deafness, meaning blindness, body  Nutrition & sensitivity disconnectedness  Personality &traits  Gut/immune/metabolic sensitivity disorders
  • 4. People are Faceblindness interchangeable • People known by situation/placement • People known by hair, clothes or objects • People known by smell • Difficulty in the playground • Lost in groups • Bonds with wallpaper, objects, textur es • Happier with objects/textures etc • May avoid faces or deeply study own face • Mirror may be best friend
  • 5. Get yourself a 'signature' – a hat, jacket, song, name tag. • Name yourself upon arrival and when you might be out of your usual place. • Show your 'signature' object (ie keyring, watch). • Offer to be smelled • Find ways of bonding unrelated to facial recogniation • Don't take lack of recognition personally. • Don't take face recognition as a reflection of inteligence or empathy. • Teach self advocacy re faceblindness instructions (even if on a card). • Find the person a playground buddy who'll find them. • Create activities where friends are easier to visually keep recognisable. • Be aware people may become strangers when in bathing costumes, when wet etc.
  • 6. Language sounds like blah Meaning (people sharing sound patterns). Deafness • Often worse with other external sounds (ie fans). • Common in those with Semantic Pragmatic Language Disorder • Echolalia is common • Tendency to play with sounds/words, later avoidance of verbal situations • Make cover ears/hum/run/spin to tune out blah • Preferance for objects, nature, animals, mir ror (non-verbal things)
  • 7. Use slowed, bullet point, telegraphic speech with processing breaks. • Gestural signing (showing the use/movements/3D form associated with words). • Use representational objects to track speech and context shifts. • Provide social opportunities which don't rely on conversing. • Provide means of self advocacy about percentages and fluctuations in meaning deafness. • Provide learning opportunities through: maps/lists/categories/systems, music/rhythm.pattern s, movement/hands on learning. • Many with meaning deafness are also meaning blind so DO NOT assume picture thinking or learning by pictures. • Ensure visuals involve observable movement/action. • Use means other than speech to bond.
  • 8. Meaning • Sees the part, loses the whole. • Plays with parts of things. Blindness • Struggles to learn board, group or interpersonal games. • Appears to only recognise specific attachment objects. • Smells, rubs, taps, flicks, mouths objects. • Will go without until seeing someone else use an item. • Can't imagine others recognise things/may not seek help. • Can't process visual context. • May fear being taught visually or flap/chew/tear pictures. • Hands on learner. Must DO in order to learn. • May have serial memory but can't visualise something novel. • Struggles to learn flexible word- meaning through looking.
  • 9. Hands on, discovery learning • Hand over hand learning ideas • Rote learning still intact • Recognition through tapping/smelling/handling. • Categorise parts • Choose games/activities which don't rest on visual processing • Provide means of self advocacy about meaning blindness. • Use physical tracing to link visual parts to a 'whole'. • Tinted lenses or peripheral vision may be employed to filter incoming information leaving more time to process what's left. • Flitting glances and finger movement at the side of the eyes may each be used to re-set visual processing. • Ensure inteligence/empathy is not judged by meaning blindness. • Use music, systems, movement for bonding
  • 10. Social Emotional • May have little use of Agnosia facial expression/body language or as characatures. • May not respond to non-verbal communications. • May stick to non- human interactions. • May be more likely to be bullied/left out. • May not know how to initiate or continue friendships.
  • 11. ideas • You Tube, DVD clips, drama classes to formally teach facial expression/body language/intonation. • Provide social and employment opportunities not dependant on reading facial expression/body language/intonation. • Provide means of self advocating about Social Emotional Agnosia. • Don't take Social Emotional Agnosia as representative of disinterest or lack of empathy. • Work with social anxiety associated with isolation/fear in not being able to process non- verbal messages.
  • 12. Visual Verbal Agnosia • May chew, flick, rip books. • May read fluently without intonation or use it randomly. • Learns from doing, not from reading. • Prefers letters, lists or interesting sounding words (when read). • Loses interest when pictures are absent.
