NonVerbal LD

Simplistically, It is the opposite of children whose verbal skills are better than their performance skills. When you see a = or > 15 pt. spread between VIQ and PIQ—with the PIQ being lower than the VIQ, look further for signs of NLD. Also happens in “flip” kids with issues on both sides of IQ test. (These kids have “higher” highs and “lower” lows on both sides—spikes.)

Symptoms can include but are not exclusively limited to:
1. Poor social perceptions/behaviors.
2. Poor transitioning skills.
3. Poor visual/spatial skills—often resulting in some or all areas of math being affected.
4. Poor motor planning.
5. Poor coordination.
6. Poor sense of time, place in space.

Not all kids have all things…and I may be forgetting some. Sue Thompson is a good read on this subject and I’m sure others have other ideas.

Research indicates that 40% of children identified with NLD do not have the VIQ/PIQ split. Sometimes math concepts are an issue. Also, hyperlexia is something to look for.

Your question can be interpreted two different ways. Do you mean can general ed/special ed teachers identify children with NLD as a rule? Or are you asking what specific things to look for to diagnose NLD?

I have a funny feeling that he has NLD and he is going for an independent evaluation, as he has alot of the signs. But, I was concerned that teaching and spotting these children would be difficult in a classroom.
He was evaluated 2 years ago and was considered borderline. He did not quality for ese services. He hasn’t changed much from that time so I guess the school team didn’t pick up on it, eventhough he can’t read his grade level.

Not all have the VIQ/PIQ, as I said, but many do.

JM,

I had a private evaluation done for my son about 14 months ago. They identified him as LD in written expression - and “probable” ADHD (inattentive). After doing some research on their diagnosis, it didn’t seem to me that they had covered everything that was going on with my son, so I had him tested for an auditory processing disorder. He was diagnosed with a severe APD. We put him on meds for the ADHD, and remediated for the APD. After almost one entire school year, we still weren’t giving my son the help he really needed, so I kept looking. I kept coming across posts in various sites about children with NLD, but whenever I started to look into it, I ran across that VIQ/PIQ split - and my son just doesn’t have it! So I didn’t look any further into NLD. A good friend of mine sort of pushed me into looking at NLD further, and …

NINE MONTHS after the originial testing, I called the psychologist and asked about a non-verbal learning disorder. He said, “Sure he has that!” So I asked for it in writing, but he was very reluctant to give me the diagnosis because it is not in the DSM-IV. My son’s neurologist also said “Of course he has a non-verbal learning disorder!” when I questioned her, but she was also reluctant to write the diagnosis for the same reason.

They both said the school system should be giving my son services based on his individual needs - and they should. But once I got the “label” and it was all sort of tied up into a neat little package, the school system started giving my son more appropriate services. Reading about the specific disorder also helped me understand my son better - so I’m sure it helped the school system! Your school system might not need the label, but mine did.

One thing to rememeber is that all disabitlities manifest themselves differently in every person. My son fits MOST of the NLD profile, but he doesn’t have the PIQ/VIQ split, and he was not an early extremely proficient reader (hyperlexia). His math concepts are also quite good, and he is good at putting parts to whole for abstract reasoning - just not social skills. :)

One item I found very helpful was this diagnostic sheet from nldontheweb.org:
http://www.nldontheweb.org/Goldstein_1.htm. There is a lot of good information on that site, plus a forum with some really great people. A couple of other places to look are nldline.com, and aspergersyndrome.org. NLD is sort of a first cousin to Asperger’s which is a very high functioning autism. Also look at the “Related Disorders” on that site, and look at the Semantic/Pragmatic Disorder information. NLDline also has a group in Yahoo that you can access from that site. I go to both frequently to keep learning about things, try to help other people, and try to determine how to help my son better.

One other note about testing - when I took my son in, they did ALL the tests in one day (we were in the office for 8 hours). I think he was really drained by the time he got to the last test (of course that was the WISC-III). If his evaluation can be broken up into smaller parts, it will be less stressful for your son, and the results will be more accurate. I sure wish I had figured that out when my son was tested!

