Developing an Educational Plan for the
Student with NLD
by Sue Thompson, MA, CET
http://www.nldontheweb.org/thompson-5.htm
The
typical school campus offers a complex, constantly changing and often unpredictable
milieu. Students are required to cope with multiple stimuli, varying behavioral
expectations, and complex social interactions, as well as the academic tasks
presented to them on any given day. They are expected to know how to behave
appropriately in a myriad of situations. Such exacting conditions can pose a
challenge for any student, but for the child with nonverbal learning disorders
(NLD) these demands can prove to be totally overwhelming and may appear
insurmountable at times. Unless the entire school staff is conscious of the
unique neurobehavioral characteristics which impede the student with NLD, and
seeks to provide appropriate intervention strategies, this student will be
destined to fail in school.
An
appropriate educational program for the student with NLD must take into account
the assets this student possesses and build upon these strengths to assure a
successful outcome. A suitable program must also recognize the areas of
neurological impairment obstructing this student’s performance and seek to
provide compensatory strategies to deal with these weaknesses. Programs which
address both academic and social competencies achieve the most success. The
child’s individualized educational program should not merely focus on academic
growth, but should also stress compensatory strategies which will assist her
future academic progress by enlarging her repertoire of coping mechanisms. In
other words, the educational program for this student should be aimed at
preparing her to succeed in the future by maximizing her potential today.
A
number of the puzzling behavioral reactions seen in the child with NLD are
often misinterpreted by educators. Prior to the development of an intervention
plan for this child, it is important to first analyze the purpose of these
behaviors from the perspective of the student’s neurological deficits and
dysfunctions. This child’s behaviors are usually prompted by his desire to
survive in a setting which is confusing, disorienting and frightening to him,
given his neurological deficits. As a learning and behavior specialist
consulting with school districts, I am often asked what can be done to
stop a child’s annoying behaviors, as opposed to being asked what
the school staff needs to know and do in order to develop an intervention plan
which will better serve the needs of this student. All too often, the
educational team wants to hold the student responsible for his neurological
condition. They erroneously respond to his unwitting behaviors as though they
were deliberate.
Ten
common neurobehavioral characteristics of NLD are described below, along with
suggestions for teacher intervention which should be considered when developing
an individualized educational plan for the student with NLD. The suggestions
given are general and should always be adapted to the unique needs of the
individual student in your care. Approaches will vary, depending upon the age
of the child and the severity of his NLD symptomology. It is important to first
obtain an accurate neuropsychological assessment in order to gather pertinent
information about any particular child’s assets and deficits, so that an
appropriate individualized educational plan can be tailored to the unique
constellation of symptoms the child displays.
Has difficulty finding her way around - - and is often lost or tardy
The
student with NLD has difficulty with internal and external organization,
visual-spatial orientation, directional concepts and coordination. Getting lost
on campus and/or arriving tardy for class are predicaments this child must
struggle with daily. Teachers can play a vital role in helping the student with
NLD learn to negotiate the confusing visual-spatial complexities of the school
campus.
It
is up to the adults in this child’s life to provide the necessary compensatory
strategies which will allow her the independence and mobility needed to find
her way around in the school environment. Continually assess her understanding
of spatial and directional concepts. Professionals who work with this student
at school must provide her with the external structure, organization, and
stability that she lacks internally. This can be accomplished by:
Providing
a "verbal-rope" to guide the student from place to place;
Assigning
a peer buddy who enjoys helping this child and who is attentive to her needs;
Training
this peer buddy to look out for her classmate with NLD on the bus, during
recess, at lunchtime, during passing periods and so forth;
Eliminating
any negative consequences for tardiness;
Rehearsing
getting from place to place, with significant markers pointed out verbally.
Has difficulty coping with changes in routine and transitions
The
student with NLD generally copes well in a structured predictable environment.
However, he will experience extreme stress when faced with forced or unexpected
changes in routine. Because this child lacks internal organizational skills, he
will need extra assistance in this area. Prepare him ahead of time for all
changes in routine and transitions, such as: field trips, assemblies,
substitute teachers and modified days. Use a written and numbered schedule to
help prepare him for changes. Panic sets in when this child feels
"ambushed" or does not know what to expect. These elevated levels of
anxiety can be decreased by offering a high level of consistency within the
school program.
