Ideally, when a child receives a learning disorder diagnosis this is the first of many successful steps towards receiving the support and resources they deserve. With a team approach families, schools, and caregivers can unify around the unique needs of the child, steering her towards academic success and social happiness.
Similar results are often possible when a child receives (accurate) diagnoses such as ADHD, oppositional defiant disorder, or Autism spectrum disorder. With appropriate care and strategizing, these children are provided the opportunity to grow and flourish to the best of their abilities.
However, in some instances a child tends to fall between the cracks of a clear diagnosis. They may not start to have academic problems until a later grade, and a child who was always a verbose teacher’s pet will begin to be described as oppositional, disinterested, or problematic. With these children parents may have noticed that they began to speak and read at a young age. While amazingly curious and inquisitive, they were also a bit clumsy. Playdates and friendships were not as common or successful as with their siblings.
A Possible Explanation
For these children, the source of their challenges might be a broad syndrome known as nonverbal learning disorder (NLD). NLD is challenging for caregivers to accurately diagnose for a couple of key reasons. First, on the surface NLD shares many features with conditions such as ADHD or high-functioning Autism. Second, the diagnosis of NLD is not an ‘official’ diagnosis per the two primary systems of diagnostic coding used by medical professionals (the DSM-V and ICD-9). In combination, these factors can contribute towards misdiagnosis or ineffective treatments and interventions.
Signs & Symptoms
NLD is not related to difficulties with verbal speech. Children with NLD are often described as precocious and bright with expansive vocabularies. The challenge lies in their poor organizational, visual-spatial, and motor skills. They tend to be quite concrete, and struggle in social situations requiring interpretation of body language and facial expressions. As they grow towards adolescence, these deficits can lead to powerful emotions of frustration and inadequacy, as they often feel misunderstood by teachers, parents, and peers. A few possible symptoms of NLD include:
- Very strong verbal skills, vocabulary, and rote memory
- Great attention to detail, but struggles to see the ‘big picture’
- Struggles with math, particularly word problems
- Appears naïve or gullible, despite being a bright child
- Poor relationships with peers, comes across as awkward or unaware
- Becomes more depressed, anxious, or moody as they grow older
- Difficulty with differentiating between abstract and concrete concepts
- Tends to misunderstand or be misunderstood in social situations
- Finally, keep in mind that unlike ADHD, NLD is equally present in girls and boys
Where to Turn?
The most accurate way to determine if a child has NLD is through a comprehensive neuropsychological assessment. A detailed interview and strategic testing can provide valuable insight into correctly identifying the specific challenges a child is facing.
For parents interested in learning more about NLD, below are a couple of links you might find helpful:
http://www.nldontheweb.org/home.html
http://www.waisman.wisc.edu/~rowley/sb-kids/Publications/Misunderstood%20Child%20-NLD.pdf
If you are concerned that your child is demonstrating symptoms of NLD, please feel encouraged to contact Summit Neuropsychology for a consultation. If for any reason we are not the right fit (e.g. your child is younger than clients Dr. Nichols usually works with) we will make every effort to find you an appropriate referral in the community.