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  1. 1. Growing up meaning deaf, meaning blind, & disconnected from body by Donna Williams
  2. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 22. For more information see the books Autism; An Inside Out Approach or The Jumbled Jigsaw and visit also more info at ducation/details.asp?id=32