<p>That’s a good tip (utilizing the extended time to build a history). My son has a tremendous work ethic probably from what it took to get himself reading. Fortunately, high school grades reflect work ethic (homework on time, extra credit, etc.) more than anything. Something my older 2 never quite learned as well LOL. The only thing he complains about is how slow he still reads and the fact that it takes him twice as long as his “buddies” to get his homework done. We’re very, very fortunate.</p>
<p>Mitdu, it sounds like our D’s are very similar! All those same troubles, (she said she felt physically ill during geometry, but has no problem with algebra!) Still can’t read an analog clock, but she can read a facial expression with frightening accuracy. Someone told me that female empathy really helps a lot of NVLD girls. </p>
<p>She has accommodations from the College Board, but she hates to use the extra time (other kids notice and call her stupid)…I guess I’d better ask the school psychologist about that before the test. </p>
<p>And yes, to you and momof3-- sounds like we’re all pretty lucky in our kids. I do think that dealing with this kind of adversity makes a kid much more persistent and resourceful, and often more kind.</p>
<p>Kind, yes. I’m often told by the teachers that my son is kind. Which is a word you don’t often hear about boys and especially high school boys. I doubt his high school football coach will ever say that though LOL. Maybe you are correct in your assesment.</p>
<p>momofthreeboys-
The KTEA and WIAT are achievement tests. The WJ has both an achievement and cognitive battery (standard and supplemental). If the evals are done in the schools, their scope and focus are different than private evals.</p>
<p>I’m going to do some reading. I should know more. The Woodcock was only done once and the Stanford-Binet once and never again. They also sometimes, not everytime do the Test of Written Language-3rd edition. I did understand that some of these were achievement as they were trying over time to see change via the achievement testing. That’s interesting that you said the evals scope and focus are different than in private evals. I originally had my son scheduled to be evaluated outside the the school, but the principal called me and said that after talking to the teachers that the school would be willing to do the evaluation so I have never gone outside the school.</p>
<p>Gwen–</p>
<p>Most of the early research into NLD was by Byron Rourke. It involved males with extreme traits. So the early writings about NLD concluded that all or most kids with NLD have extreme social difficulties. </p>
<p>Thankfully, more recent research shows that not all NLDers have extreme traits. And recent research also shows that most girls with NLD present subtle but important differences as compared with most boys with NLD. (Same can be said for ADHD, especially ADHD-inattentive. In general, girls with ADHD present differently from boys.)</p>
<p>Males with NLD do tend to have weaker social skills, more difficulty “reading” body language and tone of voice, and more difficulty with empathy. However, that is not the case with most girls with NLD.</p>
<p>My dd has incredible empathy and will go out of her way to make people around her feel comfortable. Interpreting facial expressions and tone of voice are an extreme strength for her. She is extremely concerned about accidentally hurting someone’s feelings and has an acute sixth sense that allows her to perceive what others are feeling–no matter what their words are. Yet she still fits the NLD profile in so many other ways.</p>
<p>I wish that the diagnostic criteria for NLD and ADHD were more inclusive toward females. I am grateful for neuropsychs, neurologists and other specialists who understand and accept gender differences in these and other diagnoses.</p>
<p>Mitdu,
Fortunately, many professionals are sensitive to the gender differences, especially in the manifestation of ADHD, where many more males (especially younger males) tend to have the behavioral dyscontrol. Not only are there gender issues, but there are also age issues. ADHD symptoms in adults present differently than in kids, though diagnostic criteria necessitate that the onset be in childhood. The tough issues is that these distinctions aren’t parsed out in the DSM IV. The newer DSM is still in the works, but hopefully will address thes differences in the diagnostic criteria.</p>
<p>jym–</p>
