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

Does anyone have any experience with NVLD/NLD with a social child? DD has a very high verbal score (apparently 99th+ but don't have the number yet) and low scores in visual perception, working memory and processing speed. (Original testing put these at 6th-8th but new testing is more like 30th - still a huge difference but no longer in the "impaired" range.) Neuropsych gave her NLVD, ADHD-Inattentive and anxiety. (Previous neuropsych - whose report was determined to be invalid - said there were attention issues but it was definitely NOT an ADD situation.) When I asked neuropsych about the social component that I thought had to be present for NVLD he said it is more "NLD-ish" since not all applies to her but it is apparently easier than saying super high verbal abilities along with dyslexia, dysgraphia, dyspraxia, math issues, etc.

As I have been reading I am seeing a close affiliation between NLD and AS. My DD is about as far from Aspergers or anywhere on the spectrum as night and day. She is very social and has been from the minute she was born. Her preschool teacher has told me that she believes DD has "the highest EQ of anyone I've ever known." She is extremely empathetic, sympathetic and friendly. She has always been a social butterfly and recently chose to give up a week at her favorite camp to instead spend the week having daily playdates - sometimes 2 in one day. This really doesn't match with my reading of NVLD/NLD.

The neuropsych noted things like using sign language (she took a mini ASL class this summer and has been enjoying practicing) to answer some questions and being "overly dramatic" in her excitement when she enjoyed certain things. He called these "immature" - a very different interpretation than I have ever heard before. I'm not saying wrong - just different. He said she might be uncomfortable in new surroundings and I told him it was quite the opposite. For example on a cruise last month when she entered the kids club area - new to everyone and no one knew anyone else unless they had a sibling close in age - she was totally comfortable from the first minute and walked up to the other kids and started talking to them. He said this could be a problem - she's not reading social cues and apparently SHOULD have somehow been uncomfortable in order to not overwhelm the other kids.

Can someone with more experience try to explain this to me? I have no problem with a diagnosis - anything that will make it easier for the school to understand what she needs and meet her needs is fine. I am just wondering if I am missing something. The exact part of her personality that everyone has always marveled at is now being described as a possible problem. The neuropsych was clear that it was not necessarily an issue - just something to be aware of. I am wondering, though, if the NLD or NVLD needs to have a social component or if this diagnosis could potentially cause unnecessary problems if it's not accurate.

Sorry, I have just recently heard of NVLD and don't know much about it, but in reading your post I was just struck by how this guy's evaluation seems off to you as well as very different from what others have said (e.g., the teacher who made the comment about your DD's high EQ). So the tester thought she should have been acting differently--do other kids actually have any issues with her behavior, or did the tester just think they might? It sounds like she gets along with other kids very well, so I too am puzzled by the tester characterizing this as a problem. I guess you've ruled out an earlier diagnosis--does the current tester have experience or credentials that might give his opinion more weight in diagnosing these LDs? Finally (maybe this is because I am naive and also because our DD received multiple diagnoses this year that I think are off-base, but) doesn't it seem odd that your DD was diagnosed with several disorders? I'm starting to think about this after seeing any multiple diagnosis discussed here, at least when two or more of the diagnoses have similar characteristics and particularly unless the tester is experienced with 2e kids--is this tester experienced with gifted and 2e, so that they might be able to sort out the different behaviors? Having read the James Webb Misdiagnosis book, I think a lot of our DD's ADHD/inattentive traits look more like the gifted behaviors he discusses that can mimic ADHD--which of course means they still need to be addressed, but differently. But I guess maybe if it's becoming too hard (or expensive, or time-consuming) for you to sort out what the real diagnosis is, maybe you should consider what you want from a diagnosis (like, are you trying for accommodations at school?) and decide whether it's worth going through more evaluations. Sorry things are so difficult in trying to sort this out

Best of luck,
Dbat

I have a 10yr old DD who is in the process of getting a diagnosis of AS. As a toddler and young child whenever I wondered about her I would be comforted that she was extremely extroverted, made eye contact, had empathy, needed to be out out out in the world (what i now know was sensory seeking). Teachers used to comment she could and would play with anyone, would never have trouble finding someone to play with etc...

But the thing is as she's approaching 11 it is becoming more and more clear that all those things are true BUT she doesn't read cues well, DOESN'T have good social skills, doesn't understand or use tone of voice etc. What looked like "good social skills" at 2yrs - 5/6yrs was that she LOVES company and the other kids were not necessarily more skilled at tone of voice and various other social skills like genuine reciprocal conversation that she's now obviously lacking. She talked to anyone and everyone with confidence... She seemed fabulously social. She also had a particularly ideal group of peers through preschool, k & 1 and amazing social instruction at school in those years.

I wondered about her as a toddler but the ASD checklists I found (boy lists I now know) didn't fit. If someone had told me when she was 5-6 she had social problems I would have thought they were mad. Now she's approaching 11 am I brutally aware that while she's certainly not full classic autistic that she's certainly not normal either.

I so wish I had an IQ test on her from before the wheels fell off at school, I am pretty sure it would have been high. But she had 2.5 increasingly disasterous years at school (academically not socially) before her first IQ test, where her IQ could not be calculated due to spread (WMI 13th and VCI 96th). Two years of remediation later we had a FSIQ of 131, verbal still 96thm NV 99th and WM 80-90th. Three yrs since the first IQ test we have diagnosed: CAPD, ADD, Dyslexia, we are on the way to an AS diagnosis, and I would say she's got mild dyspraxia.

