NVLD-Non Verbal Learning Disability or Disorder. All I can say is wow! Is your child struggling with pragmatics and other issues, but you just can’t find what fits? I learned so much at a presentation I went to today. It’s not what you think it is. I thought it meant that the child was non-verbal. So many parents said that when they learned their child has NVLD and read about it, lingering questions had finally been answered.
Read on to learn what NVLD is, NVLD symptoms plus NVLD learning and IEP accommodations.
NVLD: Non-Verbal Learning Disability/Disorder
Our presenter stated that Non-Verbal Learning Disability (I’ll call it NVLD from now on) is more common and can be more dangerous than I realized. I also did not realize that it is not in the DSM (unfortunately). There is an effort underway to get it in the next DSM, and also to create more awareness around NVLD. So, assisting in that effort to create awareness, I decided to post what I have learned.
First, the biggest misconception of the term “non-verbal learning disability.” Every parent there today who has a child with NVLD, has said that on many occasions, people say, “Oh so your child does not talk?” Quite the opposite! NVLDers talk all the time, too much in fact. The term means that the learning disability is NOT verbal. Think of it as a “NOT verbal learning disability.” They are verbal, what they struggle with is all the other stuff.
The main reason I wanted to share this information, is because undiagnosed and untreated, NVLD can be dangerous and sad. Generally, as a younger child, kids can hold it together and their extreme talking masks their real issues. But as academic and social demands change and intensify, the situation can quickly deteriorate. Kids with NVLD have a very high rate of depression and can become suicidal and violent. NVLD is often is misdiagnosed as Aspergers or ADHD because some of the manifestations are the same. If your child has one of those diagnoses and perhaps they still are not making progress or that diagnosis just doesn’t really fit in your opinion, you may want to pursue this. If untreated and unsupported, it can lead to extreme isolation, depression and violence. So here is an overview of NVLD, how it manifests, how it is diagnosed and some strategies.
Remember, these kids are HIGHLY VERBAL, to the point of being repetitive and boring. But their high verbal skills mask many other issues. Here is a list our presenter gave us, on NVLD symptoms.
- Toddlers are unable to put puzzles together
- Child dislikes construction toys
- Learning to ride a bicycle is extremely difficult-many have severe balance problems
- Using fine motor skills is a challenge: tying shoes, writing, using scissors
- Child excels at memorization tasks and uses language to talk through sequences which rely on a kinesthetic memory
- Boys and girls present with clinical signs of anxiety, depression and attentional problems.
- Problems with interpersonal skills
- Unable to read the body language of others
- Cannot discern humor and misinterprets “teasing”
- Unable to understand symbolic language, are very “concrete” in speech interpretation
- Failure to observe space boundaries from one person to the next, “personal space”
- Difficulty in remembering how to get from room to room in school, may become easily lost.
- Don’t seem to get the “Whole Picture”
- Performance IQ is lower than the verbal scores on the Wechsler
- Non-verbal reasoning as measured by the block design is weak
- Object Assembly, Picture Arrangement, and Coding are weak
- conceptual understanding and applications are a weakness
- great difficulty setting priorities
- 57% of NVLD children exhibit auditory processing disorders
- Difficult soothing
- Prone to depression
- Their speech has little rhythm or variation in tone and inflection; long, windy monologues are not uncommon (Gregg & Jackson, 1989) and what they talk about may seem boring.
- separating the main idea from details,
- developing outlines, taking notes
- organizing paragraphs based on topic sentences
- mathematics, computation is often stronger
- Focusing on details (that may be repetitive and/or irrelevant)
- Recently, a deficit in spatial memory has also been implicated
- Has trouble recognizing nonverbal cues such as a facial expression or body language
- Shows poor psycho-motor coordination; clumsy; seems to be constantly “getting in the way,” bumping into people and objects
- Needs to verbally label everything that happens in order to comprehend circumstances, spatial orientation, directional concepts, and coordination; often lost or tardy
- Has difficulty coping with changes in routing and transitions
- Has difficulty generalizing previously learned information
- Has difficulty following multi-step instructions
- Makes very literal translations
- Asks too many questions, maybe repetitive and inappropriately interrupt the flow of a lesson
- Imparts the “illusion of competence” because of the student’s strong verbal skills
Does any of the above sound familiar to you? It is not at all uncommon for these kids to be labeled as Autism, Aspergers or ADHD. These kids also struggle with pragmatics and pragmatic language skills.
Autism and NVLD-misdiagnoses and other issues.
- One explanation for relatively superficial semantic knowledge is the over-reliance that these children apparently place on learning through auditory and verbal means. Perhaps many of the words of the child with NVLD are “fast mapped” rather than fully understood.
- The most deficient domain of language in children with NVLD is reported to be language use or pragmatics. Pragmatics refers to the appropriate social use of language and includes the ability to generate language to accomplish a wide variety of specific social purposes (e.g., requesting objects, requesting information, commenting, greeting, etc.) as well as the ability to manage conversations successfully (e.g., initiating interactions and introducing topics, taking turns, maintaining and building on topics, recognizing and repairing conversational breakdowns, etc.)
