Children’s Nonverbal Learning Disabilities Scale
by David B. Goldstein, PhD
Parents: Please answer all of the following questions.
NAME OF CHILD: _________________________________
DATE OF BIRTH: __________ AGE: ______ SEX: ______
GRADE: ______ SCHOOL: _________________________
HANDEDNESS: RIGHT _____ LEFT ______ BOTH _____
This questionnaire has been completed by:
MOTHER _______
FATHER _______ OTHER * _______
* (Please describe):
______________________________
1. Motor Skills
a. My child has problems with balance (e.g. never learned to ride a bike).
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
b. My child displays impaired fine motor skills (e.g. significant
difficulties learning to tie shoes).
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
c. My child has problems writing or extremely slow writing.
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
d. My child seems unusually clumsy.
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
2. Visual-Spatial Skills
a. My child has difficulty remembering and organizing visual or spatial
information (e.g. has difficulty lining up numbers to do a math problem or
lining up words neatly on a page).
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
b. My child appears disoriented, lost, or confused when entering a new
situation.
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
c. My child is slow to become familiar with new physical locations (e.g.
continues to appear lost or disoriented after repeated exposures to the same
location).
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
d. My child has difficulty remembering the faces of people he or she has
met.
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
e. My child has an auditory memory like a tape recorder.
Yes ____ No
____ I don’t know ____
f. My child loses his or her way and needs help finding his or her way
around.
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
g. My child has unusually strong verbal skills (e.g. an impressive
vocabulary or early speech).
Yes ____ No
____ I don’t know ____
3. Interpersonal Skills
a. My child often does not get the humor in a joke because he or she
interprets everything so literally.
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
b. When interacting with others my child has difficulty reading the other
person’s non-verbal cues, such as tone of voice or facial expression.
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
c. My child interprets what I say very literally (for example, if I tell
my child ‘to pick themselves up by his or her bootstraps’, they appear
confused).
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
d. My child has difficulty transferring what he or she learns in one
social situation to similar social situations. For e.g. my child appears
confused when confronted with slight changes in a frequently encountered social situation.
Never/Rarely ___ Sometimes
___ Often/Always ___ I don’t know ___
Guidelines for Scoring the Children’s
Nonverbal
Learning Disabilities Scale
The syndrome of NVLD includes a number of specific symptoms. Rourke
(1995) has organized these into three primary areas: neuropsychological
deficits, academic deficits, and social-emotional/adaptational deficits.
Neuropsychological deficits include difficulties with tactile and visual
perception, psychomotor coordination, tactile and visual attention,
nonverbal memory, reasoning, executive functions, and specific aspects of
speech and language. Deficits in mathematical reasoning, math calculations,
reading comprehension, specific aspects of written language, and handwriting
are primary academic concerns. Deficits in social expertise include problems
with social cognition and perception as well as difficulties in social
interaction.
Some of the symptoms identified with Nonverbal
Learning Disabilities are similar to those described for other disorders.
Individuals with right hemisphere dysfunction, Asperger's syndrome, and
sensori-motor deficiencies each possess a number of characteristics that
overlap with those of a Nonverbal Learning Disability. An evaluation by a
Neuropsychologist can often assist in differential diagnosis.
This questionnaire is a checklist of characteristics that may be indicative of a
Nonverbal Learning Disability. A referral for a more detailed evaluation by
a pediatric neuropsychologist to rule in or rule out a Nonverbal learning
disability requires that the parent report symptoms in all three spheres
noted in the Developmental Screening and Referral Inventory (DSRI); deficiencies in motor-skills, visual-spatial skills, and
interpersonal skills.
A referral to a neuropsychologist or for a more in-depth evaluation of a
Nonverbal Learning Disability could be considered if the parent reports
deficits "Sometimes" or "Often" on over half the items
examining motor skills (at least 3 of the 4 items), visual-spatial skills
(at least 4 of the 7 items), and interpersonal skills (at least 3 or the 4
items).
~~~~~~~~~~
Reference
Rourke, B. P. (1994). Neuropsychological Assessment of Children with
Learning Disabilities: Measurement Issues. In G. Reid Lyons (ed.), Frames of Reference for
the Assessment of Learning Disabilities: New Views on Measurement Issues. Baltimore,
MD: Paul H. Brooks.
~~~~~~~~~~
The Children’s Nonverbal Learning Disabilities Scale© was
excerpted
from the Developmental Screening and Referral Inventory (DSRI) by David B.
Goldstein, PhD, 1999.
It is posted on NLD on the Web! with the express permission of
the author, who retains all rights. Reproduction
of this material in any form other than for individual educational purposes,
without the express written permission of the author, is prohibited.
About the author - David B. Goldstein,
PhD, is a clinical psychologist in independent practice in Memphis,
Tennessee, and the Director of Mind-Steps®. His practice highlights the
assessment and treatment of children, adolescents, and their families. Dr. Goldstein has a particular interest in
working with children struggling with difficulties in self-control, learning, and social
relationships.
