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Recent developments in the application of the nonverbal learning disabilities model

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Abstract

Since the original work of Myklebust et al., the concept of a syndrome of nonverbal learning disabilities (NLD) has undergone considerable development and expansion, most notably in the work of Rourke. These authors have proposed a model of white matter dysfunction, predominantly in the right cerebral hemisphere, which is thought to underlie the cognitive and behavioral impairments seen in individuals with NLD. Recent research has focused on assessing the applicability of Rourke’s conceptualization of the NLD syndrome and the white matter model to various neurologic, neurodevelopmental, and genetic disorders. This paper highlights recent investigations of the NLD model with respect to velocardiofacial syndrome, Klinefelter syndrome, high functioning autism, neurofibromatosis type I, and metachromatic leukodystrophy, and also provides a brief discussion of recent conceptualizations of the NLD model in the broader context of disorders of social and emotional functioning, and of other novel avenues of NLD research.

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References and Recommended Reading

  1. Johnson DJ, Myklebust HR: Learning Disabilities: Educational Principles and Practices. New York: Grune and Stratton; 1967.

    Google Scholar 

  2. Myklebust HR: Nonverbal learning disabilities: assessment and intervention. In Progress in Learning Disabilities, edn 3. Edited by Myklebust HR. New York: Grune and Stratton; 1975:85–121.

    Google Scholar 

  3. Rourke BP: Nonverbal Learning Disabilities: The Syndrome and the Model. New York: The Guilford Press; 1989.

    Google Scholar 

  4. Rourke BP: Syndrome of Nonverbal Learning Disabilities: Neurodevelopmental Manifestations. New York: The Guilford Press; 1995.

    Google Scholar 

  5. Goldberg E, Costa LD: Hemisphere differences in the acquisition and use of descriptive systems. Brain Lang 1981, 14:144–173.

    Article  PubMed  CAS  Google Scholar 

  6. Fuerst KB, Dool CB, Rourke BP: Velocardiofacial syndrome. In Syndrome of Nonverbal Learning Disabilities: Neurodevelopmental Manifestations. Edited by Rourke BP. New York: The Guilford Press; 1995:119–137.

    Google Scholar 

  7. Driscoll DA, Salvin J, Sellinger B, et al.: Prevalence of 22q11 microdeletions in DiGeorge and velocardiofacial syndromes: implications for genetic counselling and prenatal diagnosis. J Med Genet 1993, 30:813–817.

    PubMed  CAS  Google Scholar 

  8. Driscoll DA, Spinner NB, Budarf ML, et al.: Deletions and microdeletions of 22q11.2 in velo-cardio-facial syndrome. Am J Med Genet 1992, 44:261–268.

    Article  PubMed  CAS  Google Scholar 

  9. Driscoll DA, Budarf ML, Emanuel BS: A genetic etiology for DiGeorge syndrome: consistent deletions and microdeletions of 22q11. Am J Hum Genet 1992, 50:924–933.

    PubMed  CAS  Google Scholar 

  10. Scambler PJ, Carey AH, Wyse RK, et al.: Microdeletions within 22q11 associated with sporadic and familial DiGeorge syndrome. Genomics 1991, 10:201–206.

    Article  PubMed  CAS  Google Scholar 

  11. Tezenas Du Montcel S, Mendizabai H, Ayme S, et al.: Prevalence of 22q11 microdeletion. J Med Genet 1996, 33:719.

    Google Scholar 

  12. Golding-Kushner KJ, Weller G, Shprintzen RJ: Velo-cardiofacial syndrome: language and psychological profiles. J Craniofac Genet Dev Biol 1985, 5:259–266.

    PubMed  CAS  Google Scholar 

  13. Moss EM, Batshaw ML, Solot CB, et al.: Psychoeducational profile of the 22q11.2 microdeletion: a complex pattern. J Pediatr 1999, 134:193–198.

    Article  PubMed  CAS  Google Scholar 

  14. Shprintzen RJ, Goldberg RB, Lewin ML, et al.: A new syndrome involving cleft palate, cardiac anomalies, typical facies, and learning disabilities: velo-cardio-facial syndrome. Cleft Palate J 1978, 15:56–62.

