Descriptive Profile of Children with Nonverbal Learning
From their article: "Working with Parents of Children with
Nonverbal Learning Disabilities: A Conceptual and Intervention Model," Joseph Palombo
and Anne Hatcher Berenberg state: "In previous papers we have detailed the profile of
children with NLD (Palombo, 1995; Palombo & Berenberg, In Press). For readers who are
unfamiliar with those papers, we summarize some of these children's features. However, we
caution readers that these features represent neither a comprehensive picture of the
syndrome nor are they meant to indicate that all children have every feature mentioned.
Each child may be said to have his or her own topography of deficits and symptoms. There
is a considerable range in types, combinations, and severity of deficits and symptoms.
Just as some geographic regions may have an abundance of lakes and vegetation, while
others may be dry and barren, so too with children with NLD, some may have severe deficits
in some areas and be unimpaired in others. Each configuration of deficits will produce its
own set of presenting problems."
October 21, 1994
The attached "Descriptive profile of children with Nonverbal Learning
Disabilities" provides a compilation of the characteristics of children thought to
have this problem. It was culled from an extended review of the literature.
Because our knowledge about these children is incomplete , this Profile should
be used with caution. Some children with some of the characteristic in the Profile may not
suffer from Nonverbal Learning Disabilities. It is also possible that some children with
Nonverbal Learning Disabilities may not fit many of the characteristics described in the
I would welcome hearing from readers of this Profile, whether it be to have
questions answered, or to provide input on any item(s) in the Profile. Please feel free to
call the Center at (847) 933-9339. Leave a message stating that you are calling in
connection with the Profile. One of the staff members will get in touch with you.
The development profile:
- They are passive, fall to engage in exploratory play, and do not respond as
visual-spatial-motor problems emerge;
- Many cannot use toddler toys or enjoy coloring or drawing. They are unable to put
puzzles together (Johnson 1987);
- They appear clumsy and ill coordinated. Caregivers must watch them closely
because they bump into furniture, are unsteady on their feet, break toys and endanger
- They appear to not have a good sense of the relationship of their bodies to their
They are slow to learn limits and instructions from their caregivers,
- They appear unable to understand casual relationships;
- Caregivers must intervene and correct them constantly, to which they respond with
frustration and anger. Often, their frustration escalates so that temper tantrums emerge
that are much more intense than those normally occurring at this age;
- Their self-help skills do not develop comparably to those of children their age.
They are slow to learn to feed and dress themselves. They do not master tasks such as
hand-washing, or grooming;
- They must be helped and reminded to complete tasks that other children already
By the age of three:
- They go through an initial stage when their speech is difficult to understand
because of articulation problems. These problems dissipate and their verbal skills emerge
as an area of strength. They then become quite adept at verbal communication. This channel
becomes reinforced by caregivers who become over reliant on it to relate to the child.;
- They have difficulties interacting with other children in groups.
- They seem not to know how to play with others.
- They cling to their caregivers and find it difficult to separate. If this
strategy is unsuccessful then they isolate themselves.
By the time they reach kindergarten or first grade other
problems become evident:
- They appear to be quite bright and to have excellent verbal abilities, but their
behaviors do not match the expectations for a child this bright and verbal;
- They have major problems is the area of peer relationships. They are unable to
form friendships or to sustain being with other children even for brief periods of time
without an eruption ensuing.;
- Academically, they start out having difficulty decoding letters and words, but
once they discover the rules they become good readers;
- Their writing is quite illegible. Their small motor problems and their
visuospatial difficulties make this task particularly difficult;
- Arithmetic difficulties emerge once simple computation is introduced.
- Caregivers notice that this child is different from their other children. But
they are hard put to pinpoint what it is about the child they feel to be different:
- They find themselves frustrated in their efforts to understand the child. They
seem unable to decode the childs cues, and find the child to be socially
- They feel placed in the position of constantly having to correct, limit, or
punish the child;
- They are puzzled when the child in turn responds with fury at what the child
experiences as unfair treatment.
- The family feels controlled by the child in all its activities;
- They often feel guilty, and blame themselves for what they believe to be their
failure to parent properly. This frustration may initiate a cycle in which the caregivers
feel rejected by the child and in turn distance themselves emotionally from the child;
- Some caregivers are intuitively able to read the childs messages and soon
find themselves being the only ones who can communicate effectively with the child. If
that does not occur then the difficulties are compounded by the childs increasing
demands on the caregiver and their inability to cope.
- Some caregivers unwittingly contribute to the confusion because of their own
- Some caregivers themselves have NVLD;
- The household then appears like that of a family which each member speaks a
different language. While a measure of communication occurs there are large areas which
are fraught with misunderstandings. The level of frustration, the anger resulting from
constant injury, the lack of gratification in having such a difficult child, all
contribute to the ensuing chaos.
