Spatial and emotional aspects of language inferencing in nonverbal learning disabilities.

Although subtle linguistic deficits have been postulated for children identified with nonverbal learning disabilities (NLD), there is little empirical evidence to support this contention. Two experimental language inferencing measures that have been demonstrated to be problematic for individuals with right hemisphere brain damage (RHBD) and one norm-referenced inferencing task were examined in three groups of children aged 9-13: (1) children with NLD (n = 14), (2) children with verbal impairments (VI) (n = 14), and (3) children without learning disabilities who served as controls (n = 19). The NLD and VI groups did not differ from one another on any of the three measures, indicating a generalized language inferencing deficit in the NLD group. Relative to the control group, however, the NLD group experienced specific difficulties with spatial and emotional inferencing. The implications for right hemisphere involvement in the NLD profile are examined in relation to the effects of working memory on inferential abilities.     

Neuropsychological functioning and social functioning of survivors of pediatric brain tumors: evidence of nonverbal learning disability.

The purpose of the study was to examine if survivors of pediatric brain tumors exhibit a pattern of performance consistent with nonverbal learning disability (NVLD) and to explore the relationship between neuropsychological and social functioning in these children. A comprehensive neuropsychological battery and objective measures of psychosocial function designed to assess NVLD were administered to 15 survivors of brain tumors, ages 8-12 years. Despite the small sample size, a trend for better verbal skills compared to nonverbal skills was found using composite scores. Parents reported significant social deficits and a tendency for greater internalizing behavior problems as expected in NVLD. Additionally, there was a trend for a positive association between nonverbal scores and social function. Further research is needed to determine if the NVLD pattern observed is attributable to white matter damage of the right hemisphere. Routine neuropsychological and psychosocial assessment and intervention are indicated.     

Language, perception, and the schematic representation of spatial relations

Schemas are abstract nonverbal representations that parsimoniously depict spatial relations. Despite their ubiquitous use in maps and diagrams, little is known about their neural instantiation. We sought to determine the extent to which schematic representations are neurally distinguished from language on the one hand, and from rich perceptual representations on the other. In patients with either left hemisphere damage or right hemisphere damage, a battery of matching tasks depicting categorical spatial relations was used to probe for the comprehension of basic spatial concepts across distinct representational formats (words, pictures, and schemas). Left hemisphere patients underperformed right hemisphere patients across all tasks. However, focused residual analyses using voxel-based lesion-symptom mapping (VLSM) suggest that (1) left hemisphere deficits in the representation of categorical spatial relations are difficult to distinguish from deficits in naming these relations and (2) the right hemisphere plays a special role in extracting schematic representations from richly textured pictures.     

In Your Right Mind: Right Hemisphere Contributions to Language Processing and Production

The verbal/nonverbal account of left and right hemisphere functionality is the prevailing dichotomy describing the cerebral lateralization of function. Yet the fact that the left hemisphere is the superior language processor does not necessarily imply that the right hemisphere is completely lacking linguistic ability. This paper reviews the growing body of research demonstrating that, far from being nonverbal, the right hemisphere has significant language processing strength. From prosodic and paralinguistic aspects of speech production, reception, and interpretation, to prelexical, lexical and postlexical components of visual word recognition; strong involvement of the right hemisphere is implicated. The evidence reviewed challenges the notion that language is solely a function of the “verbal” left hemisphere, indicating that the right cerebral hemisphere makes significant and meaningful contributions to normal language processing as well.     

Learning Disabilities and Psychosocial Adjustment: A Critical Review

Research is reviewed that assesses the extent to which difficulties in psychosocial adjustment are characteristic of broadly defined learning disabilities (LD) and of specific patterns of academic and neuropsychological assets and deficits (Rourke & Fuerst, 1991; Spreen, 1989). Overall, a majority of children and adolescents with LD are in the normal range of peer acceptance and socially competent behaviour. Some measure of difficulty in these social assessments is observed in approximately one third of children and adolescents with LD, compared with 10 to 15% of non-LD controls. Similarly, internalized emotional symptoms of depression and anxiety are assessed as somewhat higher for individuals with LD than for non-LD controls but are within the normal range of scores. Externalized emotional behaviours, specifically aggression, delinquency, and hyperactivity, are problematic but these too are at subclinical levels. In the few studies that examine psychosocial adjustment for subtypes of LD, there is some evidence that individuals with nonverbal learning disabilities (NLD) are at much greater risk for personality disturbance and behaviour problems. That the psychosocial adjustment of individuals with reading disabilities is within the range of non-LD controls remains to be convincingly demonstrated.     