Good luck!

Lil

I have gotten the same response, no exact diagnosis but when I have asked, they say “of course it’s NLD.”

I am having a real hard time accepting this, though. Initially with the first round of testing 3 years ago, he had the VIQ/PIQ split. With recent testing, there is no split anymore.

He has significant reading difficulties, math reasoning, written expression, spelling and CAPD. (Definitely dyslexic).

I can’t really accept the NLD because he does NOT have the social skills deficits which I understand as being the significant aspect of NLD and the clincher to the diagnosis. Is this wrong?

So, I’m having a really hard time with what NLD really means and what classifies a person as having such a diagnosis.

I think the term nonverbal learning disability is used differently by different professionals. This summer I took my son to a neurologist to be evaluated for ADD. The pediatrician was concerned he might have Asberger’s. The neurologist said no to Asbergers (and asked me why the pediatrician thought that) but said he had ADD and a right brain dysfunction. I asked about NVLD. He said “that is what I am saying.”

Now I have read the literature on the diagnosis of NVLD. He did not have the information necessary (never asked about coordination, visual spatial, for example). He was using the term pretty generically–a disability which is not verbal in nature. Now my son also has reading issues and he said he thought he was dsylexic as well. So we have a verbal and nonverbal disability.

Does he have a nonverbal learning disability as discussed by Sue Thompson and others? That I don’t know.

Beth

How is his sense of humor? The two youngsters we know who carry an official dx of NVLD have NO sense of humor, despite high intelligence; the middle school world of puns, sarcasm, witty retorts, and jokes are lost on these kids, and leave them open to teasing. My son who is LD has a good sense of humor and it is definitely an asset in school.

My son has no sense of humor and couldn’t tell a joke if his life depended on it. He is also VERY literal - to the point he sometimes seems precocious - but he is simply not interpreting anything we say - just doing EXACTLY as we say.

For example, I was teaching how to use the washer and dryer one Saturday. He put his clothes in, soap, etc - and I threw a couple of my sweaters in because the load wasn’t full. When the washer stopped, I asked him to put his clothes in the dryer. I went into the laundry room a short time later, and MY clothes were still in the washer. When I asked him about it, he said “But Mom, you said to put MY clothes in the dryer.” And that is exactly what I had done.

This is a good example of my understanding the NLD better after the diagnosis. I had done enough reading on NLD that I knew to ask the why question, rather than just assuming he was being defiant or objectionable and getting really angry with him.

OK
Here are my son’s scores:

Verbal IQ - 83
Performance IQ 69
Full Scale IQ 74

As for his social interaction - it’s nul and void…….never had a close friend, never interacted with children on the block. Always watched, never played.
Gives out his phone number but gets annoyed if anyone calls. He is always picked on at school, so he says. I don’t think he know what is playing and what isn’t. Walks areound like a snob. Tells me why he does not like someone, if I asked why he won’t play. Is very blunt when speaking to family. Remembers everything that was promised to him that he didn’t get. The list can go on.
When tested 2 years ago - slow learner
When given Vision evaluation in 2001 he did show a preference for auditory over visual which was very weak. After the testing they told me he had a visual perception problem, at that was that. No label of what he was.

He is now going for an independent eval with a neurologist, it’s 3 hours once a week for 4 weeks. Hopefully I will know much more.

The problem I have is that

a student on the autism spectrum. Many of the very severe NLD kids are/can be labeled PDD-NOS or high-functioning autism. Has anyone made this diagnosis?

