Social Skills in Individuals with Nonverbal Learning Disabilities

Nonverbal learning disability (NLD) is often a highly misunderstood diagnosis. Challenges with the understanding and use of language in social contexts can have significant negative impacts on individuals with this diagnosis, in that they struggle to interpret both nonverbal communication and nonliteral language. Understanding these challenges is critical in order to provide effective intervention. Assessment in these domains provides information about the areas to target for intervention. While individuals with NLD rely heavily on their auditory skills, it is imperative to provide means for them to learn social pragmatic and language skills in order to function in dynamically changing social exchanges. It is often indicated that teaching must occur only through verbal scripting. However, relying solely on this modality will limit students' abilities to effectively learn to apply targets in real life social situations. Therefore, a balanced approach that strives toward generalization is necessary. This chapter will provide information regarding assessment and intervention practices related to social interactions for individuals with NLD.

Understanding Nonverbal Learning Disabilities in Postsecondary Students with Spina Bifida

Transitioning to life after high school can be challenging for most young adults, even more so for individuals with a nonverbal learning disability (NLD). However, careful planning can lead to success. Friends, family members, employers, college instructors, therapists, and other service providers need information and methods to support individuals with NLD, particularly those with spina bifida (SB). A review of NLD characteristics, effects on student learning, non-awareness and misconceptions of NLD, and effective supports for individuals with NLD (e.g., accommodations, agendas and checklists, assistive technology) will be illustrated via the example of one young college student with NLD and SB. MAP (Making Action Plans) and PATH (Planning Alternative Tomorrows with Hope)—research-based strategies and tools for transition planning and progress monitoring of teens and young adults with NLD and SB—as well as methods to self-advocate to obtain assistance from others academically, physically, socially, and emotionally will be demonstrated.

Team Collaboration for the Best-Practice Treatment of NVLD across Three Systems

Inspired by the parable of six blind men and an elephant, the authors have long been struck by the number of specialists who come into contact with children with NVLD. Each profession may emphasize a particular aspect of NVLD and may even have its own professional jargon to name it. Speech and language pathologists often refer to this condition as a semantic-pragmatic disorder; occupational therapists, as a developmental coordination disorder; and special educators, as a developmental math disorder. Many psychologists refer to these students as struggling with social skills problems; and Byron Rourke, a neuropsychologist, used the phrase “nonverbal learning disability.” The authors believe professionals do not communicate enough about how services and perspectives need to be coordinated. This chapter identifies a subtype model for NVLD. It offers a developmental perspective of NVLD across the lifespan, and emphasizes the need for teams and collaborators to organize treatment from three perspectives: hospital, school, and family. Finally, the authors address ways in which parents and other family members can best organize and manage these teams that will change over time due to the nature of the disorder.

Nonverbal Learning Disability from a Neurocognitive Perspective

This chapter presents a framework for parents and educators to recognize the profile of strengths and weaknesses in individuals with nonverbal verbal disability (NLD) across different stages of development and in the context of environmental demands. To fully understand the profile and its impact, it is important to examine the NLD strengths in relation to the weaknesses. In this chapter, the relationship between the NLD strengths and weaknesses is examined within a model of different hemispheric processing systems. Looking at only one aspect of the profile—either the strengths or the weaknesses in isolation—can contribute to a misunderstanding of the NLD student and a fragmentation of services and intervention. In this chapter, the author describes how a comprehensive assessment can provide an important step toward clarifying and understanding the NLD profile. Finally, the chapter emphasizes the importance of an integrated approach to intervention and accommodations that will enable the student with NLD to move forward with increased awareness, acceptance, and independence.

Nonverbal Learning Disorder

Since the first description of nonverbal learning disorder (NLD) was published in 1967, much research has been conducted elucidating its key features, its neuroanatomical associations, and the assessment procedures essential to establishing a diagnosis and treatment plan. Although there is theoretical and empirical evidence supporting the validity of NLD, awareness of this disorder is lacking, arguably in large part due to its absence in any formal classification system. This chapter reviews the scientific literature that has given rise to our current conceptualization of NLD. Clinical practice considerations are discussed as related to its assessment, diagnosis, treatment, and prognosis. These considerations are illustrated by a case study. The chapter continues with a discussion of issues in need of further research and the benefits of considering NLD in the context of the World Health Organization's classification system for describing health and health-related conditions. The chapter ends with a proposed definition of NLD.

