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Nonverbal learning disorders (NLD)

What is NLD? Nonverbal learning disorders (NLD) is a neurological syndrome consisting of specific assets and deficits. The assets include early speech and vocabulary development, remarkable rote memory skills, attention to detail, early reading skills development and excellent spelling skills. In addition, these individuals have the verbal ability to express themselves eloquently. Moreover, persons with NLD have strong auditory retention. Four major categories of deficits and dysfunction also present themselves:

* Motoric (lack of coordination, severe balance problems, and difficulties with graphomotor skills).

* Visual-spatial-organizational (lack of image, poor visual recall, faulty spatial perceptions, difficulties with executive functioning* and problems with spatial relations).

* Social (lack of ability to comprehend nonverbal communication, difficulties adjusting to transitions and novel situations, and deficits in social judgment and social interaction).

* Sensory (sensitivity in any of the sensory modes: visual, auditory, tactile, taste or olfactory)

* definition of executive functioning: Neuropsychological functions including, but perhaps not limited to, decision making, planning, initiative, assigning priority, sequencing, motor control, emotional regulation, inhibition, problem solving, planning, impulse control, establishing goals, monitoring results of action, self-correcting. From http://www.behavenet.com/

What is the importance of NLDline?

NLDline has been developed in hopes of increasing the awareness among parents and professionals about NLD. Early intervention yields the best prognosis for these individuals, and it is imperative to be educated about NLD in order to intervene at an early age. Also, many individuals with NLD and related neurocognitive learning disorders develop secondary neurobiological disorders - anxiety disorders, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, phobias and depression, as well as suicidal tendencies. Because of the widespread lack of understanding in all fields, many individuals with NLD are mis-diagnosed and are therefore not currently receiving appropriate intervention and services.

Nonverbal Learning Disabilities (NVLD)

* NVLD can be conceptualized as an imbalance in thinking skills ? intact linear, detail oriented, automatic processing with impaired appreciation of the big picture, gestalt or underlying theme. B. * It is not nearly as common as language-based learning disabilities, but this may be a phenomenon created by environmental demands (i.e., our societal demands for precision skills in reading assure that even the most subtle language-based LD cases are identified).

C. * Typically social/psychiatric concerns are raised before academic problems are identified.

D. * While the overlap is not complete, NVLD children may meet the criteria for Pervasive Developmental Disorder ? Not Otherwise Specified (PDD-NOS), Asperger?s Disorder, or Schizotypal Personality.

Neuropsychological Profile

* Full range of IQ

* Visual/spatial deficits are most pronounced: poor appreciation of gestalt, poor appreciation of body in space, sometimes left side inattention/neglect, may have highly developed but ritualized drawing skills that are extremely detail oriented.

* Rote linguistic skills are normal (i.e., repetition, naming, fluency, syntactic comprehension), but pragmatic use of language is impaired: weak grasp of inference, little content, disorganized narrative despite good vocabulary and grammar. Rote recall of a story may be good, but the main point is missed. Rhythm, volume, and prosody of speech are often disturbed.

* Motor and sensory findings are common: usually poor fine and gross motor coordination, left side worse than right.

* Attention is usually reported to be impaired and testing supports this, but the affect is desultory as opposed to distractingly impulsive, as in ADHD. It is as if people with NVLD do not now what to attend to, but once focused, can sustain attention to detail. The distinction between figure and ground is disturbed, resulting in attention errors. Academics

* Difficulties are often picked up late because decoding and spelling may be quite strong.

* Inferential reading comprehension is weak relative to decoding and spelling skills.

* Math is often the first academic subject to be viewed as problematic. Spatial and conceptual aspects of mathematics are a problem; math facts may be readily mastered (i.e., a student may know the answer to a simple multiplication problem, but not understand what multiplication is). * Due to spatial and fine motor problems, handwriting is usually poor.

* Organization skills are weak, particularly in written work.

Social/Emotional Issues

* Peer relations are typically the greatest area of impairment; child may play with much older or younger children rather than with same age peers, where they must manage give and take.

* People with NLVD often lack basic social skills: they may stand too close, stare inappropriately or not make eye contact, have marked lack of concern over appearance, be oblivious to others? reactions, change topics idiosyncratically.

* Children with NLVD are seen as ?odd? children who ?just don?t get it? socially. They may do better with adults, where they act dependent and immature, but may not be seen as ?odd.?

* They may show poorly modulated affect, not matched to verbal content.

* Lack of empathy and social judgment may shield them from fully experiencing the hurt of peer rejection, while the same factors increase the likelihood of being rejected.

* History of unusual thinking can often be obtained: rituals, stereotypic behaviors, rigid routines, and magical/bizarre beliefs.

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