<p>Thanks. I think the DSM’s requirement that ADHD symptoms be present by the age of 7 is wrong. ADHD-hyperactive/impulsive and ADHD-combination <em>are</em> often present by the age of 7. Especially in little boys. But as you note, the DSM-IV criteria are not always in line with how ADHD presents itself in females and in adults. My dd was not diagnosed until age 12. She was never hyper, never impulsive and not even a daydreamer. She has difficulty with sustained attention to certain tasks. She closely fits the profile of girls with ADHD outlined by Dr. Kathleen Nadeau, but those criteria are not well reflected in the Conner’s Scales or in the DSM.</p>
<p>And as I’ve said before, I really hope the DSM-V provides for a diagnosis of ADHD-SCT. Now, too many people with Sluggish Cognitive Tempo just fall through the cracks. </p>
<p>What’s the likelihood of Nonverbal Learning Disability getting acceptance as a “real” diagnosis, rather than the current grey area? Saying a person with NLD has “Cognitive Disorder NOS” is largely meaningless when arguing for services.</p>
<p>Only one state (New Hampshire) currently accepts the NLD diagnosis. I think there are still a lot of differing opinions about NLD, and even Byron Rourke had modified his thoughts about it, so until there is better concensus, it unfortunately may not be likely that we’ll see it in the DSM or ICD soon. Can’t say for sure-- just opining.</p>
<p>When my D got the NVLD ‘diagnosis’, my husband and I read the literature and started laughing, it was so wildly off the mark! I think it was outdated even then, 10 years ago, and I’m almost glad NVLD isn’t in the DSM…we just don’t know enough yet. My D lives by her sixth sense too–she compensates for a lot that way.</p>
<p>Gwen,
The scores you posted certainly suggest significant graphomotor or visual processing problems, but if you daughter doesnt meed the criteria for NLD, can I kindly ask why they diagnosed her with it? While NLD is a constellation of symptoms and often overlap with other issues, it seems that if many of the characteristics dont fit, while it may be a helpful model for intervention of the visual-perceptual and perceptuomotor issues, she might not fit with the NLD diagnosis per se. Just a thought.</p>
<p>Hmmm, thank you jym… I honestly don’t know the answer. A neuropsych affiliated with her elementary school made the diagnosis when she was in kindergarten, and she went on an IEP. We took her to someone highly recommended in Boston who tested her again and said “Well, her results certainly are skewed”, and that it was hard to know how much of it she’d grow out of. She had a great OT who helped in many ways, and when she was tested again in 4th grade they felt she didn’t need services anymore, though she had some informal accommodations. Last year, in a big new school, she ran into a lot of problems (geometry among them), and she was tested again, with the results above. Now I use NLD as a way of trying to explain it to others… for myself, I just think of her as a person with great strengths and odd weaknesses, and just take it as it comes. </p>
<p>But, are you suggesting there might be a different way of looking at it that could help her? If so I’d love to hear.</p>
<p>I agree that using the NLD nosology is a helpful way to get people to understand her issues, but the issues you raise have been discussed frequently on our professinal listservs. If a person doesnt meed the criteria to diagnose a disorder, then they may not have the disorder. That said, if the disorder is defined by a constellation of symptoms, then the constellation can vary. So it is a challenging issue.</p>
<p>I assume you’ve read the works of the late Sue Thompson? Shes written a lot about NLD and does a good job of describing common presentatins at different ages.</p>
<p>Yes, I have read Sue Thompson and she never seemed to be describing anyone much like my D, who is very focused and organized and eager, immensely capable…but can barely draw a stick figure and will be frustrated to tears by a dot-to-dot picture in a coloring book.</p>
<p>Gwen,
Your daughter may have a severe graphomotor or perceptual-motor problem, but doesnt sound NLD from what you have described. The previous diagnosis may be incorrect.</p>
<p>jym–</p>
<p>Just curious…why is it better to call it “graphomotor or perceptual motor problem” rather than NLD? Especially if the child’s difficulties go beyond graphomotor and visual-spatial.</p>
<p>My dd has many of the same issues as Gwen’s dd. I believe she has NLD, even though she doesn’t have classic social difficulties (at least as defined by Rourke and Thompson)and has overcome most minor pragmatic language issues.</p>
<p>1) Abstract reasoning is a huge issue for my dd. This is especially true in math, but even in literary analysis. She doesn’t always ‘read between the lines’ or assimilate information well when learning. She <em>strongly</em> prefers nonfiction to fiction. She strongly dislikes sci-fi or even fantasy such as Harry Potter.
