Jessica Broitman

Screening and Evaluation

As we have stated, data are the source for identifying students with NVLD, qualifying students with NVLD, and determining what types of interventions and accommodations will be necessary to help insure their success. Here we will discuss two methods for collecting data: screening and a comprehensive evaluation. Screening can be used for determining with whom to intervene, as in an RTI model, or for determining for whom a broader evaluation is necessary. A broader evaluation is necessary for helping to document eligibility for services (Hale, Nagliari, Kaufman, & Kavale, 2006) and for deciding where, with what professionals, and with what goals the services are to be provided. Screening may well be the first step toward identifying those students who need support.

Overview of NVLD

This chapter provides an overview of the evolution of what we, today, call a nonverbal learning disorder (or nonverbal learning disability) (NVLD). Although there was increased interest in this disorder in the 1980s and 1990s, researchers and practitioners have not even been able to agree whether nonverbal learning disabilities should be abbreviated as NLD (mostly used on the West Coast) or NVLD (preferred by East Coast clinicians), nor have they arrived at an accepted definition for this condition, although Rourke’s definition is the most frequently noted (Pelletier, Ahmad, & Rourke, 2001). We will use the abbreviation NVLD for the purposes of this book.

Assessments for NVLD

Capitalizing on Gerstmann’s early work (1940), Johnson and Myklebust (1967) brought thinking about NVLD into the “modern age.” In their book, Learning Disabilities: Educational Principles and Practices they described their version of the syndrome of nonverbal learning disorders. They observed fine motor difficulties, difficulties with math and writing, and difficulties in visual–spatial processing including something they called “social perception.” They suggested that children with these issues had difficulties in the following areas: understanding gesture, nonverbal motor learning, body image, spatial orientation, right–left orientation, and social perception. Additionally, they also noted that children with NVLD also demonstrated distractibility, perseveration, and disinhibition. Later work has also found overlap with ADHD and executive function issues (Landau, Gross-Tsur, Auerbach, Van der Meer, & Shalev, 1999).

Eligibility for Special Services, Screening, and Assessment

This chapter will cover eligibility for special services including brief overviews of both the Individuals with Disabilities Education Act-2004 and Section 504 of the Rehabilitation Act of 1973. Since our model suggests that students with NVLD often have academic and social impairment, knowing the pertinent laws will help the students and their families get the added support they will need.

History of the Concept of NVLD

The National Center for Education Statistics estimates that 20–25% of children will have learning disabilities (1998). “Specific learning disability” (SLD) is the most prevalent eligibility category in special education. SLD is a disorder in one or more of the central nervous system processes involved in perceiving, understanding, and/or using concepts through verbal (spoken or written) language or nonverbal means. The term does not include learning problems that are primarily the result of visual, hearing, or motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural, or economic disadvantage (Federal guidelines 34 CFR 300.7).

Asperger’s Disorder and NVLD

In this chapter we will review available data attempting to look at the relationship between Asperger’s Disorder (AS) and NVLD as there remains considerable controversy regarding the relationship, or lack thereof, between these disorders. Some, for example, postulate that they are virtually the same disorder assessed by two different systems: psychiatric evaluations and neuropsychological evaluations, respectively (Klin, Sparrow, Volkmar, Cicchetti, & Rourke, 1995; Volkmar & Klin, 1998). However, other researchers believe that AS is high functioning autism (HFA) and should be considered part of the autistic spectrum (Lord & Spence, 2006; Schopler, 1996), as part of the pervasive developmental disorder spectrum (Szatmari, 1998), or as schizoid-schizotypal disorders (Wolff, 1995). We believe these diagnostic concerns are important not just for the sake of diagnosis but because they will enable us to understand how to intervene with the differing disorders as well.

The Etiology of NVLD

In this chapter we will discuss the extent of our knowledge, as well as our uncertainty, regarding the causes of NVLD. Unfortunately, as is the case with other learning disabilities (LD: Duane, 1991) and developmental disorders (DD: Ozonoff & Rogers, 2003), the exact cause or causes of nonverbal learning disabilities are not yet clear. We review the current available information from the areas typically addressed when considering causality: genetics, neurobiology, and environment. Finally, the current model of understanding NVLD, which is commonly called the “white matter model” from a neurological perspective, will be presented.

NVLD and Subtypes

Historically, Rourke (1985, 1991) and others (Drummond, Ahmad, & Rourke, 2005; Harnadek & Rourke, 1994; Johnson & Myklebust, 1967; Pennington, 1991) spent a significant amount of time clarifying the differences between what are often referred to as verbal or phonologically based learning disorders and nonverbal learning disorders. More recently, some theorists have suggested that, as with many developmental disorders, NVLD should be considered as a disorder with different subtypes (Davis & Broitman, 2007; Forrest, 2004; Grodzinsky, 2003; Mamen, 2006). This notion fits with our clinical experience. This chapter reviews the most recent developments in the understanding of NVLD as a disorder with multiple subtypes or components.