  • 13. ideas • Gestural signing, representational objects and characterisations to bring written words to life with meaning. • Lists rather than long strings of 'embedded text'. • Tinted lenses or muted colored background may improve processing time. • Small encyclopedic entries. • One idea per sentence and one sentence per line. • Consider activities/jobs requiring limited ability to understand contracts, forms or written instructions. • Hands on experience or films rather than books.
  • 14. Simultagnosia • May appear to ignore that others are and self-other speaking. • Appears to have little self consciousness. • Appears to go blank when others are expressive/active. • Difficulty learning from being lectured. • Feels ignored (actually can't experience feedback whilst expressing).
  • 15. • Representational objects to track self/other and topic without losing any of these three. • Parallel interactions for social success. • Sit alongside or to the side, not opposite. • Focus on the object/issue, not the person. • Advocacy skills re issue. • Hand over hand teaching and rote physical patterning. • Teaching may have to be sink or swim as may otherwise not learn actions through modelling. • Singing, dance, music, arts, sharing nature, to improve sense of being in company.
  • 16. Disconnected from Body (body agnosias) • Late with toiletting, washing, groomi ng. • More likely to self injure and stim. • May appear indifferent to pain. • May have poor sense of tiredness, need for the toilet, clothing, hunger, thir st or comfort from others. • May behave puppet like or distressed at being handled. • Exposure Anxiety may be more likely.
  • 17. • Brain Gym. • Body brushing, spinning, rolling, massage, tickling. • Hand over hand rote learning for self help, toiletting, feeding etc. • Visible times/lists of routines to replace dysfunctional body feedback. • Rote hand over hand learning for sequencing actions. • Don't expect self to be identified with/through the body. • Physical patterning for skills and in following directions. • An Indirectly Confrontational approach (for Exposure Anxiety) may be essential. • Use hand over hand physical tracing and reflection to experience body as a whole. • Tapping, rocking and vibration to re-ground in the body. • Teach rote caretaking of plants/animals and transfer this to own body. • O.T exercises for finding toiletting related pushing and holding muscles.
  • 18. Difficulty telling body Alexithymia messages from emotions. • Difficulty telling one body message or emotion from another. • Difficulty guaging the degree/volume of a sensation or feeling and how to react to it. • A detached relationship to body and emotions. • Poor ability to respond to the emotional needs of others in spite of empathy. • Alienation from the social-emotional world of others. • Preference for non- human company. • Emotional dysregulation
  • 19. • Modulation games – strong, gentle, scratchy, smooth etc • A visible scale to assess the 'volume levels' of a feeling. • Use of representational objects to track competing/contrasting sensations/feelings and their contributing causes. • Statements to trigger give away reactions instead of questions which draw a blank. • Don't confuse Alexithymia for inability to love or empathise. • Use real objects to assist in making felt (not rote learned) choices. • Define differences of fear vs excitement, tiredness vs anger, happy vs scared, need for the toilet vs feeling cold etc. • Advocate for the bluntness of those with Alexithymia particularly re their own feelings (these will commonly be dismissed if the person appears unemotional in expressing them). • Create opportunities which play to the person's strengths.
  • 20. Visual thinkers will not have Learning Styles significant visual perceptual disorders. • Those who can fluently visualise speech will not have significant visual and verbal processing disorders. • Those with visual or verbal processing disorders may be unable to internally mentalise so this will need to be done externally – hands on, representational objects, gestures, characteris ations, mind maps, lists, rote, hand over hand patterning etc. • Those with body agnosias may be unable to transfer the visual to the physical and need to physically pattern new activities.
  • 21. Addressing gut, immune, metabolic Environmental disorders, poor nutrition, toxicity (ie eating fluoride toothpaste) strategies may improve processing. • Reduce unnecessary sensory bombardment but don't pander. • Work to the person's strengths. • Don't take their perceptual deficits personally. • Use respectful strategies aimed specifically at each issue not one-size-fits all approaches thrown at 'the autism'. • Respectfully help them with self advocacy and build their sense of equality. • No matter how disabling the challenges appear, always see the person, not just the disability. Then they might too.
  • 22. For more information see the books Autism; An Inside Out Approach or The Jumbled Jigsaw and visit www.donnawilliams.net also more info at http://www.autismhangout.com/e ducation/details.asp?id=32 http://en.wikipedia.org/wiki/Agnosia