Verbal and nonverbal communication of events in learning-disability subtypes

The discrepancy between verbal and visuoperceptual IQ in children with a specific learning disorder: An analysis of 1624 cases

Children with a specific learning disorder (SLD) are often characterized by marked intellectual strengths and weaknesses. In the last few years, research has focused on a common discrepancy between low working memory and processing speed on the one hand, and high verbal and visuoperceptual intelligence on the other. SLD profiles featuring a specific discrepancy between verbal and visuoperceptual abilities have been only marginally considered, however, and their systematic comparison vis-à-vis typically-developing (TD) populations has yet to be conducted. The present study examined a dataset of 1624 WISC-IV profiles of children with a diagnosis of SLD. It emerged that the proportion of children with a Verbal Comprehension Index (VCI) at least 1.5 SD (22 standardized points) lower than their scores on the Perceptual Reasoning Index (PRI) was larger than the proportion of SLD children with the opposite discrepant profile; it was also larger than the same proportion found among TD children. Comparing the two discrepant profiles revealed that the children also differed by type of learning difficulty, gender, and performance in the WISC-IV Symbol search task. Further examination suggested that children who were discrepant and also distinctly poor in visuoperceptual intelligence were particularly slow in general processing.

Psychosocial Dimensions of Learning Disability Subtypes

Evidence bearing upon the relationships between profiles of neuropsychological assets and deficits, subtypes of learning disabilities, and patterns and degrees of psychosocial functioning is reviewed. The dimensions of incidence and type of psychosocial disturbance and the differential manifestations of these in two subtypes of learning disabilities are examined. Conclusions relating to the neurodevelopmental bases of the pattern of psychosocial functioning most often seen in children and adolescents with the syndrome of nonverbal learning disabilities are emphasized.

Psychosocial and Adaptive Deficits Associated With Learning Disability Subtypes

Children with specific learning disabilities (SLD) have deficits in the basic psychological processes that interfere with learning and academic achievement, and for some SLD subtypes, these deficits can also lead to emotional and/or behavior problems. This study examined psychosocial functioning in 123 students, aged 6 to 11, who underwent comprehensive evaluations for learning and/or behavior problems in two Pacific Northwest school districts. Using concordance-discordance model (C-DM) processing strengths and weaknesses SLD identification criteria, results revealed working memory SLD (n = 20), processing speed SLD (n = 30), executive SLD (n = 32), and no disability groups (n = 41). Of the SLD subtypes, repeated measures MANOVA results revealed the processing speed SLD subtype exhibited the greatest psychosocial and adaptive impairment according to teacher behavior ratings. Findings suggest processing speed deficits may be behind the cognitive and psychosocial disturbances found in what has been termed "nonverbal" SLD. Limitations, implications, and future research needs are addressed.

Nonverbal learning disabilities: a critical review

This article presents a critical review of the term and concept of nonverbal learning disability (NLD). After a brief historical introduction, the article focuses on the apparent rarity of NLD; the hypothesis of the frequent co-occurrence of emotional disorder, depression, and suicide in NLD; the white matter hypothesis as an explanation of the origin of NLD; and the question of NLD as part of a variety of other disorders. It is argued that NLD presents a broad hypothesis, but that there is little evidence to support its use in clinical practice.

Social cognition and its relation to psychosocial adjustment in children with nonverbal learning disabilities

The current study examined social cognitive skills in children with nonverbal learning disabilities (NLD) compared to normally achieving (NA) children. The relation between social cognitive skills and psychosocial adjustment was also investigated. There were no group differences on children's ability to represent orally presented social vignettes. Children with NLD were less able to recognize self-generated competent/assertive responses as the best solutions to a problem, expected fewer positive and more negative outcomes for examiner-provided competent responses, and showed a trend toward more frequently judging a story character as being mean. A social problem solving factor predicted unique variance in psychosocial adjustment beyond variance accounted for by nonverbal intelligence and nonverbal social cue interpretation. Results are discussed within a framework for which social cognitive deficits more broadly defined than encoding and interpreting nonverbal social cues contribute to the psychosocial adjustment problems of children with NLD.