By the age of seven or eight the full-fledged
"syndrome" manifests itself. It is often at this point that children are
referred for therapy.
The "clinical presentation" of the latency age child with NVLD
Children with NVLD are generally referred for a variety of problems:
- Boys are often referred because of behavioral problems while girls may be
referred because of their social isolation;
- Both boys and girls often present with clinical signs of severe anxiety,
depression, attentional problems, obsessional preoccupations, and self-esteem problems;
- They perform poorly in some academic areas, but not in all. They are good
readers, but have great difficulty with tasks involving writing or arithmetic.
Diagnostic interviews disclose social emotional distress.
In the visual-spatial-motor area, areas of primary deficits
- Tactile perception, such as finger agnosia;
- Discrimination and recognition of visual details;
- Organization of visual stimuli;
- Tactile and visual memory;
- Complex psychomotor tasks that require the crossmodal integration of visual
perception and motor output, such as putting puzzles together, solving mazes;
In the area of verbal language;
- The children are either average or above average in verbal language skills;
- They have good syntax and good pragmatics;
- They have problems with prosody, they tend to speak in monotone, or with a
- They may reverse pronouns at an early age, but these clear up with maturation;
- They have good memories and manifest rote memory verbalizations that makes them
look much smarter than they actually are;
- Their concepts lack preciseness. Although they appear sophisticated there is a
shallowness to the content of their expressions. A child may use a vocabulary that seems
advanced for his or her age, but the communications are not always well connected, and the
content appears superficial;
- Their problem with concept formation limits their capacity to reason, analyze and
In the academic areas, they have:
- Poor handwriting;
- Deficient skills in arithmetic;
- Their reading comprehension is not on a par with their verbal skills, although
they are good readers;
- Their reading comprehension drops, as they move to higher grades. Complex
material becomes much harder to grasp and concepts are harder to understand;
- The cannot organize a narrative to pick out the main points from supporting
details, the relevant from irrelevant;
- They have great difficulty with tasks required by art classes.
In school they also have problems with:
- Exploratory behavior;
- Dealing with novel materials, and adjusting to new solution;
- Reading between the lines, making inference, and understanding the double meaning
- Giving a narrative account of en event, they grasp one aspect of the total
picture and miss the broader gestalt. Consequently, when they are asked to report on an
event they give an account that appears disconnected and devoid of feeling. It is very
difficult to reconstruct what happened from their reports;
- Problem solving; and,
- Conforming with expected behavior.
The social-emotional profile.
- The area of affective communication is problematic for children with NVLD.
- In the receptive area:
- They appear unable to decode prosodic or vocal intonations;
- They also have difficulty reading facial expressions. They are unable to decode
the emotional message conveyed by peoples faces, and
- They are unable to read bodily gestures.
In the expressive area:
- They do not use vocal intonations. They either speak in a flat monotone or with a
- It is difficult to read their mood from their facial expressions. It is hard to
tell whether they are really happy or unhappy.
- They do not sue body gestures in speaking. They seem wooden and constricted;
In the processing area:
- They may have problems in the area of decoding affective states, or in the area
of visual processing;
- They respond to affect laden situations with anxiety, withdrawal or sadness;
- They have problems in modulating or regulating certain affects;
- They loose control and have temper tantrum, when frustrated;
- They respond to most feelings with generalized excitement that is unfocused and
lacking in content;
- They appear to have no compassion or empathy for others;
- They appear not to have the same feelings about events and people that their
peers are capable of having.
Their functioning in social situations is often problematic:
- They interact quite well with adults, but not as well with peers. This may be
because adults are more predictable in their responses and can be engaged verbally;
- They respond more nonverbally and are more erratic in their responses to their
- They are unable to decode social cues involved in "reading" other
peoples body language, facial expression and vocal intonations;
- They are inept in social situations. Grasping the subtle nuances of a social
situation is difficult;
- Their eye contact (gaze) seems unnatural, they seldom make solid eye contact;
- They lack a sense of humor. They do not know when they are being teased;
- They interpret concretely colloquialisms or metaphorical expressions.
- They lack basic social skills:
- Sometimes, they are taken to be rude although they are not consciously being
- They are overly familiar with strangers. They will start a conversation with
strangers as though they were old friends. They will ask personal questions too quickly.
They do not respect privacy that we presume others to need. They share personal facts too
quickly giving intimate details to strangers;
- They do not understand the physical aspects of social boundaries. Their sense of
body in space does not allow them to respect the usual social distances, such as the
culturally determined conversational distance of physical intimate closeness and distance;
- With peers, their play is disruptive, they appear unable to negotiate social
interchanges with other kids.
At a young age, their frustration with confusing social
situations often leads them to be emotionally overwhelmed and fragmented. This frustration
lends itself, in younger children, to motor output such as hand flapping, jumping up and
down excitedly, or extreme temper tantrums. They are then mistaken for children who suffer
from Aspergers syndrome or mild autism.
