What Is Nonverbal Learning Disorder: In A Nutshell

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.  Three 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, and difficulties 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).

  Parents report several forms of therapy have been useful in the treatment of NLD to include:

 Auditory Integration Therapy 4% ;

 Cognitive/Behavioral Therapy 7%;

 Occupational Therapy 25 %;

 Sensory Integration 18% ;

 Sensory Motor Therapy 7% ;

 Social Skills Group 25% ;

 Speech/Language 3 %

 Other 7 %

Parents sometimes feel that they need to schedule every hour of the day with therapy, activity and enrichment. But children with NLD need to have time to relax and rest.  It is important as therapists that we help parents to understand the importance of participating in therapy in a logical and sequential manner. Children with NLD have low muscle tone. That means that they don’t have the same amount of muscle strength and endurance as a more typical child.  They need time to rest and recover.  Much of the day is filled with confusing sensory stimuli.  They need time to re-organize and time to be a kid. We can help parents understand that.  

These are children that will likely need support throughout their school years, from cognitive, to organizational skills, to motor skill development to pragmatics and social skills. It’s important to offer parents support in developing a plan of intervention.  It’s not helpful to provide lifeskills intervention that teaches a  13 year old girl to go shopping independently when she is dependent in showering and dressing.  We need to be instrumental in the treatment of the child, the family, and the educational setting.  It’s a tall order but children with NLD have a very positive prognosis with the right interventions.  

In a recent poll on the NLDline. (NLDline.com) parents said that poor social skills and lack of friends were the two top problems. Map out a plan for helping with those areas.  This may include setting aside two days a week for play dates for your child and a friend and  gain skills for yourself to help facilitate social development during the play dates.  FreeSpirt Press (www.freespirit.com) publishes several awarding winning books to help parents gain skills in this area. 

Children with NLD tend to have an advanced verbal and auditory memory, they are precocious readers, and have advanced vocabularies. In fact, they’re often nicknamed “little professors.”  However, NLD is a problem of language.  The children have the rote language skills but when it comes to functional use of language in everyday conversation, they have difficulties with tone of voice, inference, written expression, gestures, facial expressions and other areas of pragmatic speech.  They benefit from rote learning, practicing that which many would assume to be intuitive such as greetings, eye contact, proximity, and other social rules of conduct. These children tend to be vulnerable to bullies and punitive forms of instruction.  They’re very literal and while this can be a tremendous strength, it can also become a deficit.  If you tell a child that you want them to pick up their toys later, that’s vague and later never comes.  This can be interpreted as defiance when in fact it is a literal interpretation. However, that same child will only eat one piece of your See’s Candy you got for Christmas because you told them that was the rule.

They have difficulty with mathematics, especially when they enter 3rd and 4th grade when math skills become more abstract.  Unlike children with Asperger’s, they  have difficulty understanding patterns and lining up columns of numbers in math.  Following spoken directions is also hard because of poor visual memory and they cannot picture doing the steps. NLD effects coordination. These children tend to be clumsy, are prone to falls and in general, have poor safety awareness. Doctors are not sure what causes NLD.

One child put it this way,  “ Even though I’m good at reading and remembering, sometimes it takes me a little longer to answer a question, because I cannot find the words. Because I’m focusing on what I want to say, I talk too quickly.  It also slows down my writing.  On essay tests, I know the information, but I have a difficult time getting it on paper. Sometimes even looking at the face of someone who is speaking can be too much. I feel everyday the way other people feel in a crowded shopping mall just before Christmas”

Rondalyn Varney Whitney, MOT, OTR has developed a comprehensive program of therapy, adaptation and other interventions for children with NLD.  She has been a volunteer for the national organization SHARE Support, Inc. and NDLA and currently serves as the first vice president of NLDA.  She has lectured on NLD at PHP, area schools, and even as far as to the Nebraska School System.

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