Math Disabilities and Reading Disabilities

This article synthesizes some of the published literature that selectively compares the cognitive functioning of children with math disabilities (MDs) with average-achieving children and poor readers (children with reading disabilities [RDs] or comorbid disabilities [RDs + MDs]). All studies in the synthesis report reading, IQ, and math scores for children with MDs and poor readers. A random coefficients model of effect sizes (ESs) show that (a) ESs between MD and normal achievers were moderated by variations in working memory and literacy, (b) ESs between MD- and RD-only children were moderated by working memory and problem solving, and (c) ESs between MD and MD + RD children were moderated by long-term memory and IQ scores. No support was found for the notion that the differentiation between MD children and poor readers (RD and MD + RD) was related to variations in reading across the reviewed studies.

Syndrome of nonverbal learning disabilities: Age differences in neuropsychological, academic, and socioemotional functioning

Previous research has suggested that changes in the manifestations of the nonverbal learning disabilities syndrome (NLD) occur over the lifespan and that they do so in a manner that is consistent with the tenets of the NLD model (Rourke, 1989). Although the model would predict that age-related changes would also be evident within the childhood years, no study has yet examined this possibility. Based on the tenets of the model, specific predictions were formulated regarding developmental changes in the features of the NLD syndrome that would be expected to occur across the middle childhood and early adolescent years. The pattern of neurocognitive and socioemotional changes observed within the context of the cross-sectional data provided strong support for the predictions. Due to methodological limitations, no firm conclusions regarding the developmental manifestations of the NLD syndrome could be derived from the results of the longitudinal study. At most, these results suggested that some improvements in areas of neurocognitive deficiency may occur with the implementation of an appropriate remedial intervention program.

Imitation and expression of facial affect in autism

This study examined elicited (posed) affective expressions in children, adolescents, and young adults with autism (N = 18) or Down's syndrome (N = 24). Subjects were asked to (a) imitate five modeled expressions (Imitation task) and (b) produce five labeled expressions (Expression task). Subjects with autism produced recognizable expressions in both tasks, but they produced fewer than did subjects with Down's syndrome when target emotions were labeled but not modeled (Expression). Imitation and Expression tasks were equally difficult for subjects with autism, but subjects with Down's syndrome performed better in Expression than in Imitation. In both tasks, the responses of subjects with autism contained many unusual behaviors, such as bizarre expressions and those that looked “mechanical.” Results suggest that producing elicited affective expressions is more difficult for persons with autism than for persons with Down's syndrome of similar chronological age, mental age, and IQ.

Using puppetry to elicit children's talk for research

Although puppets have been employed by various disciplines in clinical and community (e.g. homes and schools) environments, little has been written about their use as a communication tool in research. In this article, a critical review of the literature is undertaken integrating the use of puppets in a qualitative research study exploring children's perspectives on and responses to a camp for children with cancer. Methodological considerations and ethical issues of using puppets as a data collection technique are discussed. Although some limitations exist, using puppets in interviews with children appear to help them to identify, clarify and verbalize their feelings.

Is there an increased familial prevalence of psychopathology in children with nonverbal learning disorders?

The cognitive and behavioral symptoms of nonverbal learning disabilities (NLD) have been described by previous investigators. Nevertheless, we know far less about the potential genetic contributions that may predispose a child to have NLD. An endophenotype model was investigated in 5 samples of children ages 9 to 15 years: NLD (n = 32); reading disorders (RD; n = 59); participants with a psychiatric diagnosis but without a learning disability (n = 55); typically developing controls (n = 31); and children with velocardiofacial syndrome (VCFS), a chromosomal deletion syndrome that has been proposed as being an exemplar of NLD (VCFS + NLD; n = 20). Based on a family genetic interview, the authors' data suggest that children with NLD, RD, or a psychiatric diagnosis have a higher prevalence rate of attention-deficit/hyperactivity disorder (ADHD) and substance abuse/dependence. Psychiatric controls and children with NLD--but not children with RD-- showed higher prevalence rates of familial bipolar disorder.