My Journey with Sally

During the past 10 years, the author has supported a young lady with hydrocephalus, spina bifida, and a nonverbal learning disability (NLD) for approximately 8 hours per week. The young lady referred to is “Sally,” who is now in her thirties. The writer's personal interest in this chapter is to share her experiences as a support worker—both positive and negative—and by doing so, assist fellow support workers, disability assessors, teachers, and aides who work with young people like Sally. Discussion includes first impressions of Sally's abilities, her daily life as observed during one-on-one support, and her experience with independent living. Support through several vocational training programs will be discussed as well as Sally's diagnosis of epilepsy and the impact this has had on her life. Finally, the joys and challenges involved with experiencing local community activities, special holidays, and day trips will be shared, with relevant examples provided.

Medical Conditions Associated with NLD

The pattern of neuropsychological assets and deficits that characterize a nonverbal learning disability (NLD) is evident in a wide variety of neurological diseases and dysfunctions. Numerous studies that have focused on neuropsychology, development, and cognition have resulted in a hierarchy of disorders and disabilities. Research has found that hydrocephalus related to spina bifida, and other neurological conditions, predispose the individual affected to an NLD. This chapter is organized to reflect the extent to which certain biological conditions give rise to the features characteristic of NLD with a three-level hierarchy wherein 1evel 1 disorders are the closest phenotypically to NLD. Discussion then moves to levels 2 and 3 where presentations of the syndrome are less obvious. Characteristic features of each disorder, relevant research findings, and the involvement of damaged, destroyed, or dysfunctional white matter in manifestation of the NLD syndrome are discussed.

The Road to Diagnosis and Post-School Life

This chapter is written in two sections, each with its own introduction and background. “The Road to Diagnosis” is not intended to be exhaustive. Discussion touches on the role of the psychologist and neuropsychologist in the NLD diagnostic process in light of considered views of experts offered in earlier chapters. The critical need to assess executive functions (EFs) as a core component of an NLD is raised as well as the need to include NLD in a formal classification system. Formal inclusion of NLD in an organized structure not only has potential to transform lives on an international scale, but it would acknowledge accumulated scientific research findings, and persistent advocacy of investigators. The “Post-School Life” section discusses realistic issues that may be experienced by those who live with, teach, care for, guide, and advocate for an individual with shunted hydrocephalus, spina bifida, and NLD. This section reports, as impartially as possible, some of the author's lived experience.

Case Studies

This chapter is taken from five illustrative case study reports resulting from doctoral research. Each case gave the researched a voice. The study selected five students at Level 1 risk of manifesting virtually all NLD assets and deficits as a consequence of shunted hydrocephalus related to spina bifida then spoke with their parents, teachers, aides and the students themselves. Each case begins with a brief description of the medical condition that predisposed each child to NLD followed by the contextual setting derived from family members. A snapshot of each student's life, classroom performance, psychological test results, teacher, aide, and parent perceptions of functional abilities, and the level of each participant's awareness of the NLD syndrome are then considered. Interpretative Discussions include teacher and aide understandings of the difficulties interspersed with those of the author. Practical help from teachers, aides, parents, and students is offered at the end of each case study. Case Studies conclude with a catalog of Key Terms and Definitions.

Nonverbal Learning Disability (NLD)

The purpose of this chapter is to inform practitioners in the teaching, medical, and allied health professions about the complex and serious nature of a nonverbal learning disability (NLD) so that early identification and intervention may prevent mental health issues. Children and young adults with an NLD face many difficulties not experienced by those with a language-based learning disability. Difficulty handling routine daily tasks and responsibilities on a consistent basis can threaten personal and economic independence, and a supportive network of friends may become harder to sustain over time. Involvement with community activities may also be limited. The author seeks to engage the reader with what is an enigma for some—the NLD profile. Discussion includes the origin of the disability, the physical presentation of the profile, differences between NLD and other commonly diagnosed learning disabilities, and possible consequences if the NLD is not identified early and managed.