Nonverbal Learning Disability

1. Nonverbal Learning Disability Classroom Assessment and Response Presented by Julie Trenerry

2. What is a Nonverbal Learning Disability? • Nonverbal learning disability (NVLD or NLD) is a neurocognitive/neurobehavioral disorder which is caused by a dysfunction in the brain’s processing of information; it may be more accurately described as an information processing disorder • There is some controversy regarding its cause: simple dysfunction in the brain’s right hemisphere vs. broader dysfunction involving the frontal lobe, white matter, and neural connections between right and left hemispheres • Although there is no reason to believe the disorder is new, the NVLD syndrome has been described as a distinct diagnostic entity only recently

3. What is a Nonverbal Learning Disability? (cont.) • History: Beginning in the 1960’s, researchers began to notice children with specific deficits in social-emotional functioning and poor math skills. Unlike children with traditional learning disabilities, these children did not seem to suffer language-based difficulties, yet they exhibited a cluster of problems of their own: they were socially inept, physically clumsy, and had difficulty with math and general visual-spatial processing. Yet, they were able to generate language extremely well. In fact, in the lower grades, they might often be viewed as gifted. • Distinction: Many of the symptoms of NVLD are similar to those of Asperger’s Syndrome which has (rightly or wrongly) been included with the autism spectrum. Unlike children with Asperger’s, however, children with NVLD desire and enjoy social interactions and want to relate to their peers and other people. Although the issue has not been entirely resolved, recent literature on the subject views NVLD as a discrete and separate diagnostic entity. • Prevalence: Research suggests that approximately 1% of the general U.S. population (about 2.7 million people) currently have NVLD, but since the syndrome is not recognized by school districts as a specific learning disability and many educators have not been trained to recognize its symptoms, this is likely a gross underrepresentation of its prevalence.

4. Recognizing a Nonverbal Learning Disability in the Classroom • Whereas language-based disabilities are usually readily apparent to parents and educators, nonverbal learning disorders routinely go unrecognized. Both parents and teachers may suspect that “something is amiss” early on, but they can’t quite “put a finger on it.” Students who articulate and are excellent readers and spellers do not usually prompt their teachers to consider a learning disorder. Because of their frequent inappropriate and unexpected conduct, however, NVLD children are often labeled “behavior problems” or “emotionally disturbed.” Rarely are a parent’s or teacher’s concerns given any credence until the child reaches a point in school where he is no longer able to function given the limitations of his disability and/or, in some cases, the child suffers a “nervous breakdown” (or worse). • “Unless the entire school staff is conscious of the unique neurobehavioral characteristics which impede the student with NLD and seeks to provide appropriate intervention strategies, this student will be destined to fail in school.” (Morris, 2002 at p. 66).

5. NVLD – What Do Researchers Say? • Clinical neuropsychologist, Dr. Byron Rourke is the foremost researcher in the area of NVLD. In his book entitled, Nonverbal Learning Disabilities: The Syndrome and the Model (1989), Rourke identified five areas in which children with NVLD display difficulties: • Tactile perception – the ability to know an object by its feel as well as the ability to ignore the feeling of certain things (e.g., a tag in a shirt) • Psychomotor coordination – (e.g., the ability to throw a baseball while running) • Visual-spatial organization – (e.g., the ability to maneuver around objects when walking or running, knowing that closer objects appear larger, the ability to look at a page of math problems and recognize where one problem ends and the next begins) • Nonverbal problem solving – (e.g., knowing how something goes together without an instruction manual) • Ability to appreciate incongruities and humor • On the other hand, Rourke notes that children with NVLD may excel in other areas. For example, NVLD children often display phenomenal rote memory skills, especially if they have learned things through verbal instruction. Thus, they may remember spelling words, and math facts exceptionally well. They may also display a large vocabulary and show excellent ability to produce language (although they may not effectively show how to useit).

6. In the Classroom: Three Categories of Dysfunction • In the classroom, a teacher may see these five areas of difficulty surface among NVLD children in the following three categories: 1. Motoric (lack of coordination, severe balance problems and/or difficulties with fine graphomotor skills), 2. Visual-spatial-organizational (lack of image, poor visual recall, faulty spatial perceptions, and/or difficulties with spatial relations), and 3. Social (lack of ability to comprehend nonverbal communication, difficulties adjusting to transitions and novel situations, and/or significant deficits in social judgment and social interaction).

7. Motoric • Motoricclumsiness is often the first concern a NVLD child’s parents may observe; a NVLD child may actually appear “drunk” when she first begins to walk • As the NVLD child reaches school age, her lack of motor control can result in social rejection because she is constantly “getting in the way,” bumping into other people and objects, and is generally unaware of the position in space her body encompasses • Learning to ride a bike can be an incredibly difficult task for a child with NVLD; other simple athletic skills like jumping jacks, skipping and jumping rope may also prove to be difficult • Fine motor skills may also be affected and tasks such as tying her shoes, using a scissors or holding a pencil correctly are extremely difficult The teasing and ridicule suffered by a NVLD child for her lack of coordination, even at the hands of possibly well-meaning coaches and teachers, can have a devastating effect.