Susan from the description she gives of her son I thought the same thing. I have a child labeled PDD-NOS who exhibits some of the same behaviors. However his IQ score and achievement testing is much more eradict then this childs. The nueropsychologist who saw him said that he has the “typical” pattern of an autism spectrum child. According to her MOST but not all usually have a higher PIQ the VIQ, this is true in my sons case, he has a VIQ of 83 and aPIQ of 104. He has great subtest scatter with scores of 5-13. On achievement test he scores anywhere from significantly below grade level (writing) to above grade level (math) . JM would be interesting to know if your child has eye contact, tactile defensiveness, sound sensitivies, insistance on sameness? Might be worth looking into this and see how this sounds. With intervention my son has come a long way, but this did not occur until they knew what they were dealing with. If you feel it may fit feel free to contact me and we can correspond about my experiences with my son.

Susan,
No, that was never brought to my attention by anyone.

NOW, he tells me today while we were doing homework that he has noises in his head, like static sound. Sometime he says he thinks the TV is on but it’s not.
When I asked him if it was in his ears, he said no. When I asked him how long it’s been there. He said since 3rd grade.
I am trying to sit here without bursing into tears.

I am soooo soory to bother you. You don’t have to answer me, I just needed to let this out.
JM

Could be small seizures. (Had a friend whose son compained that the TV was “jumping” when it wasn’t. Turned out the be seizures.)

Could be other things, too. Some may be difficult to diagnose until he/she is older. Kids w/lower performance *may* (not *are* but *may*) be more susceptible to emotional problems. I was surprised at the research to back that up. Anxiety disorders, OCD, other things, too.

I’d probably have the seizure possibility looked into but would observe for awhile (months, years perhaps) to see what other things may be needed.

Kids w/autism don’t necessarily have sounds in their heads.

I agree about the VIQ/PIQ thing.

I’d like to see the scatter on subtests. JM, do you have those?

My son who falls on the spectrum is VERY sensative to noise and can hear sounds such as the “buzzing of lights” ect that others can not. JM does he seem overly sensative to sound, covering his ears when others wouldn’t? Does he have a tendency too “zone out” when overly stimulated? Does he attend better in a quieter enviroment? The fact that he can tell you this is happening should be very comforting-he can tell you what is going on. Has he had chronic ear infections, ever had tubes in his ears, other respitory problems, or allergies? When was he last medically checked? I don’t mean to ask a bunch of questions but more backround might help. Such as do you have the subtest scores of the tests your son took?

My son hears “noises” similar to static on the TV. So does the son of a friend of mine. Apparently it is the noises from the lights or heating systems. The noises got better for both boys when they were put on stimulant meds for ADHD - and they could pay attention to what they were supposed to instead of everything else that was going on around them. My son is also very sensitive to loud noises - that is part of his auditory processing disorder.

You’re going to see the neuropsych very soon. Hopefully they will be able to pinpoint the causes and things that can be done to help your son.

Thanks I have the tests.
I had an MRI done about 6 months ago….he has terrible headaches, everything showed up normal. Would the MRI show seizures? He had tubes and ear infections from birth to 4.
Here are the test scores: Thanks again.
WISC11 Dated: 4/2000 CA: 9.4

Standard Scores – Verbal IQ 83; Performance IQ 69; Full Scale 74
Index Scores – Verbal Comprehension 84; Perceptual Organization 69;
Freedom From Distractibility 78; Processing Speed 80

Verbal Functioning Scaled Scores Description
Information 6 Long Term memory of isolated data
Similarities 6 Knowledge of relationships
Arithmetic 7 Aural arithmetic reasoning
Vocabulary 7 Word Knowledge, verbal fluency
Comprehension 9 Practical knowledge, reasoning
Performance Functioning
Picture Completion 10 Alertness to detail, visual memory
Coding 6 Motor speed and accuracy
Picture Arrangement 2 Social awareness, sequencing
Block Assembly 5 Reproduction of geometric designs
Object Assembly 1 Construction from part-to-whole

Optional Subtest
Digit Span 5 Immediate auditory memory

ACHIEVEMENT:
Woodcock-Johnson-Revised: Dated: 2/28/00 (By School)

