A Therapists Guide to Fix the Developmental Delay of Baby Milestones

girl with nonverbal learning disorderNonverbal Learning Disorder was unknown to me until recently.

 Despite many years of clinical treatment and working with countless children with learning and behavior problems, I had not heard of this condition. I don’t think many people have heard about it. But if you have a child with ADHD, or CAPD or who has social interaction problems or is on the Autism Spectrum, NLD (or NVLD) is something you should know about.

Some researchers and clinicians believe that NLD is sort of a mild form of Asperger’s Syndrome.

But there are other people who point out distinct differences in the two disorders. Regardless of how it is categorized, symptoms are specific and identifiable. There is a conundrum, however, which makes this problem easily overlooked or dismissed. The children with NLD are often very bright and capable students. They tend to have early speech and language development and have extraordinary vocabulary skills. They also have good rote memory, early reading and great spelling skills. They are excellent at verbal expression and have good listening skills and auditory retention. Yet these students often do not perform well in school once they get to middle school or beyond (demands of lower school make it easy to miss hallmark traits). Some end up flunking out of college. The puzzle is “why do these students with exceptional skills fail so miserably? “It seems that certain underlying skill deficits interfere with functioning.

The deficits are as follows:

Sensory problems – These children may have difficulty processing/tolerating sensory stimuli such as touch, taste, sound, and visual

• Social interactions – This one is very significant. Children, teens and young adults may have problems reading non-verbal cues in social situations. They may not be able to interpret body language, facial expressions and contextual cues during social interactions. They may not be able to transition easily or adjust to a new environment or new social situation. Social judgment is poor (not understanding what to say, when to say it, etc.)

• Executive function and visual-spatial problems – This set of problems includes difficulty with problem solving, drawing conclusions, understanding symbolism, inferential thinking, visual recall and difficulty with spatial relations. They also have problems with organization and sequencing. They may not be able to discriminate appropriate communication from other background noise.

• Balance and coordination/ graphomotor problems – Physical activities requiring balance and coordination are difficult to master. Dysgraphia and other writing problems may be manifest.

What does all this mean? It means that as learning materials and social demands become more complex, the skills which allow most students to meet those demands is absent or diminished in those with NLD.

 Many school subjects in higher grades require conceptual rather than concrete analysis. Diagrams require visual interpretation. Certain subjects require inference skills to master. And social interactions of teens and young adults require picking up on body language, interpreting communication and picking up on “vibes”. Teens are quick to ostracize and ridicule those who don’t fit in or who speak inappropriately. Teachers who don’t recognize the problem for what it is berate the student for underperformance and laziness. Some teachers and parents regard the student’s poor performance as intentional or oppositional. Nothing could be further from the truth. The truth is that they have a learning disability. Students with NLD can become depressed and alienated. Some develop psychological problems.

Nonverbal learning disorder defies traditional definitions of learning disabilities.

Typically, children who have normal range intelligence but have problems with spoken or written language are designated LD. These problems show up as difficulty with reading, writing, spelling, speaking or listening. They are associated with dysfunction of the left hemisphere of the brain. NLD is a dysfunction of the right hemisphere. The resulting deficits cannot be characterized as a learning disability under Federal guidelines. Consequently, NLD does not warrant services because it does not meet the definition of a learning disability. This is why it is so important to recognize NLD as a disability and give appropriate treatment and necessary accommodations.

In future posts, I am going to outline some of the differences between NLD and Asperger’s. I will also give specific treatment recommendations which can help with the balance issues, sensory issues and visual – spatial issues. I can also make recommendations to foster good organization and tips for social skills. Many children with ADHD might also have NLD. It is important to treat in order to give your child the best opportunity to achieve success and establish good self-esteem.

10 Responses to “NLD – an invisible disorder you should know about”

  1. Ramona says:

    Hello

    My son is 13 yrs old and was diagnoised with NLD June 2010, very difficult time in middle school , always suffered with poor organztional skills. I am having a real difficult time with school reconizing this disorder and helping my son. Have had several SSP meetings. Can you please help me in a direction where my son can get his self esteem back. He has been diagnoised by his pediatrician as clinical depression. My sad says he’s sad alot. has a hard time relating with his peers. Can NLD manifest? As my son is not properly treated. I just need some direction so that I can help my son be as successful as possible. He is told by teachers he’s a bad kid, he is not a bad kid, just misunderstood by a public system that is suppose to give him an approriate education.

    Can you please give me some guidance?

    Best Regards,
    Ramona

  2. Karen says:

    Hi Ramona,
    I’m no NLD expert, but I am a mom to an awesome 14-yr old daughter who finally received a diagnosis halfway through the 8th grade.