    PubMed  CAS  Google Scholar 

  15. Woodin M, Wang PP, Aleman D, et al.: Neuropsychological profile of children and adolescents with the 22q11.2 microdeletion. Genet Med 2001, 3:34–39. This paper assesses the applicability of the NLD profile and white matter model to VCFS using a fairly large clinical sample. Although replicating previous work demonstrating that many aspects of the NLD profile aptly describe individuals with VCFS, these authors also highlight areas of deficit in VCFS, which would not be predicted by the NLD model.

    Article  PubMed  CAS  Google Scholar 

  16. Solot CB, Gerdes M, Kirschner RE, et al.: Communication issues in 22q11.2 deletion syndrome: children at risk. Genet Med 2001, 3:67–71.

    PubMed  CAS  Google Scholar 

  17. Bearden CE, Woodin MF, Wang PP, et al.: The neurocognitive phenotype of the 22q11.2 deletion syndrome: selective deficit in visual-spatial memory. J Clin Exp Neuropsychol 2001, 23:447–464. This study assesses discrete aspects of memory functioning in VCFS within the framework of the NLD model, and suggests that, as a disorder with a known genetic marker, VCFS may serve as a prototype for further elaboration of the NLD syndrome.

    Article  PubMed  CAS  Google Scholar 

  18. Jacobs PA: The incidence and etiology of sex chromosome abnormalities in man. Birth Defects Orig Artic Ser 1979, 15:3–14.

    PubMed  CAS  Google Scholar 

  19. MacLean J, Harnden DG, CourtBrown WM: Abnormalities of sex chromosome constitution in newborn babies. Lancet 1961, 2:406.

    Article  PubMed  CAS  Google Scholar 

  20. Bender B, Linden M, Robinson A: Neuropsychological impairment in 42 adolescents with sex chromosome abnormalities. Am J Med Genet 1993, 48:169–173.

    Article  PubMed  CAS  Google Scholar 

  21. Pennington B, Bender B, Puck M, et al.: Learning disabilities in children with sex chromosome abnormalities. Child Dev 1982, 53:1182–1192.

    Article  PubMed  CAS  Google Scholar 

  22. Rovet J, Netley C, Keenan M, et al.: The psychoeducational profile of boys with Klinefelter syndrome. J Learn Disabil 1996, 29:180–196.

    PubMed  CAS  Google Scholar 

  23. Netley C, Rovet J: Relations between a dermatoglyphic measure of hemispheric specialization and intellectual abilities in 47,XXY males. Brain Cogn 1987, 6:153–160.

    Article  PubMed  CAS  Google Scholar 

  24. Bender BG, Puck MH, Salbenblatt JA, Robinson A: Dyslexia in 47,XXY boys identified at birth. Behav Genet 1986, 16:343–354.

    Article  PubMed  CAS  Google Scholar 

  25. Robinson A, Bender BG, Linden MG: Summary of clinical findings in children and young adults with sex chromosome anomalies. Birth Defects Orig Artic Ser 1991, 26:225–228.

    Google Scholar 

  26. Wesner CE, Spangler P, Petrides A, et al.: Prepubertal Klinefelter syndrome: a report of six cases. J Ment Defic Res 1973, 17:237–246.

    PubMed  CAS  Google Scholar 

  27. Theilgaard A: Men with sex chromosome aberrations-as subjects and human beings. In Sex Chromosome Abnormalities and Human Behavior. Edited by Berch DB, Bender BG. Boulder: Westview Press; 1990:145–160.

    Google Scholar 

  28. Porter ME, Gardner HA, DeFeudis P, Endler NS: Verbal deficits in Klinefelter (XXY) adults living in the community. Clin Genet 1988, 33:246–253.

    Article  PubMed  CAS  Google Scholar 

  29. Boone KB, Swerdloff RS, Miller BL, et al.: Neuropsychological profiles of adults with Klinefelter syndrome. J Int Neuropsychol Soc 2001, 7:446–456. This paper offers an alternative perspective on a disorder long thought characterized primarily by language-related, as opposed to nonverbal, deficits. In doing so, the authors underscore the potential for neurodevelopmental changes in cognitive profiles over the lifespan, and offer an alternative perspective regarding possible etiologies of the cognitive deficits apparent in individuals presenting with features of the NLD syndrome.

