PARADOX

THE PARADOX OF NLD:

Nonverbal Learning Disorders in Adults and Children

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What is NLD?

Nonverbal Learning Disorder (NLD) is an uncommon and poorly understood neurological condition with a misleading name. It is not a disorder that causes people to be nonverbal. Instead, it is a disorder that impairs the ability to process and learn nonverbal information. Because communication is about two-thirds nonverbal and only one-third verbal, the inability to understand nonverbal information can cause profound difficulties. In particular, three areas are commonly impaired in people with NLD:

Visual-spatial skills:

Most people with NLD have poor visual recall, faulty spatial perceptions, or difficulties with spatial relations. They may get lost easily, or have difficulty finding things that are in plain sight. They may not be able to tell their left from their right.

Social skills:

Most people with NLD have trouble understanding nonverbal communication such as facial expression, body language, and tone of voice. They may not "get" your shrugs, winks, grins, or wrinkled foreheads. They may have trouble adjusting to transitions and novel situations or difficulty gauging appropriate "personal space." Their deficits in social judgment and social interaction may cause them to seem immature. Other people may consider them annoying.

Motor skills:

Most people with NLD have poor coordination, balance problems, or difficulties with fine motor skills. They were probably late learning to tie their shoes or ride a bike--or they may never have learned at all. They may have trouble catching a ball. They may write slowly, and their handwriting may be illegible.

Many people with NLD do not show significant deficits in all three areas. Some people will have major problems in one area, but only minor impairments in another. Because NLD looks different in different people, it can be hard to diagnose. Sometimes it resembles other disorders of communication, such as Asperger's Syndrome (AS). It is sometimes misdiagnosed as ADHD (attention deficit hyperactivity disorder) or obsessive-compulsive disorder (OCD). And, to make things even more complicated, it sometimes occurs in conjunction with AS, ADHD, OCD, or other neurological disorders.

People with NLD usually do not have deficits in verbal skills. In fact, many have strong verbal skills that help offset their weakness in nonverbal communication. This may show up as a discrepancy in their scores on standardized tests. On the Weschler Intelligence Scale for Children, for example, some children with NLD have scores 20 or 30 points higher on the verbal scale than on the performance scale.

"The assets include early speech and vocabulary development, remarkable rote memory skills, attention to detail, early reading skills development, and excellent spelling skills. In addition, these individuals have the verbal ability to express themselves eloquently. Moreover, persons with NLD have strong auditory retention." (Sue Thompson, NLDline)

Many people with NLD learn to read early (although their ability to "decode" words may exceed their ability to understand the content). They are usually talkative--sometimes incredibly so. Many people with NLD find that, if they can't say it, they can't understand it or won't remember it. They need to talk to make sense of their world.

Who Has NLD? How Are They Affected?

NLD is a disorder of paradoxes. Someone with NLD may be bright, articulate, and extraordinarily intelligent. This same person may be utterly unable to perform some of the simplest daily tasks.

The frustration can be overwhelming. Without a diagnosis, not even the person with NLD will know why he simply can't do some things that everyone else takes for granted. He's smart enough. Why do other people call him lazy when he works twice as hard as anyone he knows? Why do other people call him weird when he does everything he can to fit in? The frustration hits children particularly hard. But it's not limited to children. Although you can learn adaptive skills, NLD is not something you grow out of.

As a child, David hated dental visits. His mother thought he was uncooperative, but when the dentist said, "Turn your head this way," David honestly didn't know what "this way" was. Now, as an adult with NLD, he asks the dentist to tell him--specifically and verbally--what she wants him to do.

Kate, a fourth grader with NLD, is an A student in math and social studies. She easily memorizes whatever information is presented to her. She has no trouble doing her homework right. But she can't copy assignments from the board, so she has trouble doing the right homework.

By the middle of fourth grade, Michael was depressed. Incredibly intelligent, he was in a gifted classroom, but he couldn't understand the rules of playground games. His endless monologues drove his classmates crazy. When he invited the whole class to his birthday party, only one child came.

Adults find Devon, a preteen with NLD, charming, cooperative, and a real delight. His peers often pick on him, calling him a nerd or a weirdo--and, sadly, he's coming to share their opinion.

Tera is an intelligent and resourceful college student with NLD. If she walks into a classroom and the chairs have been rearranged, though, she can't figure out where to sit. She finds the change so disorienting that she may turn around and leave.

Vivian, an adult with NLD, has exceptional communication skills. She's creative and adaptable. However, she can't think, listen, and write at the same time. Definitely not the person to have taking minutes at the next staff meeting!

Although all these people have deficits in all three major skill areas, the variation is enormous. Tera's most significant deficits are in the visual/spatial area; her social skills are fine. Michael lacks age-appropriate social skills, but his fine motor coordination is normal. Kate has poor fine motor skills. This variation makes it all too easy to "diagnose" their problems as immaturity or a lack of motivation.