    We’ve found some incredible support via 2 facebook groups: https://www.facebook.com/group.php?gid=5817612058 and https://www.facebook.com/group.php?gid=5817612058#!/home.php?sk=group_83530935976&ap=1

    I’d suggest checking those groups out for advice, support and suggestions from real people who live with NLD every day. They’ve been such a huge help to me and we’ve made some amazing connections with folks across the continent.

    Best wishes to both you and your son in this journey.
    Karen

  3. Thank you for the information. One of these groups is scheduled to be archived, but the other looks very informative.

    Nancy

  4. These conundra are overwhelming! I will allude to the Venn diagram (where circles representing certain elements within a set/category/subject overlap at points of similarity) – as an ironic way (it being a visual tool – which, if I recall, was nearly black with all the “important details” I though MUST be included).

    ADD, Executive Dysfunction, (Central Auditory Processing Disorder/Deficit?), N(V)LD, autism spectrum disorders, HFA, Heller’s syndrome – I mean holy #$!%. I totally get WHY diseases/maladies (especially the DSM disorders) may have a lot of similarities – but the clarity doesn’t come until AFTER you’ve already gone through SO much pain. And I include the diagnostic process and often heart-breakingly long and only laboriously successful med trials.

    And then to further complicate matters – there are often “comorbid” or secondary (meaning their etiology is from the first dx) issues with depression and anxiety! As a 39 year old who has been on the mh treadmilll now for some 20 years, and only for maybe 2-3 years now have I been blessed with the clarity of the NVLD and/or Executive Dysfunction dx. Personally, given the my default literalness as far back as I can remember – and I can remember a trauma relating to it in 2nd grade – and the whole (my phrasing) “visual stupidity” or “blind mind”, and the PITIFUL organizational/decision making/planning/ordering/multi-tasking (a misnomer by the way! – as this REALLY refers to mutliple and very quick and repeated shifts of attention from one task or stimulus to another!)/prioritizing (the Executive functioning difficulties which I believe make an Exec Dysf diagnosis redundant to a very demonstrably credible NVLD “fit”.

    Been on meds for ADD and OCD for almost 20 years. Just recently had to add an anti-anxiety med because the feelings of being overwhelmed and “panicky” (the y is important because I contain it – and if you can contain it – it ain’t panic, yes?) sensorially and responsibility and pace-of-life both in the moment and long term -often have me shaking and tense and stiff and tachycardic (to like, 132-144 bpm).

    Ugh – please forgive my tangential and grammatically lazy writing. On the tail end of my last methylphenidate dose – relax, I manage it well – 10mgx4 with no sleep issues – and TRUST ME – no “loss of appetite” issues either! – so I’m stream-of-consciousness writing here just because your post has my mind screaming in circles trying to get my fingers to get everything out!

    I’ve disclosed at work – and I’m very lucky and blessed to work in severe special ed. Most of my colleagues are supportive and nice. The ones who know are helpful. I have fully disclosed, and my boss (the program director) has been both emotionally/professionally supportive AND proactive in guiding my toward resources I have found very helpful – and which did help me manage to learn some strategies for staying organized and aware as possible – for example – EVERYTHING I don’t know gets a label – and I have a personal mailbox with “the memos” that NTs don’t need. They “catch” the news and the gossip and the plans and the agenda and the schedule. Uh uh. Put it into words – preferably in writing – and I WILL master it.

    We all speak English. And yet I feel like I and they often speak completely different languages!

    Okay – blatant stop. Have already gone on too long. Great piece! Obviously evoking plenty of feedback! :)

    -stan

  5. Mark Sheingold says:

    Your explanation of nld was very good. I think that problems getting the big picture are a part of it also.

    It is actually a very common disorder. A lot of engineers have it.

  6. Kim says:

    Stan, thanks for posting and you did a really great job!

    Kim

  7. Kim says:

    I do have a question… I read the article and all the feedback but was wondering how kids with problems with math facts are viewed with these disorders?

    Thanks,
    Kim

  8. Hi Kim,
    I am not sure whether you mean if these kids get diagnosed, or someone recognizes the problem or how they receive treatment. Can you clarify?

  9. Stanley W. Shura says:

    Those “nice folks” at the South Shore Educational Collaborative, where I *used* to work weren’t so nice after all. Speaks to yet another issue common among we with NVLD: gullibility. BE CAREFUL!

  10. Stanley W. Shura says:

    I disagree that NVLD may be a mild form of Asperger’s, because I believe that puts too much emphasis on the social impact this disorder has on *some* people.

    I think that that categorization also jeopardizes a very valid paradigm which posits 3 separate and unique areas of the impact of NVLD: visual-spacial, organizational, social.

    All that, and I know that for some people, there is nothing “mild” about the impact, effects, and lifelong consequences of Nonverbal Learning Disability.

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