Adequate
"warning time" will be required before the introduction of any novel
event. In some instances the stress of a novel encounter can only be alleviated
by allowing the student to remove himself from the stressful event or
situation. When this occurs, a "safe-place" or
"safe-person" should be pre-designated for him to go to. A
compassionate "reentry" plan should be set up in advance to assist
the student in reentering the stressful situation. Teachers must help this
child learn how to cope with changes and transitions, so that the stress of his
school day does not accumulate to the point where he is unable to function at
school. This can be accomplished by:
Providing
a predictable and safe environment with a consistent daily routine;
Minimizing
transitions and giving several verbal cues to the student before transitions;
Furnishing
the child’s parents with a schedule of activities so they can
"rehearse" (preview and prepare) for the following day with their
child and make sure he has the necessary supplies required for the day’s
activities;
Posting
a simple written schedule on the blackboard at the beginning of each day in
primary grades;
Explaining
the daily agenda to the older child so he can begin to internalize the
structure of his school day;
Writing
out a high school student’s daily schedule on a card (with any changes in
routine highlighted) that can be carried from class to class, so it is always
readily available.
Has difficulty generalizing previously learned information
Generalization
is the transfer and application of previous learning to new situations and
contexts. We are constantly making spontaneous connections, realizing that a
particular concept applies to a wide range of topics and/or recognizing that a
particular strategy might apply to a number of situations. The student with NLD
is stymied when confronted with a situation which she has not previously
encountered, even if the new situation is only slightly different from one for
which she has previously developed a successful strategy. This child is often
unable to understand what is expected of her because she is unable to apply
rules and principles learned at other times and in other situations to a
situation she currently faces. Difficulty generalizing information will cause
problems in modifying learned patterns to make them applicable to new
situations and in prediction of outcome.
When
working with a student with NLD, teachers often complain that this child
"treats everything as though it were an isolated fact or event." The
factual information that is so well-memorized and regurgitated in lengthy
monologues by this child doesn't ever seem to get "packaged" with
other similar information. Therefore, present learning is not connected to
other previous learning. Cause-and-effect relationships are lost. It becomes
necessary to discuss individual situations in depth with this student, as they
arise.
This
child learns through discussion (verbal mediation). Generalization skills that
are acquired spontaneously by most students need to be addressed in a specific
step-by-step manner with this student. Verbally review the information being
presented and take specific steps to help her internalize it and connect it to
other previously learned information. Encourage the generalization of learning.
This can be accomplished by:
Never
expecting the student to automatically generalize instructions or concepts;
Using
language as the bridge to tie new situations to old learning;
Reviewing
past information before presenting new concepts; Verbally pointing out
similarities, differences and connections;
Verbally
indicating generalizations which can be drawn in various situations;
Methodically
discussing the cause-and-effect relationships of events and situations with the
student.
Has difficulty following multi-step instructions
Confusion
over what needs to be done can be at the heart of a student's failure to
complete class assignments or follow class directions. Most students remember a
series of instructions by visualizing themselves performing each step in the
series. They don't try to remember each word (verbatim) in a long string of
directives. However, because the student with NLD is unable to pass this
information to the right hemisphere and visualize the sequence, he attempts to
memorize every word as it is said to him. He is then expected to act upon the
directives in the prescribed sequential manner. This, of course, is much more
difficult than simply storing factual information (and proves to be less
effective).
More
often than not, one or two of the directions are properly implemented (with
possibly a step or two omitted in between), and then the student asks,
"What should I do now?" (An exasperated mother recently told me her
son with NLD's mantra is "What's next?"). Teachers will often mistake
this type of behavior for an attention or listening problem. This is not the
case. The child was paying close attention and heard the whole series of
instructions, but because he was unable to visualize himself carrying through,
he could not "hold on" to the information. He is not inattentive or
unmotivated, but rather his brain processes information differently from most
other students.
So,
obviously, this situation will not be helped by repeatedly telling this student
to "Pay attention!" It is up to the teacher to "capture"
multiple oral instructions on tape or by written handout. You may need to
reduce and space out your directions when addressing the needs of this child.
Accommodate him for the abilities he lacks neurologically. This can be
accomplished by:
Writing
out and/or tape recording multistep instructions;
Numbering
and presenting instructions in the most efficient sequence;
Breaking
all tasks down into manageable segments and presenting them a few at a time;
Making
sure the student understands your instructions - don’t assume that repeating
them back to you means that he will remember and can follow through;
Pairing
the student with NLD with a nondisabled "buddy" who can remind him of
"the next step;"
Teaching
the student mnemonic devices for short term memory enhancement;
Checking
with the student at frequent intervals to be sure he is not "lost" or
confused.
Makes very literal translations
The
student with NLD tends to make very literal translations of speech and text.