Grade Standard
Subtest Equivalent Score Percentile
Letter-Word Identification 1.5 72 3
Passage Comprehension 1.4 70 2
Calculation 2.5 80 9
Applied Problems 3.6 101 53
Diction 1.7 78 7
Writing Samples 2.0 82 11
Broad Reading Cluster 1.5 68 2
Broad Mathematics Cluster 2.9 90 24
Broad Written Language 1.8 77 6
PROCESS:
Test: VADS Dated: 4/27/00
Subtest: Percentiles
Aural-Oral 10
Visual Input 10-25
Visual-Oral 25
Oral Express 10
Aural Input 25
Aural-Written 50
Written Express 25
Visual-Written 10
Intrasensory Integration: Below 10
Intersensory Integration: 25-50
Total VADS: 25-50

Age Equivalent 5-6 to 5-8 Standard Score 51

My son has a 30 point VIQ/PIQ split, primarily because his coding score was a “1”. All his perf. scores were lower than verbal, but the coding really skewed it. So right away I’m thinking NVLD- he has mild social deficits, some motor issues. Seems to fit. But nobody really thinks the official NVLD dx fits (as described by Sue Thomas et al) Our psychiatrist said yes when I asked, but I think he’s using the term more loosely. Our neuropsych “didn’t like that label for him” Maybe its a question of severity. Crank up his slightly rigid personality up several notches and maybe he’d look truly NVLD. And his academic strengths don’t line up: he’s likely dyslexic, but has excellent comprehension. He does have a sense of humor, understands metaphor, idioms etc. And then I read that many dyslexic children also can have social problems.

with the IQ-Discrepancy format. This students real strengths don’t show on the WISC and it really doesn’t show his significant learning issues clearly. It is an out-dated model.

The math scores—esp. Applied Math—tell us that he has some reasoning skills. That is juxtaposed against the lower Block Design and Similarities scores.

I wonder if the OA is really that low. Can he really not do puzzles at all???

Comprehension score tells us that he’s in the average range on understanding social norms and knowing what to do about problems related to them. Ex: What would you do if you found a letter lying on the sidewalk, with a stamp afixed? Correct answer: Pick it up and mail it. (Very culturally loaded subtest…doesn’t tell us much unless we’re testing WASP folks.)

Be sure to tell the neuropsych about the television thing. It may be nothing but you never know unless you ask.

There also should be a behavior questionaire—likes a Burke’s Behavior Rating Scale—there are several different types. You may have done them already.

Try not to be scared. It’s worse to bury one’s head and refuse to discover the real issues. We can’t help what we don’t understand.

I don’t think your child is NLD. Most have much easier time w/decoding than comprehension. Yours still seems like a dyslexic flip-kid. They’re really tough to figure out. I’ve spent 16 years trying to find the right label for mine. So have other parents w/dyslexic flips.
We keep peeking around corners for new dx information. And peeking. And peeking. For years & years.

I’ve finally accepted that I probably will never unravel all the learning threads for this now-adult person.

The test was taken 4/2000. He is now going through testing with a neurologist. I will certainly tell them about the TV hearing noises thing. That really put a topping on the cake……But, I’m glad he was able to talk about it.

Thanks so much to everyone…..I feel better now.

That depends on the kid too, though, and also the kind of joke. My NLD son has a better sense of humor than the one who is NLD-ish, but doesn’t have that dx. (he has no sense of humor at all!) The NLD kid doesn’t always “get” jokes because of his literal interpretations, but once theya re explained to him, he thinks any sort of play on words is hilarious… probably because of his generel insterest in and comfort level with words.

Karen

Since so much of what teachers ask for in school is usually verbal (depends on the teacher of course), for buckets of years kids with NLDs have gotten by without a diagnosis — which could be a good or a bad thing. Often these are kids who are a bit eccentric, or they’re the “nerd.”
If a teacher knows what s/he’s looking for it would be a different story, but there are also teachers who would swear it’s just one more way for parents to make absurd demands of them and that there’s no such thing.

