The Invisible Disability
One of the best readers in your classroom might have a serious learning disability. Could you spot the signs?
- Grades: PreK–K, 1–2, 3–5, 6–8
Seven-year-old Helen is a whiz at anything that has to do with reading, vocabulary, and language. Easily the best reader in the second grade, Helen loves Sustained Silent Reading. Her reading and her vocabulary are at the high fourth-grade level. She likes to participate in class discussions led by the teacher, and is alert and focused on her academics in school.
Her teacher, however, has noticed that Helen has some puzzling areas of weakness. She's struggling quite a bit with math, and her handwriting and copying skills are at the kindergarten level. She dislikes the small motor tasks of cutting, coloring, pasting, sewing, and assembling puzzles. Helen is also having difficulty communicating. On the playground, she will frequently interrupt other children's play or conversation. She is extraordinarily clumsy, often bumping into people and objects.
Who is this child with such an unusual profile? She is an outstanding reader but has difficulty copying from the board. She has an enormous vocabulary but when she speaks, she manages to alienate her classmates. She has difficulty with small motor tasks but she loves board games. But she couldn't possibly have a learning disability, could she? Doesn't having a learning disability indicate that a child has difficulty with reading??
Nonverbal Learning Disabilities
By definition, students with learning disabilities have neurological deficits that keep them from grasping certain content areas at grade level. Students with a type of disability commonly known as a nonverbal learning disability (NVLD, or sometimes NLD) have a unique set of academic strengths and weaknesses.
Unlike most other students identified as learning disabled, these students can start their academic career on a gifted track. They are wonderful readers, can articulate their thoughts clearly, and can memorize, categorize, and recall numerous facts. Educators have become aware that students with NVLD differ greatly from others identified with learning disabilities, especially students with dyslexia.
The Elementary Years
As early as kindergarten, students with NVLD are seen as little professors, able to read, memorize, and articulate their thoughts very proficiently. These attributes make their particular type of learning disability frequently misunderstood by the professional community.
This is in marked contrast with the dyslexic student, whose reading difficulties are readily perceived. Students with dyslexia are typically noticed in the first grade, and diagnosed with learning disabilities by the second grade; thus, they are able to get remedial help early on in their academic careers.
The child with the more elusive NVLD has right-hemisphere neurological deficits that manifest themselves in four major areas:
1. Gross motor development. Girls and boys with NVLD are slow learning to walk, ride a bicycle, and play ball. When they walk they typically seem a bit off balance, and, like Helen, they have a tendency to bump into objects and people.
2. Visual-motor deficits. Due to right-brain neurological weaknesses, students with NVLD have trouble processing and remembering visual images, causing them difficulty remembering the shapes of numbers, letters, and geometric forms. Their fine-motor deficits include difficulties eating with utensils, tying shoelaces, drawing, cutting, pasting, writing, and copying from the chalkboard. Writing tasks are arduous, as these children have problems learning how to form the shapes of numbers and letters.
Students with NVLD are able to pay attention when the teacher lectures, but they have trouble seeing and processing visual-spatial cues from graphs, maps, and charts.
3. Communication, nonverbal communication patterns, and maintaining friendships. Communication experts believe that 65-70 percent of all information is conveyed nonverbally. Due to neurological deficits in the right hemisphere, students with NVLD often misread social cues. They are not sure when to talk or when to wait during a conversation. They may stand too close to others or speak too loudly.
Students with NVLD also tend to be "concrete" and literal- they see the trees, not the forest. Helen does not understand abstract sayings such as strike while the iron is hot. She tends to take everything she hears or reads literally. In first grade, Helen's teacher saw her kick her classmate Sally and told her to stop. Helen stopped kicking Sally, but then kicked Bobby. Helen was surprised that her teacher got angry. I did what you wanted. I stopped kicking Sally! In essence, students with NVLD have trouble getting the deeper meaning of conversations and in literature.
4. Serious emotional problems. When parents, teachers, and specialists misunderstand the deficits associated with NVLD, it can lead to depression, anxiety, and phobias. Adults place a lot of pressure on their little professors to perform. Students with NVLD want to please others, and become anxious when they cannot do what is expected of them. They have no idea why they often annoy others. Adults may see their behavior as a deliberate plan to gain attention, without understanding that these children's right-brain deficits prevent them from comprehending social expectations.
Many parents and teachers honestly believe that someone like Helen is deliberately misbehaving; children with NVLD are often reprimanded for behavior over which they have no control. This can lead to feelings of inadequacy which can further develop into depression and/or a phobia; an unusually large number of students with NVLD become suicidal in their high school years. To compound matters, the students are confused and hurt by the social rejection they experience from their peers.
Some students with NVLD are seen as openly defiant, and are placed in classrooms for children with emotional and behavioral disorders. But NVLD is not the same as an emotional disorder-behavior management therapies are not the remedial services these students need.
The Middle-School Years
Middle-school students with NVLD have the same disadvantages as children starting school, but they manifest themselves in some new ways:
1. Problems with reading comprehension. In the middle-school years, students need to begin comprehending the deeper meanings, abstractions, and implications of literature; they can no longer survive by rote memorization and focusing on the details. The reading ability of NVLD students decreases as they get older.
2. Physical navigation. Without adequate visual-spatial motor skills, middle-school students have trouble physically navigating their way around large buildings including schools, large department stores, and malls. Some middle-school students report that instead of concentrating during the class they have before lunch, they are worrying about how to walk from the classroom, to their locker, and to the cafeteria in time!
3. Social problems. Middle-school students with NVLD have difficulties with visual-spatial motor skills, resulting in problems understanding graphs, maps, geometry, and how to make mobiles; with reading, science, history, and more; and with seeing how their inappropriate behavior can lead to misunderstandings. Perhaps it is the misunderstanding of these deficits, the frustration felt when adults' expectations are too high, and the rejection by peers that lead to anxiety and depression. NVLD students make very literal translations in social situations. They are too trusting, do not grasp the social implications of body language, and cannot navigate the social scene.
If teachers are aware of the signs of NVLD, they can intervene earlier to help children who are affected. Even if a child has reached middle school without prior diagnosis or intervention, a teacher's support in getting immediate help can be invaluable.
Teachers can teach to the child's strengths (see NVLD Teaching Strategies) and advocate to get each child appropriate help. Students identified with dyslexia, for example, will likely need extra help learning to read. In many school systems they will be pulled out of the regular classroom during reading time. They will typically learn to read using a multi-sensory reading program such as Project Read, Wilson, Orton Gillingham, LIPS, or Reading Recovery under the guidance of a learning disability specialist or a reading specialist.
Students like Helen, who are diagnosed with NVLD, are likely to need help from the following specialists: (1) the special education teacher for help with modifications in writing assignments, organization strategies, and reading comprehension (grades 5-12); (2) the speech-and-language therapist to work on pragmatics such as tone of voice, how to request help from a teacher, how to make small talk with students, story scripting, and other conversational skills; (3) the occupational therapist to master visual-motor and spatial skills. It is best for these interventions to occur in the lower elementary levels in order to prevent the anxiety and alienation from others that build up steadily as the child grows.
Teachers can play a key role in the success of students with NVLD in both the academic and the social-emotional realms. By understanding and being accepting of each child, and his or her individual differences, teachers can inspire students with NVLD to believe in themselves.