2) Visual processing. Everything from words wiggling and shimmering on the page to difficulty with analog clocks and timelines as discussed earlier. Vision Therapy did help with focus time, but visual processing can still be a problem for her. She has greater difficulty when the contrast is extreme between the white page and the black ink. But colored overlays didn’t really help. Nor did eye glasses.
3) Sensory sensitivity. Not pervasive, but she is very sensitive to light, sounds and textures. Her migraines are often caused by flourescent lighting. She can hear dog whistles and whispers from across a room, but has difficulty with some types of auditory processing (especially interhemispheric transfer.)
4) Fine motor difficulty. Handwriting is the most obvious, but this affects all fine motor tasks. When she tries to cut a straight line with a scissors, it looks like a 6-year old cut it, not an 18-year old. Yet she has incredibly strong gross motor skills and quick eye-hand coordination as an award-winning soccer goalie. She loves cycling, running and playing the drums. Her sense of balance isn’t great, but she can easily cross the midline and knows how to compensate well.
5) Difficulty with spatial reasoning. This affects everything from learning physics to parking a car in a parking space. Don’t even TRY to have her parallel park!! And she is terrified of changing lanes on a busy interstate highway. She can’t gauge the distance between her car and the cars around her, or gauge the speed of the other cars.</p>
<p>Her VCI is 34 points higher than her PRI. But NLD is so much more than that. WJ-Ach lowest scores were reading comp and math reasoning. Pegboard, Beery, NEPSY, DKEFS and a host of other evals conducted by a private neuropsych showed definite NLD traits. Nerve conduction and other tests administered by a ped-neuro led to a diagnosis of Focal Dystonia which I believe is part of her NLD profile. </p>
<p>(BTW, her first Block Design, before ADHD meds, was a 1. Several years later and on meds, Block Design was a 7 but was still her lowest score. By comparison, all of her VCI subtests were 14’s. Not proof of NLD, but a clear example of her pattern of cognitive strengths and weakneses.)</p>
<p>Other than shyness in new settings, my dd does not have social difficulties. Must all people with NLD have social difficulties? Or in other words, if people with this range of difficulties/strengths don’t have NLD, what is it?</p>
<p>Gwen–</p>
<p>I agree that Sue Thompson’s definitions do not fit my dd. Worse, Thompson painted a very bleak picture for NLDers as unhappy loners, unable to be remediated and unable to fit into the world. <em>If</em> that is NLD, then my dd doesn’t have NLD. But I believe Thompson, like Rourke, focused too much on people with extreme traits. </p>
<p>If NLD is a Spectrum disorder, then not all NLDers will be alike. Just like red is not blue is not green, but all are on the spectrum of the rainbow. Some NLDers will only have a few traits, but may have them in greater intensity. Some NLDers will have more traits, but they may be mild or easy to overcome. In my (uneducated) opinion, it’s not the parts themselves, but the sum of the parts, that defines NLD.</p>
<p>A well respected pediatric neuropsychologist on one of my professional listservs has just started a discussion about this very topic- to discuss the reliability and validity of NLD as a diagnosis, the stability of the diagnosis over time, the comorbid (co-existing) symptoms or diagnoses, what constitutes meeting the criteria to be diagnosed vs just having some of the traits, etc. I am not permitted to share the content of the posts outside of this professional listserv, but I can give a summary or keep you posted as to the kinds of issues being discussed.</p>
<p>jym–</p>
<p>If you would, I would love for you to summarize what’s being discussed. </p>
<p>At this point, most labels and diagnoses (such as NLD) are largely irrelevant for my two children, now in college. But I’m still intrigued by how experts understand and define disorders and diagnoses.</p>
<p>Some educators have wondered out loud how my dd could have such strong verbal scores while having some pretty significant language processing issues/auditory processing issues. I think that’s the ironic nature of learning differences. In many cases, learning differences defy simple explanations and simple solutions.</p>
<p>Will be happy to try to summarize when the discussion gets cranking. Keep in mind, when you talk to 3 psychologists you get 5 opinions :)</p>