Her images are concrete and her ability to make sense of abstract connotations
and inferences is poor. She will, in all instances, use and interpret speech
literally. This child lacks the capacity to decipher colloquialisms or
metaphorical expressions. She will not know when she is being teased or duped.
It is up to the teacher to provide an accurate bridge between the child’s
interpretation of language and the actual meaning of what has been said or
written. In this way, the student with NLD can more easily determine the gist
of a conversation or literary assignment. Her responses will then become more
appropriate.
When
abstract concepts must be used, provide additional verbal information,
breaking-down and explaining the abstract idea in detail. Avoid making nebulous
directives, such as "You need to mind!" or asking vague questions
such as, "Are you ready?" Adults need to be specific and interpret
abstract concepts, so that this child can make sense of what she hears and reads.
This can be accomplished by:
Explaining
what you mean by the things you say which may be misinterpreted;
Simplifying
and breaking-down abstract concepts;
Starting
with concrete concepts and images and slowly moving to abstract concepts and
images, at a pace set by the student;
Understanding
that metaphors, emotional nuances, multiple levels of meanings, and
relationship issues as presented in novels will not be understood unless
explained;
Teaching
the student to say "I’m not sure what you mean" or "That doesn’t
make sense to me" to give her a specific vocabulary to help her decipher
your intent.
Asks too many questions
The
student with NLD tends to ask repetitive questions and have trouble letting go
of his ideas. He often inappropriately interrupts the flow of a lesson with his
seemingly never-ending stream of questions. This can become frustrating for
both the teacher and the other students in the class, while the student with
NLD remains oblivious to the nuisance he is creating. Remember - - this child
learns through verbal mediation. It is his only way of gathering new
information. He doesn't learn through observation or "trial and
error." A good way to look at it is: If he's not talking, he's not
learning. Understanding this should help you to better appreciate his constant
questions and monologues.
When
this student engages in repetitive verbal questioning, you must validate his
need to receive verbal responses (his other senses are not taking in enough
information), while at the same time you must find ways to redirect the
continuous interruptions of class time and teach appropriate social behavior.
Nonverbal reinforcers, such as: using an exasperated tone of voice to show your
irritation, raising your eyebrows to denote your displeasure, or even ignoring
the child’s questions will not get your point across. Merely answering all of
his questions seldom helps, either, as there will always be more questions.
This child will not know when "enough is enough."
On
the other hand, the student with NLD who is repeatedly reprimanded and told
"Don't interrupt!" is in danger of withdrawing because he is unable
to discern the appropriate times to ask his questions. This child may clam-up
and shut-down completely. Dr. Rourke suggests that specific training be employed
with this student in "what to say," "how to say it," and
"when to say it." It is important to address this dilemma with
extreme sensitivity. This can be accomplished by:
Answering
the student’s questions whenever it is possible and practical (other students
in the class may actually have the same questions, but be lacking in the verbal
abilities to ask them);
Starting
the other students on the assignment and then individually answering the rest
of this student's questions;
Designating
a specific time during the day when you can continue a discussion which needs
to end at the moment;
Telling
the student you only have time to answer three questions right now (a specific
number is important - - don't say "a few"), but that you will be glad
to answer three more of his questions during the recess break;
Specifically
teaching the student when it is appropriate to ask for help (i.e. if he will be
unable to continue his assignment unless something he doesn’t understand is
explained to him) and the appropriate methods of doing so;
Explicitly
teaching the rules of polite social conduct, so that the child does not
constantly interrupt class activities with his questions.
Is easily overwhelmed
Dealing
with the ordinary demands of life and getting through a "normal" day
at school requires an extraordinary amount of forethought and determination for
the student with NLD. Imagine having to "think" every time you do
anything, even routine chores you perform everyday like eating, dressing, and
sitting at a desk. You can then start to appreciate why this child is so easily
overwhelmed by any variance of routine, by new and unfamiliar situations (or
information), and by extraneous environmental stimuli.
The
enormous pressure this child faces when attempting to function in a world where
no concessions are made for her, and where she is expected to conform to the
same standards set for her nondisabled peers, is sometimes difficult to fathom.
In her interactions with the staff and her peers on campus, the student with
NLD is missing at least 65% of the intent of their communications. And, at the
same time, she is attempting to cope with the cognitive, as well as the
visual-spatial-organizational demands of attending school. Add to this a
continuous overloading of the senses (too much noise, visual stimulation or
physical stimulation). The monumental effort mandated to get through a day at
school is both overwhelming and exhausting for the child with NLD.