Impairments of nonverbal oral movements after left hemisphere damage: A followup analysis of errors

Acquisition of a task requiring the imitation of a series of nonverbal oral movements is most severely impaired in patients with aphasic disturbance. However, nonaphasic patients with left hemisphere damage also perform more poorly than patients with right hemisphere damage or normal control subjects. Analysis of the errors made on the multiple oral movements task reveals that left, but not right, hemisphere damage is highly associated with perseverative responses. Patients with right hemisphere damage do not differ significantly from normal control subjects in the acquisition of or in the type of errors made on the task. It is suggested that the left hemisphere plays an important role in the control of nonverbal oral movement production.     

The utility of math difficulties, internalized psychopathology, and visual-spatial deficits to identify children with the nonverbal learning disability syndrome: evidence for a visualspatial disability.

This study examined the criteria currently employed to identify children with the nonverbal learning disability syndrome (NVLD). The most widely accepted definition of NVLD relies on deficits in visual-spatial-organizational, tactile-perceptual, psychomotor, and nonverbal problem-solving skills. These deficits are believed to coexist with strengths in rote verbal learning, phoneme-grapheme matching, verbal output, and verbal classification. The combination of these assets and deficits has been hypothesized to lead to psychosocial and academic problems, including difficulties with mathematics and increased rates of psychopathology. This study compared performance of three groups of children: those with NVLD, those with verbal learning disabilities (VLD), and controls. The results show that the criteria currently employed to identify children with NVLD may not adequately differentiate them. In contrast to previous findings, the study reveals that children with NVLD can demonstrate good math abilities when performing certain types of math tasks, especially those that draw on their robust verbal skills. Also in contrast to most previous findings, in this study children with NVLD (and normal controls) demonstrated lower rates of psychopathology than children with VLD. Finally, for children with NVLD it appears that their visual-perceptual deficits may include a primary deficit in locating objects in space. Based in part on the findings of this study, it may be helpful for diagnostic and treatment purposes to reserve the term Nonverbal Learning Disability for children whose visual-spatial deficits are primary and severe enough to affect academic performance in subjects such as written mathematics. Given the integral nature of social relations in children's lives, a separate category (e.g., social processing disorder) could be created for children whose social skills deficits are primary and impair their social interactions. A broader nonverbal learning model or syndrome, as conceptualized by Rourke (1995), could be retained for describing a broader constellation of assets and deficits across disease types.     

Impairment of auditory perception and language comprehension in dysphasia

Men with chronic focal brain wounds were examined for their ability to discriminate complex tones, synthesized steady-state vowels, and synthesized consonant—vowel syllables. Subjects with left hemisphere damage, but not right hemisphere damage, were impaired in their ability to respond correctly to rapidly changing acoustic stimuli, regardless of whether stimuli were verbal or nonverbal. The degree of impairment in auditory processing correlated highly with the degree of language comprehension impairment. The pattern of impairment of the group with left hemisphere damage on these perceptual tests was similar to that found in children with developmental language disorders.     

Processing the emotions in words: The complementary contributions of the left and right hemispheres

A dual-process model is suggested for the processing of words with emotional meaning in the cerebral hemispheres. While the right hemisphere and valence hypotheses have long been used to explain the results of research on emotional stimulus processing, including nonverbal and verbal stimuli, data on emotional word processing are mostly inconsistent with both hypotheses. Three complementary lines of research data from behavioral, electrophysiological, and neuroimaging studies seem to suggest that both hemispheres have access to the meanings of emotional words, although their time course of activation may be different. The left hemisphere activates these words automatically early in processing, whereas the right hemisphere gains access to emotional words slowly when attention is recruited by the meaning of these words in a controlled manner. This processing dichotomy probably corroborates the complementary roles the two hemispheres play in data processing.     

Neuropsychological and adaptive functioning in younger versus older children shunted for early hydrocephalus

Previous research on children with hydrocephalus has not carefully examined age-related changes in neuropsychological and behavioral status. We present data on 28 children with early hydrocephalus and spina bifida who were studied in two age groups: 5 - 7.5 and 9 - 12.5 years. Age-related differences in language, memory, visuomotor skills, and adaptive behaviors were examined. Consistent with other studies, the total sample showed impaired motor, performance, verbal, communication, and learning skills. Comparisons between older and younger children showed: (1) except for memory, neuropsychological patterns of functioning were generally comparable across the age groups, and (2) older children demonstrated more difficulty on specific adaptive functions (socialization, learning, conduct). Shunted hydrocephalic children may be conceptualized as exhibiting the syndrome of nonverbal learning disabilities. Clinical implications are discussed.     