Because they are often misunderstood and have repeated failures in all types of social interaction, many people with NLD are extremely lonely. Children with NLD are often targeted by bullies. Adults may suffer long periods of unemployment and underemployment. Depression and anxiety are common at every age, and, unfortunately, suicide can be a real risk when appropriate interventions are not undertaken. These people need the support and understanding of those around them if they are to achieve their potential--and every single person with NLD has their own unique strengths, abilities, and potential.

How Can I Help?

When Scott's 4-year-old son was diagnosed with NLD, he responded this way:

"Part of me at this point is scared to death, but the more I'm learning, the more I'm settling down about the reality of our situation. Part of me is relieved to finally get some meaningful clues, and part of me wants to cry because it's dawning on me that this neurological thing is something he must contend with the rest of his life; it's not a phase that will mercifully release him one day. I also want to cry because I see him struggling valiantly to make sense of his world, armed practically with only his verbal ability. He spends countless hours telling his 'stories,' long monologues with only a hint of a plot, yet filled with action and drama, that try to organize a swirling ocean of words and facts in his mind. I want so desperately to give him more tools to even the fight."

If we interact regularly with someone with NLD--or if we have it ourselves--what can we do to help even the fight?

* Learn about NLD. The more information you have, the more effectively you can support someone with NLD, and the better advocate you can be on their behalf.

* Put everything in words! People with NLD can't "look and learn." They may have trouble following a demonstration. They may not be able to read a map. They need words.

* Understand that they may not be able to "see" visual cues in their environment. "It's over there, on the shelf under the dictionary" may be completely understandable to most people, but convey absolutely nothing to someone with NLD.

* Protect children with NLD from bullies and from children who enjoy a good laugh at their social ineptness.

* Provide appropriate accommodations for physical limitations. A consultation with an occupational therapist may be appropriate. Noncompetitive sports such as swimming, jogging, or tai chi may be helpful in developing motor skills without battering self-esteem.

* Understand their need to put their knowledge and experience into words. They may not be able to remember things that they haven't said or written down. Their chatter helps them organize their world and adapt to the situations they face.

* Maintain a consistent routine, and provide a warning if the routine is going to change. Many people with NLD lack the ability to "wing it" when the unexpected occurs. They may be afraid of new unknown situations and experiences. More than most people, they need to know what will happen next. They really don't like surprises.

* Focus on their strengths. It may seem easier to focus on what needs to be fixed, but it's their strengths that will allow them to overcome whatever weaknesses they have. Verbal praise, encouragement, and positive feedback are powerful motivators; use them generously.

Where Can I Get More Information?

Many adults with NLD, and parents and teachers of children with NLD have found the following sources helpful.

Web sites:

LD Online

NLDline

NLD on the Web

Asperger Syndrome Coalition of the U.S.

Tera's NLD Jumpstation: A Resource on Nonverbal Learning Disabilities by an NLD Person

Books:

The Source for Nonverbal Learning Disorders, by Sue Thompson, M.A., C.E.T. Published by LinguiSystems; toll-free, 1-800-776-4332.

Star-Shaped Pegs, Square Holes: Nonverbal Learning Disorders and the Growing-Up Years, by Kathy Allen, M.A. Published by Unicycle Press. To order, call: Good Enough Books in Livermore, CA 925 443 4354

Hanging By a Twig: Understanding and Counseling Adults with Learning Disabilities and ADD, by Dr. Carol T. Wren (with psychotherapeutic commentary by Jay Einhorn). Published by WW. Norton and Company. URL for online orders: http://www.wwnorton.com/orders/wwn/070315.htm

The Nonverbal Learning Disorder Guide for Teachers, Parents, Employers and Therapists, by Rondalyn Varney Whitney, MOT, OTR. Email: Rondalyn@aol.com (or call (408) 248-3462).

Growing Up with NLD, by Deborah Green. Published by Silicon Heights Computers. Order toll-free, 1-800-654-6623, or on the Silicon Heights Web site.

Unaware: Living With Non-Verbal Learning Disability, by Laurie Reed. URL: Email: laurier1010@yahoo.com.

Organizations:

Nonverbal Learning Disorders Association

2446 Albany Avenue

West Hartford, CT 06117

Phone/Fax: 860-570-0217

Email: NLDA@nlda.org

NLD-in-Common (an online organization)

As you read more on NLD, you'll find that the experts don't always agree with each other. NLD is still a new diagnosis, and there is still much about it that isn't yet known or understood, even by the experts. But we're learning. And as our knowledge grows, affected people are being diagnosed at earlier ages. Useful interventions are being identified. A combination of school or work accommodations, medication, social skills training, occupational therapy, and the understanding and support of family and friends can help equip people with NLD for a successful life.

This brochure is published for informational purposes only. The Nonverbal Learning Disorders Association does not endorse or recommend any professional product, treatment, and/or service mentioned in this brochure. The viewpoints expressed by each person contributing are that of the individual and do not construe official approval by the Nonverbal Learning Disorders Association.