Helping Children with NLD

by Rondalyn V. Whitney, MOTI, COTA

Children with Nonverbal Learning Disorders (NLD) have deficits in visual-spatial-organization, social skills (especially social-cognition and social language) and motor skills. Areas to Evaluate and treat are global and at times subtle. Teachers and therapists alike are frequently baffled by a child who can recite an entire story verbatim and orally dictate a novel worthy of publication but is unable to turn in work, find the bathroom or tie their shoes.

Children with nonverbal learning disorders typically have poor sensitivity for gaining and maintaining balance. Due to poor tone and endurance, they have a tendency to develop a sedentary lifestyle with little exploration of novel events. They tend to bump people/objects especially on their left side and have very poor safety judgment. They avoid activities where they have to move rapidly through space which will overwhelm their balance reactions and, thus, miss out on many social interactions and opportunities.

Prepositions having to do with space and time are left out of their language and so they benefit from games that require them to climb OVER, jump AROUND, slither THROUGH, or hop to the RIGHT, place the ketchup BEHIND the soda. Adding the prepositions into movement help them gain a better sense of spatial relations.

They have significant deficits in visual memory, which is unreliable. They cannot "picture" the answer, days of the week, month etc. They tend to over-rely on left hemisphere strategies (rote learning) and will often employ "self-talk" as a way to organize motor and cognitive tasks. They often miss the Gestalt (whole) of overall pattern and, instead concentrate on the details, missing the meaning of text, pictures, social events and conversations.

They have difficulty recognizing and interpreting facial expressions, postures and gestures, paralanguage (tone, intensity, and loudness of voice), interpersonal distance and touch, rhythm and timing. They often seem gullible, or innocent and can be the target of bullies. Despite their precocious vocabulary, NLD is disorder of language impairment. These children have great difficulty interpreting non-literal language: analogies, idioms, expressions.

These primary deficits lead to secondary academic and social deficits to include poor judgment, clumsiness, dysgraphia, declining academic success as they advance to upper grade levels, poor safety awareness (due to poor anticipation of consequences), anxiety, inability to generalize, poor self-esteem and even depression. Suicide is a real concern for these children.

Children in general would rather look bad than incompetent. They may throw themselves on the floor to avoid visually challenging materials or have other ways of "melting down" when they are overwhelmed and unable to understand the confusing messages bombarding them. They frequently suffer from upper respiratory infections (a common response to stress). They are unable to organize and prioritize and the day to day stressors compete for equal attention and produce poor frustration in tolerance.

Traditional behavior modification is seldom successful as these children need to understand what invisible, non-verbal rule they have just broken. Called "perspective taking" by Michelle Garcia Winner (SPL), these children need to learn via rote practice, to interpret the cues from others so that they can take another's perspective and change their behavior through understanding next time. A simple reward or withholding of recess will not only not benefit the child but can, in fact, escalate the very behavior targeted for extinction. It can be useful in treatment planning to address the needs of the child in three categories: changing the child through movement and sensory integration techniques, change the environment to provide for greater opportunities for success and select areas to provide compensatory mechanisms.

Environmental Changes:

De-stress the environment, minimize activities and expectations
Provide structure environment
Set up and insist on organizational skills AT ALL TIMES
Model your own thinking processes, talk openly about mistakes, develop atmosphere of attempts and errors as accepted methods of learning
Support the teacher with educational opportunities, materials
Realize the child will need extra time from the teacher and provide her/him with adequate support. Never underestimate the severity of the disability!

Changing the neurology/sensory processing

Provide opportunities for putting the "me" back in the picture through proprioceptive, vestibular, deep pressure touch
Develop motor planning skills, strength and endurance
Develop problem solving skills
Take frequent breaks during seated work
Stress anxiety management - build resilience

Compensatory

Allow for use of lap top computer for school work due to written expression deficits
Provide word lists to compensate for word retrieval problems (make a dictionary and thesaurus part of the child's homework center)
Activities requiring drawing, copying, and lengthy writing require too much effort - provide child with teacher outline or pre-written copies
Use graphic organizers to aid child with organization of thoughts for creative writing, and other longer writing assignments. Use memory enhancing techniques such as mnemonics, rehearsal, chunking, techniques
Start early with a time management system like Premier from Franklin Covey
Insist on a binder each year (just one) with a system for organizing all materials. Give bonus/rewards if you can pick up the binder, shake it, and nothing falls out
Minimize written work - remember, this is a child with high fatigue, poor endurance, and difficulty parallel processing information
Educate teachers to analyze all homework and desk work for visual overload, handwriting levels (do they want to ascertain the math ability or handwriting? Help them to distinguish)
Use tape recorders to tape lectures, directions and other information
Give additional time for assignments - Take test orally when possible - Verbally teach what others intuitively learn


