Gifted Issues Discussion homepage Forums Twice Exceptional Nonverbal Learning Disability and a social child?

Diagnosing children can be tough, even for the experts; many symptoms overlap, and most of the diagnoses fall along some kind of spectrum of how a child is impacted. I don't know much at all about NVLD, but I have known (through a casual friendship, this isn't someone I know well) an adult who has NVLD. I've also known (again, very casually) a parent of an older child with NVLD. The adult I knew is female, tended to withdraw into herself at times from stress, but overall was a social person. Her challenges were related to understanding math (she just couldn't ever understand it really), and I think she was dyslexic too - I don't know the details, but school had been a struggle for her. Same for the child of the parent I knew... but he absolutely had friends and enjoyed being with other kids.

I think the thing to do right now is to read up a bit on NVLD so you have some idea of what it means, and then wait for your full report from the neuropsych. Our reports were always considered "drafts" until the parent had seen them and had a chance to review and ask questions. Will you have a follow-up face-to-face meeting with the neuropsych? Even if you've already had your follow-up, I would be sure to ask this question and any other questions you have once you've had a chance to read the actual report.

Back to NVLD, I thought the WISC profile that is usually associated with it is a significantly higher score in VIQ than PRI (perceptual reasoning) (I think > 1.5 or 2 SD difference). That doesn't mean that a large difference is diagnostic of NVLD, it just means that if the neuropsych sees that, they would look at other information (parent concerns, child's developmental history, school behaviors, as well as administer other types of tests to clarify why the difference in scores) - and from the combined picture of all the info they have they come up with a diagnosis.

The other side of the issue is neuropsychs do seem to see what they are used to seeing to a certain extent, does that make sense? So if one neuropsych is used to seeing primarily clients on the autism spectrum, they may be more aware of autism traits than a neuropsych who is usually seeing kids with OCD for instance (that's just an example I'm pulling out of the air fwiw). When there are so many overlapping symptoms and traits between diagnoses, it's not out of the realm of possibility for one neuropsych to see one thing and another perhaps see bits and pieces of something else... particularly when a child's diagnosis is very borderline. The thing I think is important overtime is to look for consistencies in profiles (is your child scoring with the same pattern on the WISC etc) and how is she impacted in *life*. If a diagnosis makes sense, go with it. If it doesn't make sense, use what does make sense in terms of accommodations that will work for your child, and then move forward and know that the diagnosis may very well change. It's not unusual from what I've seen for parents of children with challenges to see the diagnoses evolve over the years as their child matures.

Best wishes,

polarbear

There is a Yahoo! group called GIFTED-NLD-AS that is for parents (and a few older kids post, too) that have kids who are gifted and also have a non-verbal learning disability or Asperger's diagnosis. You might want to join that group and put your query to them; there is a lot of NVLD experience out there! My DD (age 17) has a NVLD, but she is quite an introvert and is not great at social cues. However... she has an older sister that is a true extrovert and very good at social cues who I also suspect has a NVLD, but it is less severe and was never formally diagnosed. I think if you email the address below and tell them you have a recent diagnosis of a kid with a NVLD and high IQ scores, you can easily join.

Gifted-NLD-AS-subscribe@yahoogroups.com

Pemberly...

Social quirks are sometimes just in the fabric of who we are. Your dd sounds energetic and delightful. When I start wondering about diagnostically relevant social struggles is when kids are struggling with peer and adults alike. With kids along the ASD (especially the kids with more subtle traits vs full-blown dx), there is often an almost imperceptible misaligment of emotional, verbal, energy and body language reciprocity. It might be as obvious as missing the "uh-huh" pauses we make during stories. Or as subtle as failing to smile in return (even for the briefest moment) at an enthused greeting of a friend. These kids are often misperceived as rude, pushy, immature, defiant, or even arrogant due to our nearly unconscious factoring of social nuances.

Even in medicine of the body, a diagnosis may change and evolve (from gasteroenteritis to IBS to celiac) over time. Whet is frustrating with psychological /developmental diagnostics is that the "answer" does not easily lead to a simple regime or cure.

Hang in there!

I think I may have mild NVLD. I've always been very social, though I dislike huge parties where I don't know anyone and I'm a little physically awkward (I'm definitely no athlete). I've always had plenty of friends and I'm fairly outgoing. However, I have some mild Aspie-ish traits, while at that same time being very neurotypical in other ways.

My spatial skills are extremely poor and I have virtually no mental maps of anyplace. I could not draw a mental map of my town with any accuracy at all and I cannot give directions. As a child I had significant difficulty learning to read a clock. A friend who is an OT says my visual-motor integration skills appear poor. I also have a hard time recognizing faces. All these are possible NVLD symptoms, I believe. BTW, none of this was ever recognized in school, where I did fine and was in the gifted program, but my math skills were always far behind my other abilities.