The influence of instruction modality on brain activation in teenagers with nonverbal learning disabilities: two case histories

Teenagers with nonverbal learning disabilities (NLD) have difficulty with fine-motor coordination, which may relate to the novelty of the task or the lack of "self-talk" to mediate action. In this study, we required two teenagers with NLD and two control group teenagers to touch the thumb of each hand firmly and accurately to the fingertips of the same hand, in an order specified by verbal or tactile instruction. Brain activity patterns (measured using functional magnetic resonance imaging) suggest that unlike control participants, the NLD participants used internalized speech to facilitate the novel task only when instructions were verbal. NLD participants also showed activity in a more widely distributed network of neural structures. These findings provide preliminary evidence for remediation strategies that encourage internal speech.

Social information processing and emotional understanding in children with LD

The present study aimed to comprehensively examine social cognition processes in children with and without learning disabilities (LD), focusing on social information processing (SIP) and complex emotional understanding capabilities such as understanding complex, mixed, and hidden emotions. Participants were 50 children with LD (age range 9.4-12.7; 35 boys, 15 girls) and 50 children without LD matched on grade, age, and gender. Children analyzed 4 social vignettes using Dodge's SIP model and completed 2 emotional recognition tasks (pictures and stories) and 4 emotional knowledge tasks, such as providing definitions and examples for 5 emotions (e.g., loneliness, pride, embarrassment). Study results demonstrated that children with LD had major difficulties in SIP processes and consistent difficulties with the different tasks in the understanding of complex emotions and in higher emotional understanding capabilities, such as understanding that 2 conflicting emotions (love and hate) can be simultaneously experienced. We discuss the implications of such difficulties for the understanding of social competence in children with LD as well as their implications for social skills intervention.

Acalculia and dyscalculia

Even though it is generally recognized that calculation ability represents a most important type of cognition, there is a significant paucity in the study of acalculia. In this paper the historical evolution of calculation abilities in humankind and the appearance of numerical concepts in child development are reviewed. Developmental calculation disturbances (developmental dyscalculia) are analyzed. It is proposed that calculation ability represents a multifactor skill, including verbal, spatial, memory, body knowledge, and executive function abilities. A general distinction between primary and secondary acalculias is presented, and different types of acquired calculation disturbances are analyzed. The association between acalculia and aphasia, apraxia and dementia is further considered, and special mention to the so-called Gerstmann syndrome is made. A model for the neuropsychological assessment of numerical abilities is proposed, and some general guidelines for the rehabilitation of calculation disturbances are presented.

Neuropsychological and psychosocial correlates of adult arithmetic deficiency

The purpose of this study was to examine adult correlates of rule-derived arithmetic deficiency. The authors collected neuropsychological, handedness, gender, and psychosocial data of adults with stringently defined arithmetic deficiency (AD; N = 45), reading deficiency (N = 45), and dual deficiency (N = 45). The authors did not match groups on IQ score and did not restrict analyses to right-handed men. The results indicated that AD in adults is associated with nonverbal reasoning and constructional problems. Otherwise, there was no association between AD and dysphoric complaints as defined by Minnesota Multiphasic Personality Inventory elevations. The authors also found overall intelligence was lower in adults with AD, and gender distribution differed markedly from the reading and dual deficient groups. Potential gender bias in remediation referral patterns was identified.