In
addition to this extreme exhaustion, slow processing speed and severe organizational
deficits make it necessary to lessen the homework/classwork load for this
child. The student with NLD is usually so exhausted by the time school lets
out, she literally collapses upon arriving home. It is unreasonable and unfair,
and it places an undue burden upon the child’s parents, to expect that this
child spend hours each night trying to get through tedious homework
assignments. She definitely needs some "down time" after a day at
school.
The
whole ordeal of attending school full-time, on a daily basis, often proves to
be too much for the student with NLD, especially as she enters the upper
grades. This is where modified schedules and creative programming must come
into play. Have the student attend school for half of the regular school day, or
every other day, with individual tutoring provided in the interim to ensure
that she is still meeting grade-level competencies.
The
student with NLD must receive academic support as soon as difficulties in any
particular area are noted. Because this child is quickly overwhelmed, she is
likely to react much more severely to failure than her peers will. The
classroom teacher must be aware of the many variables which exasperate and
inundate this student. Then the teacher can learn to be proactive in dealing with
these influences. This can be accomplished by:
Diffusing
potentially weighty situations as early on as possible;
Minimizing
environmental stimuli (especially visual and tactile);
Having
a consistent strategy to employ when the child can no longer cope due to
overstimulation, frustration or confusion;
Allowing
the child to abstain from participating in activities when she demonstrates any
signs of overload;
Eliminating
all nightly homework assignments;
Implementing
a modified schedule or other creative programming strategy.
May experience heightened sensory experiences
The
student with NLD may experience hypersensitivity to sensory stimulation
(visual, auditory, tactile, olfactory, etc.). Normal levels of sensory input
can be perceived by this student as too much or too little. He often also has
difficulty responding to multi-sensory stimuli. This child is unable to process
simultaneous visual and auditory input because simultaneous processing is a
function of the right hemisphere. He will usually prefer auditory to visual
input (and will actually prefer not to look at the person who is
talking to him). It is necessary to prepare the classroom environment for this
child by removing excessive "visual clutter" and implementing seating
changes, if he is troubled by other sensory distractions.
The
child with NLD can become extremely agitated by sensory stimulation and
distractions. The flicker and hum of florescent lighting can be highly
distracting and have been known to have a detrimental effect on the child with
NLD. This child may also be hypersensitive to loud or shrill noises, such as:
the school bell, PA systems, buzzers on gymnasium score boards and chairs
scraping along the floor. He may develop seemingly irrational fears because he
is afraid he may be suddenly subjected to ear-piercing feedback from the PA
system in the classroom. A hypersensitivity to smell can cause this student to
become irritated when working with tempera paint or colored markers. Further,
he may respond defensively to what he perceives as "intrusive"
touching. The apprehension surrounding such offensive sensory assaults
contributes to an increased level of anxiety for this student throughout the
school day.
Sensory
integration therapy and auditory integration training can help normalize the
reactions of a young child who becomes easily overwhelmed by sensory overload.
Along with these supplemental therapeutic interventions, it is very important
that this child's teacher carefully control the level of sensory input at
school. This can be accomplished by:
Preparing
the environment for the child (eliminating known sensory stressors);
Reducing
distractions and situations contributing to sensory overload;
Focusing
on one sensory modality at a time (avoiding multi-sensory approaches to instruction);
Allowing
modifications as needed to deal with sensitivity issues (protecting the child
from sounds that hurt his ears or avoiding the use of fluorescent lights in the
classroom);
Talking
in a low whisper to a child with extreme auditory sensitivity;
Ensuring
that this child is placed in a classroom location with the least amount of
distraction (usually up at the front of the room, away from visual and auditory
sources of "clutter").
May develop secondary issues with stress and anxiety
It
is impossible for most educators to fully appreciate the high level of anxiety
the student with NLD experiences on a daily basis. This child is easily
stressed by both internal and external pressures, leaving her extremely
emotionally vulnerable. Chronic fears pervade her life and she is prone to
developing secondary internalizing disorders. She has profound difficulty
adapting to new and complex situations. She may become overly anxious and worry
obsessively when she encounters situations where she does not know what to
expect or is unable to determine what will happen next.
Furthermore,
this child may place inordinate demands upon herself owing to her own
perfectionistic tendencies. Her self-esteem eventually plummets and she often
becomes very self-critical and unable to tolerate making mistakes. Additional
stress accumulates in situations where this child feels overwhelmed by the
novel or excessively stimulating occurrences happening to or around her.
Uncertainty, fatigue, trauma, self-reproach, and sensory overload all
contribute to heightened levels of anxiety for the child with NLD.