I would say my son is the same. My son has a wonderful sense of humor. Almost can always recognize sarcasm, definitely is able to read body language and use expression and I think has a wonderful give and take in conversation. The only thing that I have had a concern about in regards to this is when he is trying to process something he doesn’t understand. You can just see the wheels turning and smoke coming out of his ears. But he always gets it. He is very hard on himself, his own worst critic, and can sometimes (not always) perceive things inaccurately.

The neuropsych said he had poor give and take and a flat expression. But, you can definitely tell when he is nervous, his whole being changes and I think that is what she was seeing. She didn’t think so.

I don’t care how much experience one professional has in the field, a 45-minute interview with a child does not give you an accurate impression of him, especially when he can be two totally different kids. He is very different when he is nervous. Anxiety definitely gets in the way with my son at times and I think he was misread because of this?

I think you are right about that. They all use it differently and probably use it to describe “anything” that isn’t language based.

We are going for a formal speech/language eval in two weeks. I am very curious to see if we can get a signficant finding that shows his disabilities are language based because he really does not fit the real dx of NLD.

We’ll see. Thanks for bringing this point up.

Could you elaborate on what flip kid, especially dyslexic flip kid means? Thanks

Dyslexic = Reading Disordered w/average intellectual ability

Flip = highes and lows on both sides of the IQ test—Verbal and Performance. Ex: Inf 13 DS 4 BD 16 OA 5
Kid might have high processing speed with low Perceptual Organization…Might have high VC w/low FD. Doesn’t have to just be on the Indices, though. Could be just wide, wide variance on individual subtests.

I know I should probably stop worrying about whether he is or isn’t… its just that everytime someone sees his WISC they think “NLD” and while he’d benefit from OT and social skills intervention his real issue is reading. It gets people sidetracked (including us his parents!!)

Just pulled out the WISC to see the flip:

On the verbal his scores ranged from 8-16 , most above 11. A wide range?
On performance he ranged from 1 (coding!!) to 13 with most right around 9. That coding score is the real outlyer, not that its not valid. But there’s alot behind that score if I understand it correctly.

Thanks for validating that kids like this exist. You’ve been really helpful.

I believe anxiety has skewed the results of my son’s testing several times. The neuropsych actually concluded that he has anxiety and not ADD. But she never got to see him relaxed , happy, cheerful, which he is alot. So her assessment of his overal mental health wasn’t balanced. Then we had him evaluated by a psychiatrist, who mentioned Aspergers to us due to the complete lack of eye contact in their first *2* meetings. Well, yes, his eye contact can be poor, but its variable. When he’s uncomfortable its worse. (he doesn’ t have aspergers…) and on a recent reading assessment he flubbed words I know he knows. More anxiety I think.

Its not that these professionals were wrong - but its hard to get the whole picture in a contrived environment. And some people ‘s performance can really change depending on the situation.

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Boy, isn’t that the truth. Looking back, I realize my daughter wasn’t a poorly behaved preschooler, just a child who was fighting for all she was worth to survive!

All those VIQ scores are in the average range, so no discrepancy on that side. Now, the Coding score offers discrepancy so we are seeing more on the PIQ side rather than a “flip”.

If there is not big subtest scatter in each subtest but a difference in the indicies would these still hold true. Example my youngest son:

VIQ 82 (subtest scores 5-9)
PIQ 104 (subtest scores 9-13)
FSIQ 92
VC 84
PO 105
FD 75
PC 106

So part of the problem could be he is trying to process quickly but does not have the verbal skills to back it up? His older brother has a similar profile but without the VIQ/PIQ split, but he does have the spit between VC and PC and also PC and FD. Both have reading difficulties with a strength in math, both can see the big picture but miss details, both come up with uniques solutions to problems.

Karen,

My son has descrepancies also on the performance side outside the normal range (5-12) and like your son all his verbal scores are “average”. Yet, he still has trouble with reading and I was told by the neurologist that he was “probably dyslexic”, whatever that means!! Now interestingly, my kid is average on coding—his low scores are object assembly and picture completion.