Right hemisphere contribution to developmental language disorder: Neuroanatomical and behavioral evidence

Developmental language disorder (DLD) is identified by virtue of the verbal deficits that define it. However, numerous studies have also documented nonverbal deficits in this population. This study attempts to explain the co-occurrence of both verbal and nonverbal deficits in this population from a brain-based perspective. Two samples of adults selected for DLD were compared with subjects without such a history on verbal and nonverbal skills in exploratory and confirmatory studies. Subjects also received MRI scans, which were used to determine the relation between left- and right-hemisphere regions hypothesized to relate to the behavioral skills tested. Results revealed replicable differences between groups on both verbal and nonverbal tasks. In addition, a significant association between performance on tests sensitive to facial affect and spatial rotation with the gray matter volume within the right supramarginal gyrus was found in both samples. These results support the hypothesis of a right hemisphere contribution to the profile of DLD.

LEARNING OUTCOMES

As a result of this activity, the participant will be able to describe evidence in support of a role for the right hemisphere in DLD.

Coherence in short narratives written by Spanish-speaking children with reading disabilities

A novel analysis of coherence using a combination of three criteria (syntactic connexity, pragmatic complexity, and rhetorical well-roundedness) was applied to short narratives produced by a group of 60 Spanish-speaking children of different ages and grades with reading disabilities and compared to those produced by normal children. We posit a scale of 6 degrees of increasing coherence. This feature of children's writing, together with 2 others (viz. number of propositions, or "story points," recovered and number of words employed), was compared to features of children's reading by means of discriminant analysis in relation to age. We show that the combination of age, words read per minute, and degree of coherence achieved an optimal discrimination of the 2 groups.

Right hemisphere, white-matter learning disabilities associated with depression in an adolescent and young adult psychiatric population

Four hundred and eighty-four adolescents and young adults at an inpatient psychiatric facility were diagnosed as nonverbal learning disabled, verbal learning disabled, general learning disabled, or normal psychiatric controls. The nonverbal learning disabled group had the highest incidence of depression and was clearly different from the reading disabled group (66.3% vs. 33.3%). Nondisabled subjects were significantly more likely than the other subjects to be diagnosed with adjustment problems. Depressed subjects were significantly younger and more likely to be female. This study supports the contention that right-hemisphere, white-matter, arithmetic-disabled adolescents and young adults in a psychiatric population are at greater risk for depression than are psychiatric patients not showing this pattern.

Psychiatric, neuropediatric, and neuropsychological symptoms in a case of hypomelanosis of Ito

This case report presents a thirteen year-old boy who was diagnosed as having Hypomelanosis of Ito. The developmental history includes severe failure to thrive, and moderate atypical autism as well as diverse clinical and neuropsychological symptoms are present. The pattern of neuropsychological functioning, which can be partially related to the neurophysiological findings, is discussed within the context of existing neuropsychological theories about autistic disorders.

Psychosocial dimensions of learning disabilities: external validation and relationship with age and academic functioning

This study was designed to assess the following in a group of 152 children with learning disabilities between the ages of 7 and 13 years: (a) the relationships between age and psychosocial functioning: (b) the relationships among psychosocial functioning, cognitive abilities, and academic achievement; and (c) the external validity of statistically derived psychosocial subtypes. Participants were assigned to one of seven psychosocial subtypes on the basis of a profile-matching algorithm. Overall, the findings suggested no increase in psychopathology with advancing age. In addition, clear relationships were found between academic achievement patterns and personality subtypes. Finally, the subtypes could be distinguished on the basis of a behavior problem checklist not used for the construction of the subtypes.

Differences between learning disability subtypes classified using the revised Woodcock-Johnson Psycho-Educational Battery

This study examined the characteristics of students with specific learning disabilities in either reading and spelling or arithmetic. Based on scores obtained using the revised Woodcock-Johnson Psycho-Educational Battery, students with a marked weakness in arithmetic relative to reading and spelling were designated as Group A. Group R-S showed the opposite pattern. Each group included 30 participants ranging in age from 7 to 16 years, with a mean age of 10 years. The boy-to-girl ratios were 16:14 and 19:11 in Group A and Group R-S, respectively. Comparisons using measures from the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) indicated that Group A was weaker in nonverbal skills than Group R-S, despite equivalent overall IQ scores between the two groups. Group R-S showed a within-group strength in nonverbal versus verbal skills. Group A students were more likely than Group R-S students to have counseling provided as part of their Individualized Education Program, suggesting greater socioemotional difficulty among Group A students. The present study supports the connection between nonverbal skills and socioemotional functioning noted by previous researchers, and generalizes findings from earlier studies to more current test editions.