    Article  PubMed  CAS  Google Scholar 

  30. Goldstein G, Beers SR, Siegel DJ, Minshew NJ: A comparison of WAIS-R profiles in adults with high-functioning autism or differing subtypes of learning disability. Appl Neuropsychol 2001, 8:148–154. This study makes a valuable contribution to the effort to discriminate the cognitive profile of HFA from that of LD by eliminating the confounding variable of LD heterogeneity through LD subtype analysis based on Rourke’s model.

    Article  PubMed  CAS  Google Scholar 

  31. Rourke BP: Central processing deficiencies in children: toward a development neuropsychological model. J Clin Neuropsychol 1982, 4:1–18.

    PubMed  CAS  Google Scholar 

  32. Rourke BP: Neuropsychology of Learning Disabilities: Essentials of Subtype Analysis. New York: The Guilford Press; 1985.

    Google Scholar 

  33. Klin A, Volkmar FR, Sparrow SS, et al.: Validity and neuropsychological characterization of Asperger syndrome: convergence with nonverbal learning disabilities syndrome. J Child Psychol Psychiatry 1995, 36:1127–1140.

    Article  PubMed  CAS  Google Scholar 

  34. Rourke BP, Ahmad SA, Collins DW, et al.: Child clinical/ pediatric neuropsychology: some recent advances. Annu Rev Psychol 2002, 53:309–339. This comprehensive review outlines the NLD profile and white matter model, and summarizes the previous research regarding the applicability of these concepts to a variety of neurologic disorders.

    Article  PubMed  CAS  Google Scholar 

  35. Gutman DH, Collins FS: Neurofibromatosis type 1: beyond positional cloning. Arch Neurol 1993, 50:1185–1193.

    Google Scholar 

  36. Huson SM: Recent developments in the diagnosis and management of neurofibromatosis. Arch Dis Child 1989, 64:745–749.

    PubMed  CAS  Google Scholar 

  37. Moore III BD, Denckla MB: Neurofibromatosis. In Pediatric Neuropsychology: Research, Theory, and Practice. Edited by Yeates KO, Ris MD, Taylor HG. New York: The Guilford Press; 2000:149–170.

    Google Scholar 

  38. Eliason MJ: Neurofibromatosis: implications for learning and behavior. J Dev Behav Pediatr 1986, 7:175–179.

    Article  PubMed  CAS  Google Scholar 

  39. Varnhagen CK, Lewin S, Das JP, et al.: Neurofibromatosis and psychological processes. J Dev Behav Pediatr 1988, 9:257–265.

    Article  PubMed  CAS  Google Scholar 

  40. Mazzocco MM, Turner J, Denckla MB, et al.: Language and reading deficits associated with neurofibromatosis type I: evidence for a not-so-nonverbal learning disability. Dev Neuropsychol 1995, 11:503–522.

    Article  Google Scholar 

  41. Hofman KJ, Harris EL, Bryan RN, Denckla MB: Neurofibromatosis type I: the cognitive phenotype. J Pediatr 1994, 124:51–58.

    Google Scholar 

  42. Cutting LE, Koth CW, Denckla MB: How children with neurofibromatosis type 1 differ from "typical" learning disabled clinic attenders: nonverbal learning disabilities revisited. Dev Neuropsychol 2000, 17:29–47. This paper partially replicates previous work examining the cognitive profile in NF-1, and highlights the importance of analyzing patterns of cognitive strength and weakness as opposed to impairment in relation to normative data.

    Article  PubMed  CAS  Google Scholar 

  43. Kolodny EH, Fluharty AL: Metachromatic leukodystrophy and multiple sulfatase deficiency: sulfatide lipidosis. In The Metabolic and Molecular Bases of Inherited Disease. Edited by Scriver CR, Beaudet AL, Sly WS. New York: McGraw-Hill; 1995:2693–2739.

    Google Scholar 

  44. Shapiro E, Balthazor M: Metabolic and neurodegenerative disorders. In Pediatric Neuropsychology: Research, Theory, and Practice. Edited by Yeates KO, Ris MD, Taylor HG. New York: The Guilford Press; 2000:171–205.

    Google Scholar 

  45. Shapiro E, Lipton ME, Krivit W: White matter dysfunction and its neuropsychological correlates. J Clin Exp Neuropsychol 1992, 14:610–624.

