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Although it is not yet
recognized as a formal diagnosis with agreed-upon
diagnostic criterial, Nonverbal learning disorder
(NVLD or NLD) is a syndrome characterized by a
pattern of unusual strengths and deficits thought
to be due to dysfunction in the right hemisphere of
the brain.
Children and teenagers with
NVLD often have a history of early speech and
vocabulary development. They may have outstanding
rote memory sills and attention to auditory detail.
They also have history of early reading development
and advanced or precocious spelling skills.
As gifted as they appear in
these aspects of their skills development, however,
they tend to have major deficits in other skills
and aspects of functioning. For example, while
children with NVLD can decode text with relative
fluency, they may struggle to comprehend what they
are reading due to difficulty in organization and
higher level reasoning. Similarly, although they
may have an excellent retention of material
presented orally, they don't always comprehend or
"get" the subtleties and nuances of language. Like
their peers with autism spectrum disorders (ASD),
they tend to be very concrete in their thinking and
somewhat inflexible in terms of how they approach
tasks or handle transitions. Impaired in
problem-solving skills, they fail to apply or
generalize previously learned skills to new
situations or materials.
The student's discrepant
skills development is also manifest in mathematics.
Because of their advanced rote memorization skills,
they may find it easy to memorize their math facts
or equations. When it comes to applying the
information, however, they may struggle, and often
show poor visual attention to the various algebraic
signs. Visual-spatial deficits are also reflected
in poor visual recall, faulty space perceptions,
and poor sense of directionality. Indeed, poor
comprehension of visually presented material is one
of the hallmark characteristics of NVLD, and there
is often (but not always) a significant Verbal IQ -
Performance IQ discrepancy on intelligence tests
(with VIQ significantly higher than PIQ).
In general, children and
teens with NVLD may function relatively normally
when presented with verbally mediated information,
but they do poorly in coping with nonverbal
information. This impairment not only affects their
academic functioning, but also impairs them
socially.
On a motoric level, students
with NVLD also appear to be clumsy, and many will
have balance problems as well as graphomotor or
handwriting impairment.
Not all students with NVLD
will have significant impairment in all of the
deficit areas noted above. They may be impaired in
only one of these aspects of these functioning.
The "profile" of a children
or teenagers with NVLD depends on which author or
researcher you read, as there are no agreed-upon
diagnostic criteria. Thus, Telzrow and Bonar (2002)
identify the profile of an NVLD student as one who
has:
- Stronger verbal than
perceptual cognitive skills
- Weak psychomotor and
perceptual motor skills
- Deficiency in
arithmetic
- Difficulty with novel and
complex tasks
- Poor problem-solving
skills
- Social and interpersonal
deficits
- Psychosocial adjustment
problems
Since these characteristics
might suggest an autism spectrum disorder to those
who are experienced in working with students with
Asperger's Disorder or high functioning autism, it
is worth noting that some investigators have
questioned whether NVLD is truly different than
autism spectrum disorders (ASD) or whether it may
just represent part of the same spectrum.
The NLDA,
an organization devoted to nonverbal learning
disorders, provides its own perspective on the
characteristic features of a child or teenager with
NVLD:
- Bilateral
tactile-perceptual deficits
- Bilateral psychomotor
coordination deficits
- Outstanding deficiencies
in visual-spatial-organizational
abilities
- Deficits in the areas of
nonverbal problem solving, concept formation,
hypothesis testing
- Difficulty dealing with
negative feedback in novel or complex
situations
- Difficulties in dealing
with cause-effect relationships
- Difficulties in the
appreciation of incongruities
- Well-developed rote
verbal capacities and rote verbal memory
skills
- Over-reliance on prosaic
rote, and consequently inappropriate, behaviors
in unfamiliar situations
- Relative deficiencies in
mechanical arithmetic as compared to
proficiencies in reading (word recognition) and
spelling
- Rote and repetitive
verbosity
- Content disorders of
language
- Poor psycholinguistic
pragmatics (cocktail party speech)
- Poor speech
prosody
- Reliance on language for
social relating, information gathering, and
relief from anxiety
- Misspelling almost
exclusively of the phonetically accurate
variety
- Significant deficits in
social perception, social judgment, and social
interaction skills
- Marked tendency for
social withdrawal and isolation as age
increases
- High risk for
social-emotional disturbance if no appropriate
intervention is undertaken
As should be clear from the preceding
discussion, NVLD is a syndrome
of assets and deficits. The combination and extent
of assets and deficits will vary across students.
Most students with NVLD, however, will exhibit a
pattern of relative impairment in social
perception, visual-spatial abilities, and
mechanical arithmetic, with well developed verbal
skills and rote memory.
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In another
article on
this site, Jean Foss provides some strategies for
teachers. In a second article of hers published on
the NLDline
web site, she has also suggested the following
strategies:
- provide verbal
mediation for nonverbal experiences, and in
conjunction with their interactions with others,
whenever appropriate
- teach them to use
their own verbal analytic strengths to mediate
their own experiences
- anticipate
situations in which they might have difficulty,
and act as a buffer and support to facilitate
the most positive outcomes possible - help them
to anticipate the kinds of situations in which
they might have difficulty, and to plan in
advance some alternative responses they might
have to those situations
- teach them to
interpret facial expressions, gestures and other
nonverbal aspects of communication
- teach them to
watch for and interpret indications from others
that they are talking too much, or that the
communication is ineffective in some other
way
- monitor their
understanding when communicating, and teach them
to self-monitor their understanding and ask
clarifying questions
- be particularly
careful to ensure their understanding when
spatial language is involved
- take care to make
cause-effect relationships explicit, whenever
possible
- help this learner
to anticipate cause and effect relationships in
order to avoid difficulties in many areas of
life
- teach and
practice organizational skills
- control as much
as possible the demands for performance to be
sure they are manageable and not seemingly
overwhelming
- relying on verbal
strengths, help this individual practice and
internalize the process of making decisions,
setting goals, making plans and taking action to
achieve those goals, and reflecting and
evaluating the results. The outcome of the
process must be to credit oneself for one's own
efforts and accomplishments
- be confident and
hopeful; interventions like those above can
effect a positive difference
Other positive
interventions, suggested by the NLDA, include:
- Clearly Stated
Expectations
- Computer
Use
- Consistent
Scheduling
- Facilitated Group
Activity
- Foreign Language
Waivers
- Good Role
Models
- Language based
therapy
- Logical
Explanations for Change
- Mentoring
- Methods for
Coping with Anxiety
- Methods for
Coping with Sensory Defensiveness
- Modified Art and
Physical Education
- Modified
Grading
- Modified Homework
Assignments
- Modified Testing
(Time, Content)
- Occupational and
Physical Therapy
- Organizational
Skills Coaching
- Prompted Writing
Assignments
- Psychotherapy,
Cognitive Therapy
- Second Set of
Textbooks at home
- Social Skills
Training
- Speech and
Language Therapy which addresses social
cognition rather than articulation
- Time Management
Coaching
- Trained
Advocates
- Verbal
Brainstorming
- Verbal
Explanation of Visual Material
- and
especially
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