Specific learning disabilities: a neuropsychological perspective

A dispersion in cognitive abilities is expected in normal populations. Specific learning disabilities would represent an extreme polarity in a continuum of normal cognitive dispersion. Three propositions relative to learning disabilities are advanced in the present paper. First, specific learning disabilities are expected to be found for diverse cognitive functions, even though some of these specific learning disorders have yet to be described in scientific literature. Second, it is noted that specific "factors" can be affected in cases of learning disabilities. Lastly, a parallel between focal neuropsychological syndromes and specific learning disabilities is proposed. Developmental learning difficulties would represent dysfunctional or dysmaturational defects; whereas neuropsychological syndromes represent a consequence of acquired structural brain pathology.

Psychosocial functioning of children: relations between personality subtypes and academic achievement

Five hundred children from ages 6 to 12 who had been referred for neuropsychological assessment were clustered into six subtypes using a k-means technique applied to 10 PIC scales. Five of the six subtypes were virtually identical to subtypes identified in previous research (viz., normal, somatic concern, mild anxiety, externalized psychopathology, and internalized psychopathology). A sixth subtype (conduct disorder) was also found. Wide Range Achievement Test (WRAT) Reading and Spelling scores discriminated between normal, somatic concern, and conduct disorder subtypes on the one hand vs. the more disturbed externalized and internalized psychopathology subtypes on the other; the latter groups scored higher on these measures. The internalized psychopathology subtype also showed large discrepancies between reading vs. arithmetic and spelling vs. arithmetic. The results support the view that psychosocial functioning is related to assets and deficits in cognitive/academic functioning in children, and that particular patterns of such assets and deficits are related to particular forms of psychopathology.

Nonverbal learning disabilities and socioemotional functioning: a review of recent literature

Over the past decade, there has been increasing interest in the use of subtyping techniques for research and treatment of learning disabilities (LD). This article presents an overview of the current literature relating to a nonverbal learning disabilities (NLD) subtype. Research on the relationship between nonverbal learning disabilities and socioemotional functioning is critically reviewed. Issues of generalizability of research outcomes, individual differences, and treatment validity are addressed. Emphasis is on findings that are most likely to have direct relevance for practitioners.

Arithmetic disabilities, specific and otherwise: a neuropsychological perspective

From a neuropsychological perspective, this article summarizes research that addresses some of the developmental interactions of disabilities in reading, spelling, and mechanical arithmetic. The focus is on two subtypes of children with learning disabilities who exhibit equally impaired levels of arithmetic achievement, but with vastly different patterns of neuropsychological assets and deficits. Qualitative as well as quantitative analyses lead to the conclusion that one of these patterns of neuropsychological assets and deficits (i.e., the nonverbal learning disabilities syndrome; NLD) leads--at the same time and in much the same manner--to specific patterns of impairment in mechanical arithmetic and in psychosocial functioning. The other pattern (Group R-S) is found to lead to particular patterns of academic deficits (including arithmetic), but not to any particular level or type of psychosocial dysfunction. The manifestations of the NLD profile in various types of neurological disease, disorder, and dysfunction are also explored.

Emotional disorders in learning disabled adolescents

We retrospectively reviewed patients discharged from the psychiatric inpatient adolescent service and correlated neuropsychological subtypes with the patient's psychiatric diagnoses. Depressed learning disabled patients had visual memory and processing deficits. Conduct or behaviorally disordered patients had expressive language deficits. Learning disability subtypes may affect psychotherapy and therefore should be known when planning psychotherapy.