Dyslexia is a well-known term which describes an impaired ability to read.
Less known is another "reading disability" which can be at least as
disabling. Nonverbal learning disabilities (NVLD) are often associated with
difficulty reading and responding to social information, particularly nonverbal
cues or "body language." Verbal language alone will often not convey
all the information needed to understand a given social situation. Approximately
65 percent of the communication in an average conversation is believed to be
nonverbal. This means that the child with nonverbal learning problems has to
rely on approximately 35 percent of the communication in order to discern what
is being communicated and how to respond. Earliest nonverbal information comes
from a child's learning to process visual information from a parent's face. The
child begins to associate various internal feeling states with the configuration
of the face of the parent. When happy inside (feeling) matches happy outside
(parent's smile) this feeling interaction becomes associated in the infant's
social/emotional system. A template begins when nonverbal signals and their
associated feeling states are internalized as patterns of relating. There is
also a congruence of affects that is an organizing force in the young child's
life. When moods and signals match, this results in a congruence of feeling and
a sense of well being in the child. Children who have difficulty processing
visual spatial information will have difficulty internalizing these visual
templates. Consequently, they may not have the same congruence of feeling. The
resultant development and social/emotional organization will then be delayed. If
these missed cues continue through early childhood, they will affect the child's
peer relationships. When the child becomes more interactive with others (around
4 to 5 years old) he/she may misread cues about when to join in, when to stay
back, what someone might be feeling (difficulty with development of empathy) and
how to respond to others. For example:
Johnny sees Jimmy playing with a toy. As he gets closer he doesn't notice
that Jimmy begins to turn his body away. Johnny continues to move closer and
reaches for the toy. Jimmy, interpreting this as a threat, hits Johnny.
Johnny, experiencing this as an unprovoked attack, hits him back.
In this case, missing the nonverbal cues led to an inappropriate approach on
Jimmy's part. Johnny reacted to this as if Jimmy was ignoring his feelings and
reacted aggressively. Jimmy is left confused about why he received such an angry
response, not knowing what to expect from his interpersonal interactions.
As the world of social relationships becomes more complex, the child with
NVLD may become more confused and often more withdrawn. Not only do they have
difficulty discerning the nonverbal social cues, they also struggle with
organizing all of the information into a meaningful whole. Since they feel
incompetent within the social arena, they will stay away from that area of
incompetence, thereby depriving themselves of further practice.
Children with NVLD will struggle with picture puzzles and how the pieces fit
together. Social information is more abstract and quickly changing than pulling
together puzzles. If a child has great difficulty arranging the static pieces of
a puzzle, imagine how difficult it is to assemble all of the quick paced and
changing "pieces" of social information. Lacking the ability to form
this information into meaningful patterns, the child's sense of self and other
is concrete and fragmented.
Stanley Greenspan, MD (1) hypothesizes that "visual spatial processing
is related more to the perception of the intensity of affect than its
meaning." He feels that children with NVLD may be able to discern the
meaning of social communications but miss the emotional strength of these
communications. These children struggle with managing the intensity of their own
feelings and with judging the intensity of the feelings of others. They can be
easily overwhelmed by their feelings and then, in turn, easily overwhelm others.
They are "sensitive" and overreactive children as they lack self
organization and the ability to self soothe. They are a challenge for parents,
teachers, and others who are often confused as to how to respond, resulting in
the child feeling more alone and confused. Because of their reactivity, they are
frequent targets of teasing by bullies.
So, with all this information in mind (and probably feeling overwhelmed
ourselves), how can we help? Dr. Stanley Greenspan writes that "the
optimal environment balances a sense of empathy (the difficult test of
feeling the distress of the out of control child when he is excessively
excited) with the firm and consistent setting of limits."
We, as parents, teachers, and others helping children with NVLD need to
be calm in the face of the storm of the child's intensity. We need to
provide the organizing and calming forces when the child is unable to
provide them for himself. When emotions are running high and we are coping
with our own stress, this is no easy task.
The optimal environment for a child with NVLD to learn social skills
involves minimal stimulation. Just as limiting the amount of written
material on a page helps the child to focus, limiting the amount of visual
(and other) stimulation helps the child to focus and be focused on social
cues. Some children will become overloaded by too much facial information.
Someone who is very expressive may overwhelm the child with a nonverbal
learning disability, as it is too much to process all at once. Therefore,
when communicating with children with nonverbal learning problems it is
helpful to do so in a quiet, straightforward manner without too many facial
gestures or feelings all at once. It is also important to "check
in" verbally to ascertain whether the child has interpreted the meaning
of the communication and gesture appropriately. It is important to overuse
the verbal channel in order to aid the development of the visual channel as
well as self organization in general. Talking and playing through various
situations will help a child develop visual-verbal associations and increase
the complexity of their feeling vocabulary. Most children start out with the
three basic feelings: happy, mad, sad. Children with NVLD will tend to stay
with the three basic feelings longer than other children. We need to help
them to learn to verbalize gradations of feelings, e.g. "a little
happy," "very sad."
Processing social interactions with the child, breaking them down into
understandable parts, can help the child with nonverbal learning problems.
Watching television sitcoms can be very instructive. Asking a child what is
happening in their favorite television show while watching it with them can
be helpful in discovering where the child misinterprets social
communication. I am often surprised by the interpretations I get when I ask.
It can be even more fun when you turn the sound off on the television set,
relying only on the nonverbal cues available. This allows the child and
adults to learn about nonverbal communication in a playful manner. For older
children, this could even be practical at the local mall. "People
watching" provides a wonderful opportunity to guess about what others
might be feeling or talking about. After a child has been involved in a peer
interaction, adults can sit down with him and break down the components of
communication such as asking "what do you think he was feeling
then?" and "what about his body language told you that he was
feeling that way?"
Social skills group psychotherapy, focusing on pragmatic social skills,
is often quite helpful for the child with nonverbal learning problems. The
group affords the child and therapist an opportunity to work on
misperceptions and learn appropriate social behavior in the "here and
now." The therapist helps the children use the interactions that arise
with the group to learn about how they come across to others and to
interpret correctly how others come across to them. In group therapy, we
often like to play "Name That Feeling." In the game, children take
turns at acting out a feeling. It gives the child a chance to practice
portraying the appropriate nonverbal gestures, and the children who are
guessing a chance to hone their interpretive skills.
Children with NVLD will often have trouble with proxemics. They may not
know how close or far away to stand from others. Whenever possible, a
concrete rule can be very helpful. In this case we usually use the
"arm's length" rule: in regular conversations we should always
stand about an arm's length from the other person. They respond well to the
structure of rote, concrete rules as they make the confusing social world
feel a little more under control. I know one boy whom I see who spends a lot
of time watching other children. He looks and tries to find patterns that
will make it all make a little more sense.
The social world does not have to be a confusing and frustrating place.
Children with nonverbal learning problems need to be taught how to
understand and respond to a complex array of social communication. We need
to help them to see patterns and to see that there is some sense to be made
of all of this. With firm and understanding teaching, the children can learn
to better interpret the world of social communication.