8. Visual-Spatial -Organizational • A NVLD child often focuses on the details of what she sees and fails to grasp the “big picture” • Experiences are stored in her memory by their verbal labels, not by visual images so she may have a poor memory for new or complex material or material which is not easily verbally coded • Spatial reference is often neglected entirely so that a NVLD child will commonly have problems aligning columns of numbers, observing directionality, and in organizing her work; copying from the board or a book may be particularly difficult A NVLD child constantly “talks herself through” situations as a means of verbally compensating for her motoric and visual-spatial deficiencies. Although she can often use this and her well-developed rote memory skills to survive, this coping technique breaks down whenever the child encounters a new or complex situation.

9. Social • A child with NVLD is often unable to interpret body language such as facial expressions, gestures, and postural clues. A NVLD child may also be oblivious to changes in tone of voice and social norms governing personal space • A NVLD child is very concrete/literal in her translations; hidden meanings have to be pointed out to her and the concept of dishonesty is beyond her understanding • NVLD children tend to have poor social judgment which may be evidenced by impulsive behavior and inappropriate affect; young children with NVLD frequently have inattentive, hyperactive, and impulsive behavior patterns which may lead to an erroneous diagnosis of ADHD; when children with NVLD become older, such behaviors may be replaced by a pattern of internalizing adjustment problems, characterized by anxiety and depression • “Because of their verbal strengths, many individuals with NVLD succeed in formal educational situations. However, if their social competence has not developed commensurately, they may not find and keep employment at the level for which their education has prepared them.” (Foss, 2001). • Dr. Rourke’s research has led him to make even more serious predictions for children with NVLD, as he notes that nonverbal learning disabilities “predispose those afflicted to adolescent and adult depression and suicide risk.“ (Thompson, 1996).

10. Interventions for NVLD: What Can Teachers Do? • In their article, “Responding to Students with Nonverbal Learning Disabilities,” Telzrow and Bonar identify classroom interventions for the various motoric, visual-spatial-organizational, and social deficits that NVLD children may display in the classroom. For each of these skill areas the authors suggest three different types of interventions: remedial interventions, compensatory approaches, and instructional or therapeutic interventions. • Remedial interventions are designed to exercise deficient skills directly. Such interventions might include specific practice in handwriting and direct instruction in such things as reading maps and graphs, interpreting facial expressions, making eye contact, making and keeping friends, and the use of self-monitoring skills to reduce inattention and impulsive behavior. • Compensatory approaches use assistive technology or other techniques to help students with NVLD cope with their areas of difficulty. For example, NVLD students may benefit from using a word processor instead of paper and pencil, mnemonic devices to remember sequences or processes, teacher-prepared lecture guides to minimize the need for note-taking, or calculators to help themselves keep up with their classmates despite weaknesses in mechanical arithmetic. • Instructional or therapeutic interventions use specialized methods to teach the student foundational skills or strategies to enhance performance in deficient areas. Examples of these types of interventions might include occupational therapy to enhance psychomotor deficits, problem-solving instruction and practice, social skills training, and teacher/parent awareness training concerning risk for depression and suicide.

11. Conclusion • In the 1970’s and 80’s, educators, clinicians and researchers began to focus on language based learning disabilities and as a result, great progress was made in understanding and in developing effective interventions for such disabilities. As author Kathryn Stewart suggests, today we are on a similar “threshold of the same kind of explosion of information and program development for children with NLD.” (Stewart, 2007). • According to Dr. Michael Roman, although much work remains to be done to better understand the etiology, prevalence and practical consequences of NVLD, work to date has clearly shown that the syndrome is real and a “disabling condition” for many. In order for children with complex syndromes such as NVLD to be better and more appropriately served, it is essential that educators, clinicians, and administrators become better informed about the condition and the ways in which it affects a child’s learning. (Roman, 1988).

12. References Differences between NLD and Asperger’s. Lighthouse Project. (2002). Available: http://www.thelighthouseproject.com/index.html Foss, J. (2001). Nonverbal Learning Disability: How to Recognize It and Minimize Its Effects. ERIC EC DIGEST ##E619. Available: http://www.tourettesyndrome.net/foss.htm#ERIC%20Digests Morris, S. (2002). Promoting Social Skills Among Students With Nonverbal Learning Disabilities. Teaching Exceptional Children. (Vol. 34), No. 3, pp. 66-70. Roman, M. (1998). The Syndrome of Nonverbal Learning Disabilities: Clinical Description and Applied Aspects. Current Issues in Education (On-line), 1(7). Available: http://cie.ed.asu.edu/volume 1/number7/ Rourke, B. (1989). Nonverbal Learning Disabilities: The Syndrome and the Model. New York: Guilford Publications. Stewart, K. (2007). Helping a Child with Nonverbal Learning Disorder or Asperger’sDisorder:A Parent’s Guide. Oakland, CA: New Harbinger Publications. Telzrow, C. and Bonar, A. (2002). Responding to Students with Nonverbal Learning Disabilities. Teaching Exceptional Children. (Vol. 34), No. 34, pp. 8-13. Thompson, S. (1996). Nonverbal Learning Disorders. Available: http://www.Idonline.org/article/Nonverbal.Learning/Disorders Thompson, S. (1998). Developing an Educational Plan for the Student with NLD. Available: http://www.Idonline.org/article/Developing-an-Educational-Plan-for-the-Student-with-NLD