Home News Meetings & Conferences Articles Links & Resources Ask the Expert Chapters Books	Helping Children with NLD by Rondalyn V. Whitney, MOTI, COTA Children with Nonverbal Learning Disorders (NLD) have deficits in visual-spatial-organization, social skills (especially social-cognition and social language) and motor skills. Areas to Evaluate and treat are global and at times subtle. Teachers and therapists alike are frequently baffled by a child who can recite an entire story verbatim and orally dictate a novel worthy of publication but is unable to turn in work, find the bathroom or tie their shoes. Children with nonverbal learning disorders typically have poor sensitivity for gaining and maintaining balance. Due to poor tone and endurance, they have a tendency to develop a sedentary lifestyle with little exploration of novel events. They tend to bump people/objects especially on their left side and have very poor safety judgment. They avoid activities where they have to move rapidly through space which will overwhelm their balance reactions and, thus, miss out on many social interactions and opportunities. Prepositions having to do with space and time are left out of their language and so they benefit from games that require them to climb OVER, jump AROUND, slither THROUGH, or hop to the RIGHT, place the ketchup BEHIND the soda. Adding the prepositions into movement help them gain a better sense of spatial relations. They have significant deficits in visual memory, which is unreliable. They cannot "picture" the answer, days of the week, month etc. They tend to over-rely on left hemisphere strategies (rote learning) and will often employ "self-talk" as a way to organize motor and cognitive tasks. They often miss the Gestalt (whole) of overall pattern and, instead concentrate on the details, missing the meaning of text, pictures, social events and conversations. They have difficulty recognizing and interpreting facial expressions, postures and gestures, paralanguage (tone, intensity, and loudness of voice), interpersonal distance and touch, rhythm and timing. They often seem gullible, or innocent and can be the target of bullies. Despite their precocious vocabulary, NLD is disorder of language impairment. These children have great difficulty interpreting non-literal language: analogies, idioms, expressions. These primary deficits lead to secondary academic and social deficits to include poor judgment, clumsiness, dysgraphia, declining academic success as they advance to upper grade levels, poor safety awareness (due to poor anticipation of consequences), anxiety, inability to generalize, poor self-esteem and even depression. Suicide is a real concern for these children. Children in general would rather look bad than incompetent. They may throw themselves on the floor to avoid visually challenging materials or have other ways of "melting down" when they are overwhelmed and unable to understand the confusing messages bombarding them. They frequently suffer from upper respiratory infections (a common response to stress). They are unable to organize and prioritize and the day to day stressors compete for equal attention and produce poor frustration in tolerance. Traditional behavior modification is seldom successful as these children need to understand what invisible, non-verbal rule they have just broken. Called "perspective taking" by Michelle Garcia Winner (SPL), these children need to learn via rote practice, to interpret the cues from others so that they can take another's perspective and change their behavior through understanding next time. A simple reward or withholding of recess will not only not benefit the child but can, in fact, escalate the very behavior targeted for extinction. It can be useful in treatment planning to address the needs of the child in three categories: changing the child through movement and sensory integration techniques, change the environment to provide for greater opportunities for success and select areas to provide compensatory mechanisms. Environmental Changes: De-stress the environment, minimize activities and expectations Provide structure environment Set up and insist on organizational skills AT ALL TIMES Model your own thinking processes, talk openly about mistakes, develop atmosphere of attempts and errors as accepted methods of learning Support the teacher with educational opportunities, materials Realize the child will need extra time from the teacher and provide her/him with adequate support. Never underestimate the severity of the disability! Changing the neurology/sensory processing Provide opportunities for putting the "me" back in the picture through proprioceptive, vestibular, deep pressure touch Develop motor planning skills, strength and endurance Develop problem solving skills Take frequent breaks during seated work Stress anxiety management - build resilience Compensatory Allow for use of lap top computer for school work due to written expression deficits Provide word lists to compensate for word retrieval problems (make a dictionary and thesaurus part of the child's homework center) Activities requiring drawing, copying, and lengthy writing require too much effort - provide child with teacher outline or pre-written copies Use graphic organizers to aid child with organization of thoughts for creative writing, and other longer writing assignments. Use memory enhancing techniques such as mnemonics, rehearsal, chunking, techniques Start early with a time management system like Premier from Franklin Covey Insist on a binder each year (just one) with a system for organizing all materials. Give bonus/rewards if you can pick up the binder, shake it, and nothing falls out Minimize written work - remember, this is a child with high fatigue, poor endurance, and difficulty parallel processing information Educate teachers to analyze all homework and desk work for visual overload, handwriting levels (do they want to ascertain the math ability or handwriting? Help them to distinguish) Use tape recorders to tape lectures, directions and other information Give additional time for assignments - Take test orally when possible - Verbally teach what others intuitively learn
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