non-verbal learning disability

[Anonymous]

My 4 year old was recently diagnosed with ADHD. He was given an IQ test where he scored very high in the linguistic part and average on the non-verbal part. While he did not receive a formal diagnosis of a non-verbal disability, there was a significant split (2 standard deviations) among the scores. Usually a split like that indicates a non-verbal disability (this is my minimal knowledge of this-- I am an SLP and I have only worked on this via social language cues, not visual spatial etc.). When I look at the definition of NVLD, there are a range of issues from difficulty with math, puzzles to reading social cues/expressions. Does anyone have a child with NVLD and if so, what is the treatment? Even if my son does not have a formal diagnosis yet, I wonder if there is anything I can do about it at home on my own. Thanks for any ideas.

[Anonymous]

I am wondering if your professional training is causing you to overthink this. Couldn't the split simply be the ADHD? Plus, my sense of NVLD is that its an educational diagnosis and not a medical one, and that it is really not used as much anymore.

[Anonymous]

No, NLD is alive and well. My son, age 9, has characteristics of AS and NLD--NLD is a better characterization. His verbal-performance discrepancy score is in the 0.4 percentile (!). We have done a home-based ABA-type program since he was 4, emphasizing visual-spatial, fine-motor, executive function, and social (social-cognitive). THE most important thing we have done is follow Michelle Garcia-Winner's Social Thinking curriculum. If you post your email address I can email you a summary of concepts and activities. The book to buy is Michelle Garcia-Winner's THINK SOCIAL--her red curriculum guide. She has activities and concepts explained. Her other books are great too. (And when your son is older you'll see she has resources on organization as well). I highly recommend going to one of her workshops if they come to town. They are fantastic! You're an SLP so you must know social pragmatics--that's probably the most important thing you can emphasize--draw attention to other person's perspective, and others' feelings, thoughts, intentions, plans, motives. etc. Watching TV together is a great way to talk about this--pause and discuss, What do you think will happen next. Also use lots of gesture and nonverbal language and draw your son's attention to "thinking with your eyes" so he looks for information in your facial expression, gestures, and body language to predict what's going on. Social Thinking is part of our everyday vocabulary--it takes years, not months, to develop these skills. My son knows all the concepts but it still doesn't always come automatically, in the moment, but it's getting better and better. Some people swear by visual training/behavioral optometric exercises. When your son is a little older you might try BrainWare Safari, which has some good visual and spatial cogntive training exercises. My son has worked on puzzles for years and still has trouble--partly due to impulsivity and lack of planning. We have worked on Stop and Think, Make a Plan; and Goal, Plan, Do, Check. Emphasize planning and sequencing when you can.

Best wishes to you! Hey, can you recommend someone in the Montgomery County who has proven experience with lateral lisp?? We are moving to the area soon and my DS needs help with laterizations and R's. : )

[Anonymous]

I'm sorry 08, I just don't see how anything in your post points to NVLD as opposed to an ASD. The deficit in social thinking is a big red flag for an ASD. As I wrote, NVLD is an educational label. So, sure, the discrepancy on such tests will point to such a thing. But everything else you've written screams ASD.

It seems to me to be another soft-landing label, like sensory integration disorder, to avoid the ASD diagnosis. I've written about this before here, I just get very angry at the sense of shame with which we seem to treat ASDs and the great lengths clinicians and parents go to to avoid the diagnosis. Anything but that!

And, by the way, most kids with AS also have ADHD and that would contribute to the discrepancy as well.

[Anonymous]

Oh, and as for R's, my son struggled with them for years until we found a speech therapist at Laura Rubinoff's who specializes in the R sound. I wish I could remember her name but she was amazing, she was like a genius for getting kids to say R.

[Anonymous]

The labels are just getting so ridiculous. It's all spectrum.

[Anonymous]

Actually, if you read the DSM, it's not all spectrum. There are specific requirements for someone to be diagnosed with autism, aspergers, or ppd-nos.

And if you read the new DSM coming out in 2013, there are new requirements coming for someone to be diagnosed with an autism spectrum disorder. There will also be several other categories for children with language problems that are at the root of their pragmatic communication issues.

We can't have an intelligent discussion about the criteria for an autism diagnosis without referring back to the DSM, which sets the criteria.

IMO, Promoting a one-size-fits-all diagnosis serves no one. A more specific diagnosis leads to more specific interventions.

[Anonymous]

08 here. I have no problem acknowledging my son has ASD, but I find that the description of NLD is a better fit than a description of AS, or people's preconceptions about ASD for that matter, even among professionals. Many kids with ASD, but not all, are good at visual processing. The visual/spatial processing deficit is captured best by the NLD label. Neither psychologist who diagnosed our son with AS/NLD said anything about NLD being an educational lable, and I seriously doubt Byron Rourke would say that either. The deficits go far beyond the educational environment as they pertain to the social and physical domains of functioning in the world, from my understanding.

[Anonymous]

08 again. PP: my post also screams NLD. Honestly, how many kids with ASD do you know who cannot do a puzzle for their life after years of teaching? And how many kids with ASD do you know who detest LEGO? I see nothing wrong with using a designation that can help more precisely define what is going on with a child. The labels are only relevant in so far as developing an understanding of the child and helping address certain areas of difficulty, as well as teaching the child to self-advocate by developing an understanding of their strengths and weaknesses.

[Anonymous]

p.s. thanks for the tip on Laura Rubinoff and R's.

[Anonymous]

@ 21:20.....I think it's funny how much you believe in separate labels. It's like the medical community just loves to rearrange it's symptoms and make up new names for it when it's all the same basic underlying problem.....environmental toxicity causing brain damage.

Label doesn't matter anyway. If you want to treat symptomatically, you just address your child's weaknesses as you see them. Seriously, you people crack me up.

[Anonymous]

Its a total myth that kids with ASDs have visual/spatial strengths. Some do, of course. But it is far from a defining characteristic. My DS with an ASD does not, he's much more of a language/artsy guy and has never been particularly strong in math (nor has he ever liked Legos).

I think you are splitting hairs in a way that perpetuates myths about ASDs, what you refer to as people's preconceptions. But, hey, its your child.

[Anonymous]

My niece does not have ASD but she does have NVLD. They ca exist separately