To my mind, for my daughter, the AS diagnosis makes sense and pulls everything together. But I would not have understood if I had looked at my daughter at 6yrs old and been told what you have been told. Despite my disbelief in her case it would have been true. I obviously don't know your daughter and can't tell you how true it is for her. Just saying I appreciate the possible truth of what the psychologist is saying.

AS in gifted girls, particularly if it's mild, particularly if they are extroverts, is very very hard to pin down. But that is my DD.

Has your daughter ever done the SB5? Both my girls do much better on the NV section of the SB5 compared the WISC or WPPSI, particularly the eldest that I am describing above. I am not really sure why.

Did the NP diagnose her on one visit only? The art of diagnostics is tricky, confounding, and often like peeling away layers of an onion.

What may appear as ADHD may eventually be teased out to anxiety - or even a side effect from an inhaler (random example). I would never diagnose spectrum disorders (mind you NVLD is not - nor is it recognized in the current DSM) without multiple visits along with checklists from teachers, parents and other caregivers of significance.

That being said, I have talked to clients about NLVD as a possibility. With this, I usually see a cluster of physical issues (as you described with your DS), coupled along with some social peculiarities (as opposed to significant impairments as with ASDs), and in the absence of significant rigidity, emotional lability, and/or obsessed area of interest (that seems beyond typical).

Because there is no set guidelines for NVLD, it remains an unclear diagnosis...sometimes used as "Aspergers Light" and other times used to cluster together a host of delays void of social of emotional delays.

Thanks this is all very helpful, although it remains SO confusing...

I was just researching private LD schools (none nearby and all unbelievably expensive. Really - $40k+ per year for elementary school. Wow!) and I saw that some will exclude children with NLD/NVLD from even applying.

Yes one visit, no idea what tests were used. I will get the report in about 6 weeks - this was just from the short conversation immediately afterwards.

I am surprisingly not too worked up about the ADHD-I diagnosis. She gets very antsy whenever she has to do "seat work" - not surprising with her combination of visual perception, fine motor and working memory issues. She has laser focus on anything that involves learning new information though. I am not sure how that one will play out.

MOT's description of her dd socially is very interesting. I will have to mull that one over...

EM: her social "peculiarities" are a big, cheerful, outgoing personality. She is very dramatic and loves to perform whether or not she has an audience. When younger she was always a magnet - especially to the more shy kids her age. I have chalked up any recent social discomfort to a combination of anxiety causing her to respond by withdrawing and a bit of discomfort or feeling unsafe after being around kids with behavior issues who physically hurt her during her awful K year at the terrible magnet school. She is totally comfortable with older or younger kids. Recently I have noticed that *very bright* kids her age love her but more *typical* kids sometimes don't know what to make of her until they get to know her better. She is very aware of other's emotions - she will ask a crying child what is wrong and try to "fix" whatever is causing their distress, try to comfort someone - child or adult - who appears to be in distress, offer words of encouragement, etc. All well beyond her years of experience. Does that make any sense?

Does your neuropsych not schedule a followup where they really explain the results to you in detail? They should.

I would not consider them done until all these questions are answered and you understand why they think what they think, in detail...

DeeDee

I would be suspicious of any diagnosis that seems off. Before I started dealing with my son's gifted issues, my only experience with psychologists was through work in the criminal justice system. If my client's current mental state or mental state at the time of the offense is an issue, each side will have their own psychiatrist/psychologist. The experts will look at the same facts, evaluate the same person and often come to completely different conclusions. How can anyone have faith in a diagnosis when the diagnostic criteria is so open to interpretation? Jurors seem to go with the expert with the best courtroom presence.
I would like to see a study where a group of suspected 2E kids are evaluated by a group of psychologists and see how things change from doctor to doctor.
I am sorry for the rant and that you didn't get an answer that ties it all in for you.

It sounds like your biggest concern stems from the testing, with the spread of verbal (99%) and processing speed/memory/visual (30%).
Maybe just see how she does in school. Alot of posters describe how their kids have lower processing speed scores.
My son had a verbal 99.9% and processing speed 43% at age 6. We've done lots and lots of flash cards, etc., and he's "fast enough" to be able to complete SCAT, OLSAT, and STAR testing with the other children (and do very well). I think all too often, people try to plug their child's test scores into a specific LD. As another poster said, it makes you wonder if you had different psychologists independently evaluate the child, you would probably get lots of different diagnoses.

This is an excellent idea! I have certainly been very deferential in the past to what I thought was the final word--i.e., an expert opinion from a psychologist--only to realize later that there was a lot of controversy about various issues relating to the diagnosis, and also much later that there are specialists who know a lot more about 2e kids than some others. My DH and I have been stymied in our sporadic efforts to learn more about how these evaluations are supposed to work because in many cases the evaluations and the questions are proprietary so it's difficult and/or expensive to get copies. Also there do not seem to be many studies of how well the evaluations actually work in practice--although this is an area that could be very confusing, because how could you really validate way of evaluating, for example, borderline ADHD-I vs. PDD-NOS, etc.? It could be very hard to avoid going around in circles. I personally would like to see some kind of objective tests (like fMRI/neurofeedback) become developed to the point where they become the standard, rather than a questionnaire that even well-meaning people could fill out differently on any given day.

But in the meantime, we have to make do with what we have--which I guess means trying to find a good specialist, trying to find the money to pay for a thorough workup, and doing what we can to get the diagnos(es) that will help our kid the most.