NLD "experts" - what is your opinion on this...

One big part of the NVLD picture is the social skills too. I know many students who just are very disabled in their visual spatial, perceptual, motor abilities. On paper some of them appear as non verbal language disordered but their social skills are not. I know one boy who is just shy and when adding the visual motor deficits many professionals thought he was a sure thing for NVLD, but they were dead wrong once they got to know him.
The testing that you have included is only one part of the diagnosis, social skills is another.

My son displays NLD traits socially, mild enough at the age of 8 to allow him to have friends, but there nonetheless. What I’m trying to understand about this test is what it says about his strengths, which may be compensatory or not related to the deficits of NLD at all. I don’t know because I can’t interpret what this test is really going after. I’m still learning the language of neuropsychology and LD. : - O

(BTW his weaknesses on the CAS would indicate some kind of executive function deficit which is the other place I see NLD in him.)

Karen,

I don’t know about those test scores but let me share this with you. Now you know my son has had difficulty with IM. He is very herky jerky and his original score was a wopping 250. His biggest problem is quite obviously finding balance and coordination with his feet. (gross motor) Also this is the kid that when I tested myself for visual perception using the TVAS in Rosner’s book he tested at the kindergarten level almost 3 years younger than his chronological age.
Well I pulled out and evaluation done by his OT at school 1 year ago. This is what it said:

He was given the entire battery of the the Bruinninks-Oseretsky test of Motor Proficiency consisting of eight sub test areas. The results point to a superior performance in gross motor area. The sub tests evaluating running speed, balance, bilateral coordination and strentgh throughout the body resulted in a gross motor composite score of 98%. His battery composite score is in the 88th percentile. Chris shows less developed skill in the fine motor area but still had normal test in response to speed, visual motor control, drawing through mazes, cutting with scissors, and copying shapes. He had slightly depressed scores in the upper limb speed and dexterity section which evaluated tasks such as sorting, playing cards, stringing beads, displacing pegs, manipipulating pennies, all in timed testing. This fine motor composite score placed him in the 21%.

Later tests done by this same OT did point to visual spatial problems. But the subtest that involved drawing mazes showed there was no problem. My son is very good at mazes yet I KNOW his visual spatial perception is way off. I think you are right there is a fair amount of compensation going on that can throw a test off. Several OT reports mention the fact that my son enjoys the logic of the drawings.
Also a year of sensory integration OT from a therapist that pretty much everyone you talk to says is the best there is, did not get my son past the kindergarten level on the tvas test for visual perception. He was only seeing her once a week because she really didn’t think he was that bad.

And now I understand why our neuropsych didn’t like NLD as a dx for my son. And maybe why one diagnosis doesn’ t fit him at all.

If anyone needs info. on this test ( I seem to be the only one who’s child has taken it LOL) let me know.

In a nutshell, he scores poorly on attention and planning. Warning signs for ADD certainly, but there were other things in other tests that made her think he’s not ADD. But certainly has some exec. function problems.

He scores very high on simultaneous and successive processing - things you would not expect from an NLD kid. These tests measure spatial and part-to whole skills. But what I note is that alot of these tests were verbal/spatial. Didn’t require him to write or draw, which on the WISC really dragged down all of his scores.

Did he have a bender? Did anyone ever say the words visual motor deficit?

He had mild motor delay on the bender, about a 6 month delay. Her comments were that he performed well on it. Would that be a indicator of whether VT would be appropriate? what were you thinking about the bender?

Some of our kids have not read the book on being LD. My gut reaction is that he has output issues like motor planning. My observation is that my son has big problems with part to whole reasoning, regardless of the type of task. But my son scored average (9) on coding on the WISC so I think his IQ test in this area is perhaps more indicative of his ability.

My son scores average (94) on the tests of VMI. Still he has problems copying from the board and the like. I think the test isn’t sensitive enough to certain kinds of problems. The OT tried to dismiss him last year from OT services and I just wouldn’t budge. The classroom teacher agreed with me.

Beth

I think you are right. I’m sure ds has motor planning issues and graphomotor issues which impacted his wisc across the board. (his coding was a 1) I feel like we are intervening on the planning, attention and motor issues as best as we know how - IM now, OT in the past etc. The reason I am persuing understanding these test results is b/c he clearly has some strengths that are inconsistent with the conventional assumptions about certain types of LD. If I can understand his strengths (as well as the deficits) that info. can be used to help him compensate. Like his part-to whole reasoning seems to be strong if the task is verbal.

The other reason is the same I have for many of my questions these days: trying to anticipate as best as I can what educational environment he’ll need over time.