    PubMed  CAS  Google Scholar 

  46. Shapiro E, Lockman LA, Knopman D, Krivit W: Characteristics of the dementia in late-onset metachromatic leukodystrophy. Neurology 1994, 44:662–665.

    PubMed  CAS  Google Scholar 

  47. Kohn H, Manowitz P, Miller M, Kling A: Neuropsychological deficits in obligatory heterozygotes for metachromatic leukodystrophy. Hum Genet 1988, 79:8–12.

    Article  PubMed  CAS  Google Scholar 

  48. Christamanou H, Martinius J, Jaffe S, et al.: Biochemical, psychometric, and neuropsychological studies in heterozygotes for various lipidoses. Hum Genet 1980, 55:103–110.

    Article  Google Scholar 

  49. Weber Byars AM, McKellop JM, Gyato K, et al.: Metachromatic leukodystrophy and nonverbal learning disability: neuropsychological and neuroradiological findings in heterozygous carriers. Neuropsychol Dev Cogn Sect C Child Neuropsychol 2001, 7:54–58.

    Article  CAS  Google Scholar 

  50. Wasserstein J, Stefanatos GA: The right hemisphere and psychopathology. J Am Acad Psychoanal 2000, 28:371–394.

    PubMed  CAS  Google Scholar 

  51. Scheeringa MS: The differential diagnosis of impaired reciprocal social interaction in children: a review of disorders. Child Psychiatry Hum Dev 2001, 32:71–89.

    Article  PubMed  CAS  Google Scholar 

  52. Panos PT, Porter SS, Panos AJ, et al.: An evaluation of a case of agenesis of the corpus callosum with Rourke’s nonverbal learning disorder model. Arch Clin Neuropsychol 2001, 16:507–521.

    Article  PubMed  CAS  Google Scholar 

  53. Woods SP, Weinborn M, Ball JD, et al.: Periventricular leukomalacia (PVL): an identical twin case study illustration of white matter dysfunction and nonverbal learning disability (NLD). Neuropsychol Dev Cogn Sect C Child Neuropsychol 2000, 6:274–285.

    Article  CAS  Google Scholar 

  54. Cornoldi C, Rigoni F, Venneri A, Vecchi T: Passive and active processes in visuo-spatial memory: double dissociation in developmental learning disabilities. Brain Cogn 2000, 43:117–120.

    PubMed  CAS  Google Scholar 

  55. Njiokiktjien C, de Rijke W, Jonkman EJ: Children with non-verbal learning disabilities (NLD): coherence values in the resting state may reflect hypofunctional long distance connections in the right hemisphere. Fiziol Cheloveka 2001, 27:17–22. This paper offers exciting preliminary data suggesting a possible electrophysiologic mechanism underlying the cognitive and behavioral abnormalities seen in NLD, which is consistent with Rourke’s white matter model.

    PubMed  CAS  Google Scholar 

  56. Harnadek MC, Rourke BP: Principal identifying features of the syndrome of nonverbal learning disabilities in children. J Learn Disabil 1994, 27:144–154.

    Article  PubMed  CAS  Google Scholar 

  57. Smith LA, Rourke BP: Callosal agenesis. In Syndrome of Nonverbal Learning Disabilities: Neurodevelopmental Manifestations. Edited by Rourke BP. New York: The Guilford Press; 1995:45–92.

    Google Scholar 

  58. Wocadlo C, Rieger I: Very preterm children who do not cooperate with assessments at three years of age: skill differences at five years. J Dev Behav Pediatr 2000, 21:107–113.

    Article  PubMed  CAS  Google Scholar 

  59. Dugbartey AT: Nonverbal learning disability: adult outcomes. Semin Clin Neuropsychiatry 2000, 5:198–204. This article addresses the ramifications of the NLD syndrome in adults, a frequently overlooked and understudied area of inquiry.

    Article  PubMed  CAS  Google Scholar 

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  1. Neuropsychology Program, Department of Psychiatry, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, 03756, Lebanon, NH, USA

    Brenna C. McDonald PsyD

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McDonald, B.C. Recent developments in the application of the nonverbal learning disabilities model. Curr Psychiatry Rep 4, 323–330 (2002). https://doi.org/10.1007/s11920-002-0079-5

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