NVLD

I don’t know why the VIQ/PIQ spread affects organization (or whether it’s something else) but I know that most NLD kids have trouble with it. I also know that some NLD kids are hit harder in some areas than others. My son’s worst area is visual/spatial. (which I would think would HAVE to affect organizational skills) He has much less trouble socially, and when he was 8, I probably would have said he didn’t have any.

The social problems tend to get worse as they approach middle school, and kids in general get meaner. :-( They tend to lessen again in HS, as kids become more accepting of differences. My son still has quite a few friends, but if you watch and listen to the things he says, you can see that he misses many social cues. I think the fact that he has been in a very nurturing Montessori integrated classroom, where all the kids are used to kids with learning differences has protected him to a large extent.

I guess the bottom line is that I don’t think you can tell for sure whether an 8 year old will or will not have social problems as time goes on. I wouldn’t rule out NLD. I also think that if the same interventions help, use them!

Karen

Karen,

Thanks for your response. I find NVLD rather puzzling. What I can’t figure out is whether it is more than the sum of its parts. In other words, do you have it if you have 2/3 conditions (I read this somewhere) or is it more than that?

Your thoughts on the social are well taken. It is hard to know when he is only eight—being good socially is not as complex at eight as it is at 12 or 15. I do know though when he was evaluated for CAPD the audiologist commented on how unusual his social skills were for someone with his profile. I actually think he developed good social skills because he couldn’t understand the world due to poor receptive language skills, he watched.

Beth

>>I find NVLD rather puzzling. What I can’t figure out is whether it is more than the sum of its parts. In other words, do you have it if you have 2/3 conditions (I read this somewhere) or is it more than that? <<

I don’t think you’re the only one who wonders about that. I know that there are parents in our NLD parent’s group who have been told that their children are NLD, but do not show signs of deficiets in all areas. I also know that our neuropsychologist said that NLD has become the “dx du jour” in many areas. Her feeling was that there are kids receiving the label who do not really fit the profile.

What I’ve gotten from ther eading I’ve done is that NLD is a right brain deficit, probably a problem with the “white matter” in the right hemisphere of the brain. They’ve decided this based largely on the fact that adults with right brain injuries have exactly the same impairments as NLD children. The jury seems to be out on how this damage comes about. Some children have risk factors, but others don’t. Is it always a result of actual “damage” to the brain, whether in utero or later? Or are there genetic factors that can cause the same sorts of brain dysfunction? It seems to depend on who you talk to.

In my son’s case, he does have some risk factors, (pre-term labor, dificult delivery and severe asthma that caused low O2 levels as a baby) but his school problems are very similar to ones I had in school too. So who knows?

The experts on NLD seem to be pretty clear that a child with NLD will have a very specific pattern of strengths and deficits, but every child will differ in how MUCH they are affected in each area. In some kids, (my son included) you might have to be observant to catch the pragmatics and prosody difficulties that lead to social difficulties. It was only looking back, after learning about NLD that I was able to see a clear pattern. In other kids, their fine motor skills might be fine, but they are just a little akward or uncoordinated. Others might do fine in terms of gross motor skills, but have a tremendous amount of difficulty learning to write. And some will have much more trouble with visual/spatial issues than others.

>> I do know though when he was evaluated for CAPD the audiologist commented on how unusual his social skills were for someone with his profile. I actually think he developed good social skills because he couldn’t understand the world due to poor receptive language skills, he watched. <<

But to me, the “unusual social skills” comment would be a red flag if he fit other parts of the NLD profile. My son said “Please” and “Thank you” _regularly and without prompting_ at 18 months. He _never_ lies, and he loves to help an adult that he likes. He regularly offers to help without being asked. He is very naive, trusting and friendly. He has a smile, a wave and a greeting for every teacher in the hallway. All the school personnel know and love him… even the ones he doesn’t have classes with.

As delightful as this all is, and as much as I’d like to take credit for it, it’s not “normal” behavior for a child. Most kids need to be reminded of their manners, almost all lie at least occasionally, and certainly by 4th grade, most have learned that it’s not “cool” to be overtly friendly toward teachers. Many NLD children are very good at getting along with adults. But the same behaviors that impress adults, and are reinforced by their positive reaction are not necessarily appropriate with peers. As the other kids become more socially savvy, the NLD kids start to stand out, then be targetted and teased because they stand out.