Social functioning using direct and indirect measures with children with High Functioning Autism,nonverbal learning disability,and typically developing children

Social perception is an important underlying foundation for emotional development and overall adaptation. The majority of studies with children with High Functioning Autism (HFA) or nonverbal learning disabilities (NLD) evaluating social functioning have used measures of parent and/or teacher ratings. The present study utilized parent and teacher ratings of behavior as well as executive functioning in addition to direct measures of social perception. Three groups participated in this study (control [n = 38] HFA [n = 36], NLD [n = 31]). Results indicated that the HFA group experienced the most difficulty understanding emotional cues on the direct measure while both the HFA and NLD groups experienced difficulty with nonverbal cues. Significant difficulties were reported on the parent rating scale for sadness and social withdrawal for both clinical groups. Executive functioning was found to be particularly problematic for the clinical groups. The direct social perception measure was highly correlated with the measures of executive functioning and reflects the contribution that executive functions have on social functioning. These findings suggest that the clinical presentation on behavior rating scales may be very similar for children with HFA and NLD. Moreover, it appears that measures of executive functioning are sensitive to the clinical difficulties these groups experience. The findings also suggest there is a commonality in these disorders that warrants further investigation.     

Cognitive and AI models of reasoning

Although relatively few in number, cognitive neuroscience studies of reasoning have two general implications for cognitive theories of deduction. First, an important distinction among these theories is whether they focus on the effect of personally relevant content on the processes and representations underlying deductive reasoning. Evidence is reviewed indicating that there is a neuroanatomical basis for both content-independent and content-dependent theories of deduction. Clinical and neuroimaging studies appear to show that content-independent reasoning is mediated by the left hemisphere, whereas content-dependent reasoning is mediated by regions in the right hemisphere and the bilateral ventromedial frontal cortex. In normal subjects, reasoning is likely to be based on contributions from both hemispheres. Second, clinical evidence indicates that the visuospatial processes used in deductive reasoning are mediated by the posterior areas of the left hemisphere, and that verbal and visuospatial reasoning representations overlap at the neuroanatomical level. This finding weighs against the claims of mental-model theory that deduction involves a significant nonverbal component. Further investigation, particularly with contemporary neuroimaging methods, is needed to test these preliminary conclusions.     

Iconic reading in a case of alexia without agraphia caused by a brain tumor: a tachistoscopic study

The lack of nonverbal reading comprehension in the clinical disconnection syndrome, alexia without agraphia, has been contradictory to the relative reading comprehension of the right hemisphere in split brains. We report a 39-year-old patient with verbal alexia without agraphia caused by brain tumor. On rapid tachistoscopic presentation of object names, he denied seeing anything but showed nonverbal reading comprehension by pointing to the corresponding objects. He lost this ability when he recovered ability to name individual letters of the object names. Our results suggest that even partial verbal reading such as the naming of single letters makes demonstration of iconic reading impossible and that total functional disconnection from verbalization, as initially noted in this case or in split brain studies, is necessary to show nonverbal reading comprehension.     

IMPLICATIONS OF A NEUROPHYSIOLOGICAL APPROACH FOR THE STUDY OF A NONVERBAL COMMUNICATION

This article reviews the neurophysiological literature as it pertains to nonverbal communication. It provides an overview of research on the function of the cerebral hemispheres as related to communication, with particular emphasis on the right hemisphere where most nonverbal communication is processed. Limitations of the neurophysiological approach are discussed. Finally, implications of the neurophysiological approach are discussed for: (1) defining nonverbal communication, (2) the phylogenetic development of communication in humans, and (3) communication research and theory.     