- Speakers with NVLD often are characterized as verbose. Other examples of pragmatic difficulties that may occur include frequent use of stereotyped expressions such as “by the way” or “actually,” an inability to read or use facial expressions or tone of voice, difficulties in using facial expression and gestures to express feelings, problems with appropriate speech prosody resulting in a lack of affective modulation in language, and abrupt topic shifts.
Evaluating for NVLD
Our presenter is an SLP, and this is what she provided as far as getting your child evaluated for Non-Verbal Learning Disorder. This is what she and ASHA recommend (American Speech and Hearing Association).
- In terms of assessment, if anecdotal accounts of the language deficits associated with NVLD are correct, then pragmatic language skills present the greatest problem.
- In addition, many of the instruments that have been developed (e.g., the Test of Pragmatic Skills, etc.) quantify pragmatic skills in relation to developmental norms rather than focusing on qualitative abnormalities in communication.
- In order to evaluate pragmatic features of the sort that are reported to typify the population with NLD (e.g., verbosity, inappropriate content, etc.), it’s important to assess behaviors that are difficult to elicit in test situations and that may be rare, but salient, in occurrence.
- Dorothy Bishop has developed such a tool. She calls it the Children’s Communication Checklist.
- Diagnostic criteria for NLD have historically included lower visuospatial reasoning compared to verbal reasoning.
Nonverbal Learning Disability Teaching Strategies and Accommodations
- Have your child use the computer at school and at home for schoolwork.
- Help your child learn organizational and time management skills.
- Make use of your child’s verbal skills to help with social interactions and non-verbal experiences. For example, giving a verbal explanation of visual material.
- Teach your child about non-verbal communication (facial expressions, gestures, etc.). Help them learn how to tell from others’ reactions whether they are communicating well.
- Learn about social competence and how to teach it.
- Help your child out in group activities.
- Get your child into the therapies they need, such as: occupational and physical therapy, psychological, or speech and language therapy
- The student with NLD, however, cannot avoid the need to put ideas into a written format.
- The role of the special educator at this point is to put a structure in place for the child so that he or she can see that written discourse can closely parallel verbal thought.
- The intervention strategy for written language begins by verbalizing and outlining what the final product will look like.
- The special educator begins by teaching the components of a sentence, a paragraph and then an essay.
- At times, using a math-like algorithm, a topic sentence + specific supporting details + a concluding sentence = a paragraph.
- It is important to allow the student with NVLD to understand the structure first so that, following this structure, a response can be formulated mentally.
IEP Goals and Strategies for NVLD
Suggested strategies include teaching, then re-teaching; getting the child to explain things back in his own words; and requiring the use of words different from the ones used in the initial explanation. These strategies will push the child to process and hold on to the information that has been presented rather than to offer rote repetition.
IEP Goals for Nonverbal Learning Disability
I was not provided with a specific list of IEP Goals for NVLD, per se. However, below is a list of desired skills sets for students, and some IEP or 504 accommodations. From this list, it’s not difficult to turn it into an IEP goal.
For example, let’s use the first one. Having the student rehearse getting from place to place is a teaching strategy or accommodation. So, clearly the goal is to have the student move from Place A to Place B without assistance. The specifics of that will be dependent upon the individual student. Use the flow chart below (about IEP Goals) to input the desired outcome and make it an IEP Goal.
Accommodations for Students with Non-verbal Learning Disability
- Rehearse getting from place to place
- Minimize transitions and give several verbal cues before transition
- Avoid assuming the student will automatically generalize instructions or concepts
- Verbally point out similarities, differences and connections;
- Number and present instructions in sequence;
- Simplify and break down abstract concepts,
- Explain metaphors nuances and multiple meanings in reading material
- Answer the student’s questions when possible, but let them know a specific number (three vs. a few) and that you can answer three more at recess, or after school
- Allow the child to abstain from participating in activities at signs of overload
- Thoroughly prepare the child in advance for field trips, or other changes, regardless of how minimal
- Implement a modified schedule or creative programming
- Never assume child understands something because he or she can “parrot back” what you’ve just said
- Offer added verbal explanations when the child seems lost or registers confusion
- Phonology is intact mastery of the sound system
- Morphology which deals with inflectional word marking is also adequate.
- Syntax including the formation of complete sentences and the use of various sentence types is described as age-appropriate. IT APPEARS THAT LANGUAGE STRUCTURE IS NOT AN AREA OF DYSFUNCTION FOR THESE CHILDREN.
It’s important to note that NVLD is NOT in the DSM and it is NOT one of the 13/14 eligibility categories under IDEA. However, remember that IEPs are needs-driven, not diagnosis driven. You can still request that your child be evaluated for special education services and follow the IEP process. More information below.
Thank you, Sherry, for this great information! If you wish to reach Sherry for Special Education Advocacy in the metro Philadelphia area, you can email her at [email protected]