As
I have said many times before, it is absolutely imperative for teachers and
parents to do everything possible to minimize the stress a student with NLD
experiences. This can be accomplished by:
Previewing
and preparing for all novel situations and transitions in advance;
Providing
a consistent and predictable daily routine;
Gradually
exposing this child to new activities, teachers, classes, schools, etc.;
Ensuring
that this child is safe from physical and emotional abuse;
Avoiding
sudden and unexpected surprises;
Thoroughly
preparing the child in advance for field trips, modified schedules, or other
changes, regardless of how minimal;
Talking
the child through stressful situations or (nonpunitively) removing her from the
stressful situation;
Providing
personal space in the resource room or other designated area for regrouping and
relaxation.
Imparts the "illusion of competency"
The
student with NLD is cognitively intact, usually displaying above-average to
superior verbal intelligence. This creates an "illusion of
competency" and the expectation for success in school. This child’s
adultlike manner of speaking and impressive vocabulary give the illusory
impression that he is highly competent and understands much more about the
world around him than he actually does. Although he may have well-developed
speech, practical life skills and "street smarts" are deficient.
Generally,
this student has an excellent memory (especially for overlearned rote
material). He will amass a seemingly endless stockpile of impressive factual
information, demonstrating expertise far beyond his chronological age level.
But, this impressive memory capacity is unimodal in nature and breaks down when
the child is presented with novel material or placed in situations where he is
expected to evaluate incoming information and act appropriately based upon his
past knowledge and experience. He lacks higher level comprehension and
evaluation skills.
Considering
this child’s impressive areas of strength, it is not surprising that adults
tend to generate such high expectations for him. Verbal intelligence is a
highly-touted trait in our culture and the verbal precocity seen in the child
with NLD often causes us to overlook or devalue the gravity of the neurological
deficits which underlie the vexatious behavioral characteristics presented in
this article. All too often educators focus on the "left-brain"
strengths of this student and make false assumptions regarding his competency
in other areas, responding to the child as though he were capable of
functioning at a much higher level than is actually possible for him.
It
is important for educators to appreciate the full scope of this child's
disabilities. Even a highly intelligent student with NLD, who has an incredible
memory for rote information, will experience trouble with comprehension and
organizational skills. He may be capable of memorizing extensive statistical
information, while at the same time he forgets the due-date for an assignment
or to bring a pencil to class. Decision making and problem-solving skills are
other areas of deficiency for the student with NLD which are often not
recognized because of his obvious verbal precocity.
Dr.
Rourke emphasizes that the principal impediment to a successful educational
program for the student with NLD is invariably the teacher's "faulty
impression that the child is much more adept and adaptable than is actually the
case." Consequently, in order to create an appropriate educational plan
for this student within a school system which is often oblivious to his needs,
it is vital for teachers and other staff members to specifically address this
child's severely impaired capacity for fluid reasoning and extreme difficulty
in dealing with novel situations. This can be accomplished by:
Providing
a highly individualized educational program;
Applying
age and grade-level expectations with flexibility;
Emphasizing
the strong academic skills and gifts of the child with NLD by creating cooperative
learning situations in which his proficient verbal, reading, oral spelling,
vocabulary, and memory skills will be showcased to advantage (and his
difficulties with writing can be de-emphasized);
Never
assuming this child understands something just because he can parrot back what
you have just said;
Never
assuming this child understands what he has read, just because he is a
"proficient" reader (has excellent word recognition);
Offering
added verbal explanations when the child seems "lost" or registers obvious
confusion.
Within
this article, I have offered a number of simple and inexpensive intervention
strategies which can be employed in the school environment to enhance the
student with NLD's capacity to form compensatory structures, thereby increasing
his capacity to cope within the school environment. These relatively minor
interventions can make a huge difference in the life of a child with NLD (both
present and future). It is the responsibility of educators to ensure an
appropriate learning environment for all of their students. You hold the key.
You can maximize this child’s potential or you can destroy his life. There
really isn’t any choice here - - we must all rise to the challenge!
~~~~~~~~~~
© 1996 Sue Thompson.
This article is posted on NLD on the Web! with the
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Distribution or sale of this material is strictly prohibited. If you wish
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About the author - Sue Thompson, MA,
CET, is an Educational Consultant and Therapist. She specializes in
training educators and educational therapists to understand and provide
appropriate interventions for individuals with NLD. She holds a Master's Degree
in Special Education from St. Mary's College of California, and taught for over
20 years in California Public Schools in both regular and special education
classrooms. Sue is the author of The Source for Nonverbal Learning Disorders
(LinguiSystems, 1997), formerly titled I Shouldn't Have To Tell You.