Could My Child Also Have NLD?

Question

My 8th grade son is gifted with an IQ of 132. He’s been diagnosed with anxiety, disruptive mood disorder & dysgraphia, plus he has symptoms of ADHD and takes medication for it. I’m not convinced, however, that he does not have other problems. What I’ve read about NLD describes him perfectly with one exception: He has strong visual spatial ability, which seems to be uncharacteristic of kids with NLD. Could he still have NLD?


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Marcia Eckerd, Ph.D.

Marcia Eckerd is an evaluator, consultant, and therapist who specializes in working with children with NLD and autism-spectrum disorders.

Yes, children with NLD usually have visual-spatial disability based on testing. However, bright verbal children are often able to talk their way through visual-spatial tests. There doesn’t have to be a huge discrepancy between Verbal and Visual Index scores to have visual deficits, if someone is just going by numbers.

Also, there is more than one visual-spatial test. Even with the WISC or WAIS, there are multiple subtests, and he may have done well on one and not as well on another, yielding an “OK” looking Index score that combines the two.

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I’d suggest looking carefully into the process used in testing (how did he do the tasks?) as well as at the discrepancy between subtests to see if averaging scores together played a role.

There’s another test called the Rey-Osterrieth Complex Figure that I find very revealing about the visual organization and conceptualization of NLD children.

I would see if someone can administer that test. If with all of that, his visual spatial scores are every bit as strong as his verbal scores, I would say an NLD diagnosis probably is not appropriate.

Keep in mind that many school districts do not accept NLD as a diagnosis, so his accommodations or IEP would be based on his learning disabilities and ADHD. There are ways of looking at his social functioning; if they will do that, he might get some social goals.

Finally, NLD is not a learning disability nor a clinical diagnosis. It is a neuropsychological profile. Many children who are diagnosed Asperger’s have this profile and social difficulties, inflexibility, problems with emotional regulation, etc. You might consider a clinical evaluation to assess if this should be considered. (Asperger’s is now called Autism Spectrum Disorder, level 1). I suggest you read Tony Atwood’s book on Asperger’s Syndrome and see if you think it should be considered.

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