- They generally suffer from high levels of anxiety, and severe self-esteem
- They also suffer from depression, obsessive compulsive symptoms, or attentional
problems that lead them to a misdiagnoses as ADD.
- In contrast to children with Aspergers syndrome, they appear to crave
social contact, and to be capable of relating to others. They try reaching out to other
people. But their attempts are inept and are misread by others who misinterpret their
overtures. Their withdrawal is reactive rather than primary.
- Comorbidity with other diagnoses is often present.
Joseph Palombo M.A. is a Clinical Social Worker, Research
Coordinator, Founding Dean and Faculty Member, Institute for Clinical Social Work.
This paper was done in conjunction with Rush Neurobehavioral Center, 970 Knox Avenue,
Skokie, IL 60076, Phone (847) 933-9339. Mr. Palombo also has a private practice in
Highland Park, IL.
May 30 1994
SELECTED BIBLIOGRAPHY ON NONVERBAL LEARNING DISABILITIES
Updated Bibliography April 20, 1998
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attachment, memory:Contributions toward psychobiologic integration. Psychiatry, 59(3),
Atwood, T. (1988). Aspergers Syndrome: A guide for parents and
professionals. London: Jessica Kinsley Publishers.
Badian, N.A. (1986). Nonverbal Disorders of Learning: The Reverse of
Dyslexia? Annals of Dyslexia, 36, 253-269.
Badian, N.A. (1992). Nonverbal Learning Disability School Behavior And
Dyslexia. Annals of Dyslexia, 42, 159-178.
Baron-Cohen, S. (1997). Mindblindness: An essay on autism and theory of
mind. Cambridge Mass. The MIT Press.
Benowitz, L. I., Moya, K. L., & Levine D. N. (1990). Impaired Verbal
Reasoning and Constructional Aprazia in Subjects With Right Hemisphere Damage.
Nueropsychologia, 38(3), 231-241.
Blakeslee, S. (1996). Researchers track down a gene that may govern
spatial abilities. NY Times (Tuesday, July 2,) B6.
Bonnet, K. A. (1996). Asperger Syndrome in neurologic perspective.
Journal of Child Neurology, 11(6), 183-189.
Bretherton, I. Ridgeway D., Cassidy, J. (1990). Assessing internal
working models of the Attachment relationship in D. S. M. T. Greenberg and E. M. Cummings
Attachment in the Preschool Years (pp. 273-308). Chicago. The University
of Chicago Press.
Brumback, R. A., Harper, C. R., Weinberg, W. A. (1996). Nonverbal
learning disabilities, Aspergers syndrome, Pervasive Developmental
DisorderShould we care? Child Neurology, 11(6), 427-429.
Casey, J. E., Rourke, B. P., & Picard, E. M (1991). Syndrome of
nonverbal learning Disabilities: Age difference in neuropsychological, academic, and
socioemotional functioning. Development and Psychopathology, 3, 329-345.
Casey, J. E. S., J. D. (1994). The neuropsychology of nonverbal learning
disabilities: A practical guide for the clinical praticioners. In L. F. K. C. E. Stout,
(Ed.), The Neuropsychology of Mental Disorders: A practical Guide (pp. 187-201).
Springfield: C.C Thomas.
Cohen, D. J., & Volkmar, F. R. (1996). Issues for Research. In F. R.
Volkmar (Ed.), Psychoses and Pervasive Developmental Disorders in Childhood and
Adolescence. (pp. 249-286). Washington, D.C., American Psychiatric Press.
Davidson, R. J., (1994). Temperament, affective style, and frontal lobe
asymmetry. In G. D. K. W. Fischer (Ed.), Human behavior and the developing brain (pp.
518-536). New York: The Guilford Press.
Denckla, M. B. (1983). The Neurospychology Of Social-Emotional Learning
Disabilities. Arch Neurology, 40, 461-462.
Denckla, M. B., (1991). Academic and extracurricular aspects of nonverbal
learning Disabilities. Psychiatric Annals, 21(12), 717-724.
DePaulo, B. M. (1991). Nonverbal behavior and self-representation: A
developmental perspective. In R. S. R. Feldman, B. (Ed.), Fundamentals of nonverbal
behavior. (pp. 351-397). Cambridge University Press.
Duke, M. P., Nowicki, S., and Martin, F. A. (1996). Teaching Your Child
the Language Of Social Success. Atlanta: Peachtree.
This profile is an extract from a paper by J. Palombo titled: The Effects
of Nonverbal Learning disabilities on Childrens Development: Theoretical and
diagnostics considerations, which will appear as a chapter in a forthcoming book. B S.
Mark & J. Incorvaia, The Handbook of Infant and Adolescent Psychotherapy: A guide to
Diagnosis and Treatment. Jason Aronson Press. The concepts used in this profile are drawn
from the literature in the attached bibliography.