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Wednesday, October 24, 2012

Nonverbal Learning Disability

From GreatSchools.org

By Anastasia Hubbard, M.S., Brenda Smith Myles, Ph.D.
October 20, 2012

Answers to some of the most common questions about this well-publicized -- but somewhat controversial -- disorder.

Locating consistent, reliable information about nonverbal learning disabilities (often referred to as NLD or NVLD) is a challenge for parents because it has yet to be clearly defined and accepted by many educators and other professionals as a distinct disorder. Nevertheless, parents often seek information about this often-publicized and somewhat controversial disorder.

In this article, we answer some of the most common questions parents ask about nonverbal learning disabilities.

What is nonverbal learning disability (NLD)? Is it a distinct diagnostic category?

Nonverbal learning disability (NLD) is believed by some to be a neuropsychological disability. Although it has been studied for the past 30 years (by Byron Rourke, Ph.D. and others), it has not yet been included as a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV TR).

Many characteristics associated with NLD are similar to those that describe other, more "established" disorders, such as Asperger's Syndrome and specific learning disabilities.

For a professional's perspective on NLD, we turned to Brenda Smith Myles, Ph.D., an associate professor at the University of Kansas and editor of Intervention in School and Clinic, a practitioner-oriented journal designed to provide practical, research-based ideas to educators who work with students with severe learning disabilities and emotional/behavior problems.

Dr. Smith Myles says, "Additional research and better diagnostic tools are required to clearly define the characteristics of NLD, and determine whether or not it can be considered a distinct disorder."

For now, let's review how this disorder is defined - and how it might apply to your child. What characteristics are associated with NLD?

NLD is usually defined by a distinct pattern of specific strengths and difficulties.
Individuals thought to have NLD typically demonstrate strengths in the following areas:
  • Intelligence quotient (IQ) which is typically in the average to above-average range. Children with NLD tend to have verbal IQ scores that are higher than their performance scores, a factor that distinguishes them from kids with language-based learning disabilities such as dyslexia.
  • Rote verbal and expressive and receptive language skills, such as the ability to memorize and repeat a great deal of information presented to them in spoken form. They also exhibit early language development.
  • Auditory processing skills, which entail learning better through hearing information, rather than seeing it (visual processing).

 

Individuals thought to have NLD generally experience difficulties in several broad categories:
  • Motor skills, such as graphomotor skills (related to printing and cursive writing), physical coordination, and balance
  • Complex conceptual skills involved in problem-solving, understanding cause-effect relationships, and seeing the "big picture" versus focusing on details
  • Visual-spatial-organizational skills, such as visualizing information and understanding spatial relations
  • Social skills, such as using and understanding nonverbal communication (e.g., gestures, facial expressions), dealing with new information and situations, transitioning between situations, conversation skills, and understanding the nuances of spoken language (e.g., hidden meanings, figurative language)
  • Activity level: hyperactivity (when younger), and hypoactivity (as they grow older)1

What type of professional is qualified to identify NLD, and what type of testing is used?

The "diagnosis" of NLD is normally made by neuropsychologists and clinical psychologists. Such professionals assess NLD using a battery of tests that cover abilities such as:
  • intelligence
  • motor and psychomotor
  • tactile-perceptual
  • visual-spatial-organizational
  • auditory-perceptual
  • auditory and visual attention/memory
  • problem solving
  • language
  • academic achievement
  • personality/adaptive behavior

NLD is difficult to diagnose because its manifestations change significantly depending on the child's age. In general, the deficits involved in NLD get worse as the child gets older. For example, a preschooler with NLD may have exceptional verbal skills and speak like a little adult.
 
During his younger years, the challenges a student with NLD faces are often overlooked because of his high intelligence level and verbal strength.2 As the child matures and encounters school work and social situations that require abilities such as abstract thinking and nonverbal communication, his deficits in those areas will become more apparent and problematic.

Parents tell us they get conflicting information about NLD from educators and other professionals. Is there consensus among professionals regarding the validity of NLD as a syndrome?

Brenda Smith Myles explains, "One reason why parents receive mixed messages about the existence of NLD is the fact that the disorder is viewed very differently by the psychological and education communities. At this time, very few schools will acknowledge that a child has NLD based on neuropsychological test results alone.

However, if standardized testing reveals a discrepancy between the child's IQ and his academic performance, some schools will refer the student for special education services."

How might having NLD affect a child's academic performance?

Students thought to have NLD generally do well in areas that relate to concrete thinking but have difficulty in areas that relate to abstract thinking. The research done to date has yet to prove how the cognitive limitations of NLD directly impact a child's academic performance.

Nevertheless, consider how having NLD might apply to math, reading, and conceptual learning:
  • It may be difficult for a child with NLD to understand mathconcepts and solve problems, but he may have no trouble applying a mathematical formula which he has been explicitly taught. Additionally, due to his poor spatial-organization ability, he may have difficulty aligning problems on a page to solve them correctly.
  • With regard to reading, a student with NLD may have strong word decoding skills, but may experience difficulty with reading comprehension, as he may miss inferences, have difficulty visualizing a story, and may not see the "big picture."
  • Children with NLD also experience difficulty when information on assignments and tests is not presented in the exactformat in which it was taught. For example, if a child with NLD learned about neighborhoods in social studies using a matching format he may have trouble answering true/false questions about the same information.

How does NLD impact a child's social life and communication skills?

Because of their uneven profile of strengths and challenges, children with NLD may experience difficulty in their interactions with adults and peers. Children with NLD usually have strong verbal skills; consequently, adults may hold unreasonably high expectations of them. Peers may not understand a child with NLD; for example, peers may be unaware of the child's inability to understand nonverbal communication and therefore may not know how to interact with him.

A child with NLD tends to take things literally and often misses the point of humor or misinterprets good-natured teasing.

Does having a diagnosis of NLD mean a child is eligible for special education services?

Children who have been identified as having NLD may qualify for special education services under the "learning disabilities" or "other health impairments" category included in the Individuals with Disabilities Education Act or under Section 504 of the Rehabilitation Act.

At this time, only one state, New Hampshire, appears to recognize nonverbal learning disability as a specific learning disability. Because the categorization of NLD varies from state to state, parents will want to check on the education laws in their particular state.

Looking to the Future

Much remains to be learned about the nature and characteristics of NLD, as well as the most effective ways to work with and support children with the disorder. Future research and the development of effective diagnostic tools will facilitate a better understanding of this complex disability.

References

  • Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV), TR; American Psychiatric Association, 2000
  • Foss, J.M. (1991). Nonverbal learning disabilities and remedial interventions in Annals of Dyslexia, 41, 128-140.
  • Matte, R.R., & Bolaski, J.A. (1998). Nonverbal learning disabilities: An overview, Intervention in School and Clinic, 34(1), 39-42.
  • Morris, S. (2002). Promoting social skills among students with nonverbal learning disabilities. Teaching Exceptional Children, 34(3), 66-70.
  • Myles, B. S., Trautman, M. L., & Schelvan, R. L. (2004). The hidden curriculum: Practical solutions for understanding unstated rules in social situations. Shawnee Mission, KS: Autism Asperger Publishing Company.
  • Thompson, S. (1996). Nonverbal learning disorders. Retrieved January 26, 1998.
  • Tsatsanis, K.D. (2000, March). Nonverbal learning disabilities. Presented at the Special Education Resource Center (SERC) Forum to Discuss Social Skills Training Programs for Children and Youth with Autism Spectrum Disorders and Nonverbal Disabilities, Bristol, CT.

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