When my daughter was in Year 10 at a private girls’ school, I got the call that every parent dreads – a summons to the deputy’s office. My polite 15-year-old girl had no behavioural problems, but she couldn’t keep up with class or homework tasks, and was considered “lazy” by some.
So the message was clear. The school could no longer meet my daughter’s learning needs and she had to leave.
Life at her new school was much harder, both in the classroom and socially. One day my daughter told a teacher that she’d shoot herself if she had a gun.
There was something wrong, yet for years, no one could put a name to my daughter’s condition.
As a parent, there is nothing worse than not being able to help your child.
It took until she was 18 years old to finally get a proper diagnosis: non-verbal learning disability (NLD).
So what is it? How common is it? And what are some of the potential warning signs to look out for?
What is non-verbal learning disability?
NLD is a complex neurological disability that becomes more obvious with age.
Children with NLD usually have poor coordination, are clumsy, have difficulties with maths, struggle to follow instructions, meet deadlines, handle new tasks, develop friendships and understand social interaction within groups.
They tend to have cognitive and functional limitations that hinder many everyday classroom tasks.
NLD is believed to be caused by damage, disorder or destruction of neuronal white matter in the brain’s right hemisphere. It may be seen in people suffering from a range of neurological diseases such as shunted hydrocephalus, Williams syndrome, foetal alcohol syndrome (high functioning), and other types of brain injury.
It doesn’t usually affect speech or reading – in fact, children with NLD tend to excel in these areas.
Asking questions is the only way a child with NLD can make sense of what is happening in the immediate environment. This child does not learn intuitively from observation as would a same-age peer. Many everyday tasks must be explicitly taught.
In class, concrete maths that follows set routines and learned tables may be well-handled, although signs and symbols may be misinterpreted. Fractions and area are almost impossible for these students to grasp, with challenges further exacerbated by poor concentration.
Inability to apply learned tables and simple mathematics routines to a word problem or new context is a common problem for students with NLD.
It can also place a student at risk of emotional problems. If problems in the non-verbal areas of functioning accrue, a predisposition to anxiety, depression, social isolation, and suicidal ideation may develop. This may explain in part my daughter’s distress in secondary school when she wished she had a gun.
How symptoms can be misunderstood
Impairments are lifelong and most students only get diagnosed by psychologists or neuropsychologists in the middle to late years of childhood or young adulthood.
In the US and Canada, NLD reportedly affects 1% of the general population. In these two countries, NLD is widely recognised and formally diagnosed. But the same isn’t true for Australia – here NLD is not well-known or identified.
Getting NLD officially recognised
Despite 40 years of research into the theoretical and neuropsychological underpinnings of NLD – including several hundred peer-reviewed journal articles, dozens of books and book chapters, as well as several websites – there is still some debate about the essential features necessary to establish a diagnosis.
Formalisation of an NLD diagnosis would provide a framework and language for describing NLD characteristics, interrelationships and behavioural consequences.
Official recognition in the International Classification of Functioning would guide clinical practice and future research. It would also support development of policies and services that better meet the needs of people with NLD in Australia.
Signs to look out for
Some key NLD signs to look out for include, poor:
- basic self-help skills
- coordination and clumsiness
- early handwriting
- ability to handle problem-solving maths
- ability to start and finish a task
- comprehension (written and verbal)
- time management and problem-solving
- understanding of social interaction (individual and group)
- ability to develop and maintain friendships
- anxiety and depression
Of course, any combination of these indicators does not mean a child has NLD. But a better understanding of the neuro-psychological profiles of NLD and other similarly presenting disorders would help parents, teachers and doctors to at least ask the right questions.