Lost in Space: Nonverbal Learning Disability

Abstract

Though Catherine had always been somewhat intense and anxious in her style and approach to people and events, her recent experiences of extreme anxiety, moodi-ness, and outbursts of frustration seemed out of character and much more than “adolescent angst.” She was unable to sleep and experienced tachycardia at night, which fueled acute panic attacks and a chronic cycle of fears about her health. She was exceedingly irritable and difficult to reason with or to help calm down. She constantly complained about her “friends” not being friends at all; they thought she was mean or nosey when she was only trying to be helpful and did not share her interests or listen to her ideas. She became particularly focused on certain kids who irritated her and would obsess about their behavior even when it did not affect her directly. Though she had learning difficulties, she had always been a conscientious student, utilizing the support available from school and getting along okay, but now everything seemed too difficult and she was tired of doing the same thing over and over, especially in math.

At the time Catherine was referred, she was just beginning her eighth grade year. Her periods of acute anxiety had subsided, and the summer break had been somewhat helpful in reducing her overall stress level, but she remained chronically irritable, edgy, and frustrated with almost any demands, whether they be academic, interpersonal, or routine expectations. Her attitude toward school was especially negative, feeling that she was not learning anything, kids were all mean, and so on. Within individual therapy sessions, efforts to develop relaxation and self-monitoring skills yielded limited results, because her rigidity in interpreting social cues and situations made it very difficult for her to step back and reflect on her options. Work in a therapy group focusing on social interaction and problem solving was somewhat helpful, but her core frustration and tension remained at a high level. After reviewing the progress and challenges in her case, a full psychological evaluation was recommended to help better understand her cognitive and emotional development and hopefully generate new directions for her treatment.