Nonverbal Learning Disabilities and Remedial Interventions Jean M. Foss
Pine RidgeSchool Williston, Vermont
Adolescents with nonverbal learning disabilities who enroll in private, special secondary schools consistently present a pattern of behaviors which prevents achievement of their potentials in academic areas and impedes their abilities to interact effectively with others. With weaknesses in the fine graphomotor skills for writing and poor organization at all levels, they produce limited written output and often fail to complete academic assignments. Their response to pressure to produce is to become less productive. These students perceive social situations inaccurately; they are not successful in their interactions, especially with peers. They have learned to resolve difficult situations by employing their relatively strong verbal skills to enlist parents and other adults in intervening for them. They have not developed the skills to intervene for themselves. Effective remedial interventions include training the students in skills for planning and organizing, for studying, for written expression, and in social cognition and interpersonal communication. Students gain positive feelings of personal effectiveness through a process--at first verbally mediated, ultimately verbally self-directed--in which they are encouraged to plan, risk, and act on their own behalfs to resolve matters of personal concern.
The number of adolescents with deficits in nonverbal aspects of learning who apply for admission to independent special secondary schools has grown significantly in the past several years. Histories based on school records and parents' anecdotes indicate that there has been little understanding of the nature of the difficulties these young Annals of Dyslexia,Vol.41, 1991. Copyright©1991by The Orton DyslexiaSociety ISSN 0736-9387 128
NONVERBAL LEARNING DISABILITIES
129
people have faced. Nor have they received instruction directed toward overcoming their areas of weakness. The limited research on this population indicates that the prognosis for success in adapting and functioning is poor. To change this, professionals must improve diagnostic skills in order to identify these individuals in a more timely way. We must devise and implement interventions to strengthen areas of weakness. We must also teach these young people strategies for adapting and coping when faced with expectations for performance which exceed their skills and abilities. My purposes in this paper are these: 1) to describe such learners and their development sufficiently to promote earlier identification and intervention, and 2) to direct attention to the varied areas which can be strengthened through remedial intervention. Processing Strengths and Weaknesses The pattern of strengths and weaknesses in individuals with learning disabilities involving processing nonverbal information is characteristic and highly recognizable once we are sensitive to it. On the WISC-R or WAIS the verbal scale score often exceeds the performance score by 15 points or more. When subtest scores are grouped as suggested by Bannatyne (1974), the verbal conceptualization factor is usually the strongest, the spatial factor the weakest. Reading skills in word identification, phonetic analysis, and oral reading of passages usually surpass comprehension of implicit semantic relationships among words and of literal and inferrential meanings of passages. Spelling skills are strong, handwriting is poor, and other skills for organizing and producing written work are problematic. All areas of mathematics are weak relative to decoding and spelling. While these students perform arithmetic operations with some success because they can follow the formulae, they lack understanding of mathematics concepts and do not readily solve problems in mathematics. Within the framework of an information processing model and a hierarchy of processes, we hypothesize that the weaknesses these individuals demonstrate in academic skills are rooted in deficits in perception and visual imagery. These deficits result in confusions in language processing and cognition (Johnson and Myklebust 1967). The confusions are manifest in difficulties in interpreting spatial, part-whole, and causal relationships and in expressing such relationships orally and/or in writing. These individuals do not form visual images readily and do not revisualize (see Figure 1). They also tend to focus on details and frequently fail to grasp the complete picture. When asked to produce from memory the design in Figure 2 during administration of the Memory for Designs subtest of the Detroit Tests of Learning Aptitude (Baker and Leland 1935), dyslexic individ-
130
IssvEs AND PROGRAMS
%k
Ob L r l©O.JC ,
F~u~I.
q
Lack of ability to revisualize the most basic of spatial relationships is manifested in errors such as these on an informal task which requires labeling body parts as being on another person's left or right side.
uals usually represent the gestalt and the relationships of the parts to the whole. Individuals with nonverbal learning disabilities usually fail to depict a unified whole, as seen in Figure 3. Even those products which appear to approximate the stimulus were constructed in a partby-part fashion. Given their fundamental difficulty integrating discrete parts with a unifying whole, these individuals also have difficulty grasping classifications and classifying information.