Maybe because of what I’ve seen with my own son, I’d be particularly reluctant to rule out NLD in a young child based on the apparent lack of social problems. It’s just too hard to tell at an early age. Everything I’ve read about NLD points to the fact that the earlier these kids are identified, and the sooner correct interventions are started, the better they do. The problems only get worse, not better. It’s a hard and scary thing to hear, but there is a _lot_ that can be done to help them.

Karen

I concur with much of what Karen shared. I don’t know if NLd is the dx du jour, but it has only recently (last 20years) been studied in any depth (from what I’ve read). I think it is still a big “box” the way dyslexia used to be (and now there is a much better understanding than there was 40 years ago about all the different kinds of dyslexia). From NLD parents I’ve talked with it’s very clear that each NLD kid is very unique - my 10 yr old daughter is “classic” NLD in many ways, except, in 5th grade she still has excellent math skills.

She has huge organizational issues which come from executive function disorder —is this part of the NLD or related to the ADD label (and ADD/ADHD is often being referred to now in terms of executive function problems) — she has continuing social issues, but is this inherent to NLD, or is it because she has such difficutly with simultaneous processing (looking and listening at the same time). Is it because she is so literal that as the social pace has picked up for 5th grade she can’t keep up with the verbal banter which isn’t concrete. etc.

bottom line: find strengths and weaknesses, build strengths and intervene (OT, speech, etc). for weaknesses.

Thanks for your thoughtful response. My son is not as “good” as yours—I know what kind of kid you are talking about from your description. My daughter actually fits that description more than my son. And you are right—it is not rewarded as you move up in grades. She has a few close friends but isn’t in the “in group.” My son, on the other hand, is good at joining groups, making friends for a day among who ever is around, and following the leader. He bows to peer pressure easily and often doesn’t seem to have a mind of his own, except with his parents.

We are currently doing therapy for his auditory processing problems. I am then going to do PACE to work on visual processing problems (vision therapy removed his LD qualification for visual-motor integration—now low average). I think afterwards I am going to take him to a Neuropsychologist for a complete eval. I am concerned about ADD too—the organization issues show up there as well. Because of his history of speech and language problems, we have relied almost entirely on speech and language therapists and audiologists for evaluations.

I don’t want you to get the idea that my son is perfect behavior-wise, because he’s not. He’s still a kid. But his sins are more often sins of omission rather than comission. He’s much more likely to not do something he should. He can also argue you blue in the face.

I also know from other parents of NLD kids that some are much more oppositional than my son is. There’s a lot of variation in how behaviors manifest. I think for clues, you ahve to look at the underlying reasons for the behavior. In the case of my son, his verbal ability is his strength, and he uses it very effectively. (sometimes to wear you down!) Also, in many cases when he argues with you, if you think about it, you realize that you said something that lead him to have different expectations than what you really meant. For instance, you can’t say to my son, “Will you please set the table?”

His response might very well be “No.” Not because he’s being wise, but because he’s answerng you honestly. If you say instead, “I need you to set the table now.” He may grumble, but he’ll probably comply. If you don’t include the “now” you’ll find it undone an hour later, and he’ll be totally shocked that you’re upset. After all, you didn’t say WHEN he had to set the table!

Karen

My son wouldn’t make that sort of mistake—he isn’t that literal. I understand that is typical of kids with NVLD which is the way he doesn’t seem to fit. He also isn’t that verbally skilled–he has history of speech and language delays. His problem is he is deficient in both visual and auditory processing. I suppose one could have CAPD and NVLD–seems like a heavy burden and I sure hope it isn’t him!!!

I don’t remember if you said whether your son had had a full neuropsych eval. I believe that CAPD is dx’d by an audiologist, not a neuropsychologist, correct? If you HAVEN’T had a full neuropsych, I would. Although my son doesn’t (as far as we know anyway) have CAPD, I know a number of parents who’s children DO have problems in both areas. And you’re right, it seems like a double whammy to me too! I hope that’s _not_ the case with your son.

Mine doesn’t have CAPD… he “just” has a fairly severe hearing loss in one ear, just in the range that a female teacher’s voice usually falls, as well as the babble of all the other children in the classroom. So we have to be very careful that he’s seated with his good ear toward the teacher.

Karen

We had an appt. for full evaluation set for last summer but then my son started Fast Forward for his CAPD. There was no way he could go through that as well. We put it off but by then had OT and developmental vision evaluations. At the time, I felt we had a handle on everything but now think I will pursue the neuropsych. as well.