Thanks again for so much useful information. If I am understanding correctly there can be 2 different uses of this diagnosis - one implying an Aspergers type profile and one just a cluster of results where other skills pale in comparison to the super high verbal abilities. Am I interpreting correctly? Most people, however, are not likely to understand this dual purpose and may assume/assign social issues to DD that aren't actually a problem. (I had to laugh at the idea of DD showing subtle traits that we overlooked. I vividly remember the 2 year old who used to "mirror" whatever body language she saw. Whenever a well meaning adult kneeled down or bent over with their hands on their knees to make eye contact and speak to her on her own level DD would do the same, making her eye level even lower...) Is it possible that her social skills are actually advanced - like her verbal abilities - and what we may be asking her to do is "dumb it down"?

I checked out that yahoo group - I will need to set up a Yahoo account to join. Thanks. Again though it is listed as Gifted NLD/AS - this points out where my discomfort is coming from...

The other day we were at a birthday party - ironically for a new friend she met on that cruise where she "should" have been seen as making the other kids uncomfortable. Huge excited hello, big hugs for the birthday girl. Then all of the kids off in their own direction to play in the large play gym where it was being held. I observed to see if I should be concerned. DD would have much rather be playing with another child than on her own but respected the "rules" of this group that all were playing on their own. Once a group started playing together she joined. Later, after the limo ride (don't ask!) back to the birthday girl's home she was 100% one of the group - as if she had known all the kids for years. I realize my vision may be skewed but does this sound like a kid who has social issues? Yes she was a bit sad when she had to play alone at first since she is VERY social and would have preferred to be with someone right away but she adjusted to the group dynamic and followed their unwritten rules.

I had tried to find someone who specialized in 2e and went through Dr. Beljan to get the referral to the first guy we saw last November. That was a disaster - totally useless "report" that was deemed to be invalid. When I spoke to this neuropsych about his 2e experience he said that his practice has found that you get better results without a specific area of specialty - you diagnose without blinders on so to speak. He assured me he sees many, many gifted kids (and the area where he is located makes me believe that) and he was highly recommended by our consultant. I can't try to substitute my own untrained opinion for his on things like the ADHD-I diagnosis but I can recognize that it is known to be an issue with gifted kids. Yes, we will be going back for a follow up meeting after the report is written. In the meantime the psych plans to speak with him - hopefully that will help.

I have now entered the discouraged almost panicky part of this journey. I am hoping the psych we found will coordinate with this neuropsych and together they will present the information in a way that will help the school understand how to meet her needs. I just can't help the feeling that with the principal already making very, VERY poor decisions for DD we may just be providing her more weapons for her arsenal rather than ways to improve things. Unfortunately we had to decide that day about releasing the yet-to-be-written report into her educational file. If the district was going to pay for it we had to sign all the releases before the testing began. It is now going to be a part of her permanent record - good, bad or indifferent...

It seems that you are not seeing any problematic social skills. Trust me, if they are truly impaired (again beyond personality traits), you will know. I haven't mentioned this earlier, but anxiety can seriously inhibit a child 's (or anyone's) social skills or give a false impression. Sometimes I see kids who act really odd or "goofy" in their early sessions, and it came down to their nervousness. Examples: one child who wanted to spell his answers to my questions, another who talked the entire time with a pillow covering his face, and lots who laugh and get really "silly".
Your counseling psych will be able to give you a clearer impression of any concerns socially, as dd has (or will have) a relationship there.

Got the pysch report today and PsyD gave the following diagnoses:

Disorder of Written Expression
Expressive Language Disorder
Anxiety Disorder NOS

Does this complicate things or back up my confusion anout the NLD diagnosis? I know NLD is a neuropsych diagnosis not a psychologist diagnosis. I am very confused, though, by so many labels. Psych did not indicate any social concerns other than DD's "sweet and kind nature" could be misinterpreted as weakness thus potentially making her a target for bullies.

Otherwise this report backs up 100% what I have been telling the school and asking for in terms of anxiety control. How does it work with the psych and neuropsych now? I think both are planning to be at the next IEP meeting. Are these diagnoses something they will disagree on or just the way their different specialties address the same set of facts?

p.s. Thanks intparent - I joined that Yahoo group. I have been reading other people's stories and I have to say they really don't seem to mirror our experience. The descriptions by the parents there really seem to highlight serious social/behavior issues which we (fortunately) don't have.

Hi Pemberley,


Can you have your professionals talk? And then conference with you? Ideally this should happen before they both show up at school and confuse everybody. They should be able to get each other and you on the same page about what exactly they are seeing and why they think what they think. It is possible you can get them to agree if they talk. Even if they do not ultimately agree on diagnoses you should be in no doubt of what each of them means by their diagnosis.


That seems like the most important thing.

Don't panic now-- just keep asking questions and learning, and I think you will get some clarity from your pros.

DeeDee

It sounds like the psych's assessment fits very well with what you've experienced with your dd. I would bring/fax the report to the neuropsych and discuss your concerns with the NVLD diagnosis, maybe discussing that you've had a chance read up more about NVLD and that the social issues don't seem to fit. Hopefully, you don't have a narcissist on your hands with the neuro. I think it's fair to ask how social behavior is accurately assessed in the midst of untreated anxiety (as the delay of such assessment is clinically appropriate). In the long run, the school may not even be aware of the specifics of an NVLD dx, as it is not yet recognized with a controlled set of diagnostic criteria.