Still, despite his average verbal scores there is something going on with him. I would say the same for your son. Your son is gifted in some areas while scoring low average in others.

Beth

My son doesn’t have the anxiety but like your and Little Lulu’s son’s, but he can do the not look you in the eye routine with a flat voice. He did this at the pediatrician’s office and that was the reason why he was referred to the neurologist to rule out Asberger’s. Now the neurologist was clueless as to why the pediatrician thought Asberger’s because he didn’t act in any of these ways with him!! I had to tell him why. But the neurologist had him sitting in a chair as opposed to up on a table and was having a conversation with him. In contrast, the pediatrician was asking him the age old (for kids) so what is your favorite subject in school. I don’t think my son thought it was worth looking at him for!!

My son was diagnosed with right brain dysfunction by the neurologist and I think the variable eye contact and flat voice is related to this neurological weakness. Most of the time he isn’t like this—but sometimes he is.

Beth

JM,

Remember that no matter what the tests say, the neurologists say, the teachers say or anyone here says that child is still the child the you have always known and loved. Put the labels where they need to be over to the side. Use them if you need them but don’t let them define the little guy.

Our children are just so much more than all of that. My child has been labeled with things that no longer fit. I have tried to focus on labels that provide me with specific interventions, otherwise what is the point.
If you child has fine motor skills get them ot. If they have an auditory processing deficit get them to speech or to an audiologist. If the problem is visual tracking maybe a vision therapist is in order. There are many great programs discussed on here that have provided children with small miracles.
Phongraphix and interactive metronome were the keys for my son. Next we will be trying seeing stars or audiblox.
I am taking my child out of sped tomorrow. A victorious day for a child who was the absolute bottom of his first grade class.
He is’nt finished but he is far from where he started.

Good luck to you and hang in there. We are all here to help!

Linda F

“Flip kid” is just a “Sally Smithism” (of Lab School fame) from a few years back that describes a difficult to analyze kiddo. A kid that had problems in some aspect of verbal skills and some aspect of visual/perceptual would describe this kind of kid.

Your child, like mine, is a complex child. He has more than one LD processing issue going on.

You of course are right not worth fretting over because BOTH my boys are very complex who truly dont fit one definition—I liken it to they have their own drummer.

Just curious - are you going to continue with him on consult in order to keep him IEP? Might be a thought.

.

I can hear lights buzzing all the time, and so can my daughter and her boyfriend. It can be really annoying, especially in places like K-Mart with huge numbers of high-powered fluorescent lights. We can also all see the lights flicker. My laptop humming right now is enough to be a nuisance. Some people are just high-sensitivity. My father was gifted in music and had perfect pitch, and my daughter has talent too; my mother and I can match paint colours by memory; so it’s not all bad to be high-sensitivity. Given that, you do need to learn how to manage it. Realize that he’s not just griping and making excuses when he complains about skin irritations, sounds, lights, and so on; he really feels these things. Partly you need to control the environment (soft clothes and non-irritating soap; remove perfumed soaps and “fresheners” etc if these things bother him; directed lights with regular incandescent, not fluorescent bulbs; remove as many electric/electronic gizmos as possible to cut the humming; etc.) Partly he needs to focus his attention away from the irritants, and this is a matter of teaching and calling his focus back.

There is also a problem called tinnitis, which I also have; ringing or buzzing or humming in the ears. It can be caused by infection, scarring from old infections (my problem), congestion, allergies, over-stimulation by loud noise, medications including aspirin, and so on. A doctor may help but in most cases the only thing to do is to remove all irritants possible, and then learn to focus away from it if it still happens. It makes the situation a lot easier if parents and doctor recognize the problem and don’t call him crazy or lazy.

The human brain is a pattern-seeking organism. If you see blotches on the moon you try to make them into a face. This is normal. If you hear a low intermittent sound, you try to interpret it as meaningful, as language. It helps to explain this and let him know it’s just a processing glitch, not something wrong with his mind.

And of course get good medical advice and follow up on the other post about possible seizures.