非言语学习不良的研究现状和展望

非言语学习不良日益成为学习不良研究的新热点,非言语学习不良的概念界定、筛查和诊断标准以及非言语学习不良的神经心理、认知、社会性和教育干预等领域取得了大量的研究成果。但是,非言语学习不良研究中还存在许多需要解决的问题,如：界定标准不统一;对非言语学习不良的系统研究有待完善;缺乏有效的干预模式及实证研究等。这些问题都需要进一步的研究、探讨     

Turner Syndrome: A Review of Genetic and Hormonal Influences on Neuropsychological Functioning

Turner syndrome (TS) is a genetic disorder in females that arises from the loss of X chromosome material. Affected individuals demonstrate a characteristic neuropsychological profile of strengths in verbal processing and weaknesses in visuospatial processing, consistent with the Nonverbal Learning Disabilities syndrome. Previous research has described a wide range of visuospatial deficits in TS; however, their verbal abilities are less extensively studied. The present paper describes the processing difficulties of a 9-year-old girl with TS who demonstrated problems in integrating details of a complex visual display and using organizational terms to describe visual scenes or events. Her specific cognitive disabilities were thought to underlie some of the social and behavioral problems she was currently experiencing. Her pattern of results is consonant with the neuropsychological pattern that others have attributed to right hemisphere dysfunction and/or white matter abnormality.     

Cortical morphology associated with language function in neurofibromatosis,type I

Neurofibromatosis, type I (NF-I) is associated with verbal and nonverbal neuropsychological deficits and neuroanatomical anomalies. Few relationships between CNS abnormalities and cognitive function in this population, however, have been found. Reading disabilities and developmental language impairments in the general population have been associated with particular morphologic features in inferior frontal gyrus (IFG) and Heschl's gyrus (HG). We compared the morphology of these regions in children with NF-I and controls. Verbal skills in NF-I were related to IFG morphology, such that individuals with NF-I who showed "typical" gyral patterns in the right hemisphere performed worse across language measures than those showing an extra "atypical" gyrus. A doubling of HG in the left and right hemispheres was also significantly associated with performance on several neuropsychological measures. This is the first study to link regional gyral morphology with language function in NF-I. A possible molecular basis for the observed relationships is discussed.     

Emotion knowledge,emotion regulation,and psychosocial adjustment in children with nonverbal learning disabilities

Nonverbal learning disability is a childhood disorder with basic neuropsychological deficits in visuospatial processing and psychomotor coordination, and secondary impairments in academic and social-emotional functioning. This study examines emotion recognition, understanding, and regulation in a clinic-referred group of young children with nonverbal learning disabilities (NLD). These processes have been shown to be related to social competence and psychological adjustment in typically developing (TD) children. Psychosocial adjustment and social skills are also examined for this young group, and for a clinic-referred group of older children with NLD. The young children with NLD scored lower than the TD comparison group on tasks assessing recognition of happy and sad facial expressions and tasks assessing understanding of how emotions work. Children with NLD were also rated as having less adaptive regulation of their emotions. For both young and older children with NLD, internalizing and externalizing problem scales were rated higher than for the TD comparison groups, and the means of the internalizing, attention, and social problem scales were found to fall within clinically concerning ranges. Measures of attention and nonverbal intelligence did not account for the relationship between NLD and Social Problems. Social skills and NLD membership share mostly overlapping variance in accounting for internalizing problems across the sample. The results are discussed within a framework wherein social cognitive deficits, including emotion processes, have a negative impact on social competence, leading to clinically concerning levels of depression and withdrawal in this population.     

Nonverbal learning disabilities: The syndrome and a case study

Presents the syndrome of nonverbal learning disabilities (NLD) and the model developed to encompass its complex manifestations. Included are the history of the development of the syndrome, the types of children in whom its principal features are manifest, the hypothesized neurological bases of the syndrome, and a test of its developmental dimensions. A case study with assessment results and treatment implications illustrates the clinical dimensions of the syndrome. General developmental and treatment implications of the NLD syndrome and the NLD model are also included.     

Visual integration difficulties in a 9-year-old girl with Turner syndrome: parallel verbal disabilities?

Turner syndrome (TS) is a genetic disorder in females that arises from the loss of X chromosome material. Affected individuals demonstrate a characteristic neuropsychological profile of strengths in verbal processing and weaknesses in visuospatial processing, consistent with the Nonverbal Learning Disabilities syndrome. Previous research has described a wide range of visuospatial deficits in TS; however, their verbal abilities are less extensively studied. The present paper describes the processing difficulties of a 9-year-old girl with TS who demonstrated problems in integrating details of a complex visual display and using organizational terms to describe visual scenes or events. Her specific cognitive disabilities were thought to underlie some of the social and behavioral problems she was currently experiencing. Her pattern of results is consonant with the neuropsychological pattern that others have attributed to right hemisphere dysfunction and/or white matter abnormality.