Have I thanked you all lately for your insights? : )

I think the anticipating is difficult, but I sure understand where you are at. My son is in 4th grade now and I think of this as the year to decide what to do—before middle school. I think the problem is your son doesn’t neatly fit any category of LD. The difficulty with this kind of profile is that the future is less predictable.

I would teach him to type though. I would be surprised if writing didn’t turn out to be a real problem. My son though is doing so much better on the writing front post IM. So it may be all hard to predict!!

Beth

Karen

The reason that I asked it because my son scored with a 12 to 18 month deficit on the bender. Further tests that tried to isolate whether or not it was more motor planning or visual perception seemed to indicate that he didn’t really have a problem with either.
I think I finally got that it isn’t a problem with either but the integration of both the visual and motor issue together. I think this is sensory integration which is certainly a picture I thought he fit when I read, The Out of Sync Child.” I think even within sensory integration there are many sub categories. The private sensory integration OT said that she could do a comprehensive test to see exactly where the breakdown was. It would cost a mere 5 to 8 thousand dollars. With these results she could help the OT at school design a very specific sensory integration program for him.
Well you know what I said to that!
She said that it didn’t really matter he would benefit greatly with IM and I believe she is right on that count.
I have come to understand that the TVAS from Rosner’s book and the Bender are pretty similar tests. My son has been fully remediated based on the TVAS results. I now want my son to do the Bender again to see if this problem truely has been remediated. I will ask the school psych if she will help.

It seemed to me that your son could do the visual exercises when motor planning was not required based on the test scores you outlined. I must say that I could be totally wrong on that assumption, it was just something I thought I saw. I was just wondering if it wasn’t the same thing as my son.

I was thinking that maybe an OT could look at your son’s motor planning issues. The test that was done for my son was the Bruininks-Oseretsky test of Motor Proficiency. It seems pretty clear from everything you have told us that he has some dyspraxia. Dyspraxia is an output motor issue. Your brain knows what it needs to do but can’t get the muscles to oblige.You may not see a problem with that now that you have already done IM. Interactive metronome is supposed to be great for this particular issue. I have made friends through this board with a speech therapist who does IM. She is a truely gifted amazing woman who cares deeply about helping people. We have talked at length about these issues and she thinks the motor planning is one area where she sees the most significant improvement along with attention.

One important thing about the whole therapy remediation process. Rosner says that even though you remediate the area of deficit you still have to now teach the skills they never learned back when they had the deficit. So something like handwriting will be easier to learn once the dyspraxia is remediated BUT you still have to teach the skill. Also, if they learned a skill using inneficient means to circumvent the deficit they will still rely on “that way” of doing it even though they have the new skills.

One more reason to remediate early.

Beth from FL wrote:
>
> Some of our kids have not read the book on being LD. My gut Still he has
> problems copying from the board and the like. I think the
> test isn’t sensitive enough to certain kinds of problems.
> The OT tried to dismiss him last year from OT services and I
> just wouldn’t budge. The classroom teacher agreed with me.
>
> Beth

Beth,

You are so right. I think our kids have some gifts that allow them to fool us at times. They have figured out how to compensate for an area of deficit so we have to dig deeper.

With my son, the more specific tests through a wrench into the works. They tried to say he didn’t need OT because his motor planning was sufficient and he could tie his shoes and hold a pencil. He also has a great visual memory. The broader Bender showed the problem.
This diagnosis business is extremely difficult. It is like finding a needle in a haystack.

The private OT that evaluated my son who is now 14 in 2nd grade said he was dyspraxic. His visual perception tested fine. His motor skills improved on the motor tests over time but what do the tests require. They usually ask the child to copy at near point. As Linda says the problem is a visual-motor integration problem. My son has trouble remembering the shape of letters and the motor movements to produce the letters. I am considering IM. It is good to hear peoples reports of improvement after IM.

Helen

My NLD son is 11, in the 6th grade and he STILL can’t tie his shoes tight enough to keep them on his feet. (we’ve given up and get him the slip-on sneakers that are popular now) He can’t cut his food either. But the school wouldn’t give him OT. I think that as long as a kid can walk from one room to another without hitting the doorways on the way through, he doesn’t qualify for OT in our school system!

Karen

I had to really bug them to get my son in OT. I was rather relentless. I know what therapy can do. It is sad that there is so little emphasis on therapy in our schools. It is just so important. I know so many say it is a money issue but I think even just getting an OT involved with the assessment and having the parent do exercises at home with ocasional oversight from a good OT could be hugely beneficial.
That is how therapy should be done in all situations. Even when your child gets OT it is more likely than not to be a once a week event. Once a week is really rather useless. Therapy needs to be intensive to have an effect.