NONVERBAL LEARNINGDISABILITIES
131
Figure 2. This design is to be drawn from memory following a five-second presentation. Our first, most basic communications are nonverbal. It follows that breakdowns in processing nonverbal information have significant impact on perception and interpretation of social situations and on the behaviors which are responses to those perceptions and interpretations. The young people with whom we are concerned do not attend to nor interpret accurately the nonverbal messages inherent in interpersonal and social interactions. They derive little or no meaning from vocal tone and pitch, facial expressions, gestures, conventions governing touch and distance, nor from relationships implicit in the status and roles of participants and in the nature of an occasion. As a consequence they are likely to misinterpret interpersonal and social interactions and to interact in inappropriate ways. Further, they appear to have formed concepts of self which are based exclusively upon the verbal messages we give in response to them. The histories of such students, as provided by their parents, contain many similarities. As young children these learners were considered precocious by parents and other adults because they were extremely verbal and used language in ways similar to adults. Although these youngsters were awkward and slow to acquire motor skills and did not "fit in" with other children, adults developed high expectations for them based on their verbal precocity. In their early years in school, expectations that these youngsters would succeed in academics were reinforced by their diligent efforts to learn and eagerness to please. These efforts and attitudes diverted attention away from the nagging awareness that they had few or no
132
IssuEs AND PROCRaMS
m
i ,
Figure 3. Thesedrawings are attempts by individuals with nonverbal learning disabilities to reproduce the stimulus design (Figure 2) from memory.
friends. They did not adjust their communications to the interests nor the level of language of peers. They did not seem to share peers" developmental agenda. They did not apprehend fully the context of peer interactions. Instead, they responded on the basis of highly literal in-
NONVERBAL LEARarINC DISABILITIES
133
terpretations of the words used. Parents and teachers tended to minimize or ignore concerns about this lack of peer acceptance and to focus on the youngsters' academic achievements. When academic demands shifted from rote learning of skills, facts, and procedures to more complex integrated learnings and applications, these individuals began to fail and to cease to try. Similarly, as opportunities increased for both structured and spontaneous social interactions with peers, these youngsters' communication difficulties became more evident. They were rejected, frequently and overtly, and became increasingly isolated and withdrawn. Unless the strengths, weaknesses, and needs of these youngsters are recognized and appropriate interventions are initiated, the prognosis is poor for success in school, for accomplishing the goals of adolescence, and for making positive personal and social adjustments in their lives. Without appropriate interventions these students are likely to become passive and unproductive. They are at risk for becoming depressed, isolated, and for presenting many vague somatic complaints which obscure their underlying causes (Rourke 1989; Strang and Rourke 1985).
Interventions Effective remedial interventions can be designed to help such students improve their understanding of and performance in many areas of concern. To be effective, interventions must address the problem areas directly and explicitly. They must also involve the student in planning to apply newly learned behaviors to similar tasks and situations beyond the training exercises. The most effective instructional procedures help the learner to associate verbal labels and descriptions with concrete objects, actions, and experiences. Instruction depends heavily upon verbal mediation and verbal self-direction, both for analyzing information and for organizing to perform a task. These processes are modeled by the instructor while the student learns to direct himself.
Clarifying language concepts The type of learner described above interprets the language which describes space and spatial relationships in vague, confused, or rigid ways. Developing accurate and flexible interpretations of this vocabulary must be a priority for diagnostic remedial instruction. The educational therapist (tutor) continually assesses the student's understandings of spatial and directional concepts in varied contexts and provides explicit multisensory instruction to establish meaningful associations
134
IssuEs AND PROGRAMS
for the language of space and direction. An adolescent student whose responses to a design copying task are represented in Figure 4 reproduced the same designs with improved accuracy (Figure 5) following such training. It is important to note that the training did not include practices with the same or similar designs. Training involved establishing verbal labels for geometric forms and for direction in two and three dimensions. Instruction also involved making linear measurements and estimating distance. The student also practiced a systematic, verbal self-direction procedure for analyzing and reproducing designs, which he and his tutor devised together.
Developing verbal reasoning While such students tend to be concrete and rigid in their thinking, many successfully perform such structured reasoning tasks as completing verbal analogies and can learn to do so with increased flexibility. Instruction must first focus on developing flexible concepts of similarity and difference, of classification and categorization, of part/ whole relationships, of time order and cause-effect relationships, and of spatial relationships. Student and tutor then devise a sequence of steps which includes self-questioning and self-monitoring with regard to understanding the vocabulary, identifying the implicit relationship among the words presented, describing the anticipated definition of Spatial Relationships Reproduce these designs using the dots at the right of each as polnt~ of reference.
Figure 4. Even with the stimulus design and points of reference provided, an adolescent student with a nonverbal learning disability shows great confusion and difficulty copying designs.
NONVERBAL LEARNINGDISABILITIES
135
Spatial Relationships ~eproduee these designs using the dots at the right of of
each as
points
reference.
/\/x, F~u~5. The student whose initial efforts resulted in the designs shown in Figure 4 demonstrated improved performance as a result of multisensory instruction to establish~clarify concepts of space and direction.
the target word, and retrieving a word to complete the analogy. Until he has internalized the procedure, the student refers to a list of the steps, verbalizing each step. The purpose and effects of such a procedure are to promote analysis and thought and to reduce impulsive responding which tends to be driven by verbal associations rather than understanding of the implicit relationships. For example, as a result of identifying and verbalizing the controlling relationship in the analogy foot:toes:: hand: as being one of a whole to its part, this student provides "fingers." A highly predictable response, without using this procedure, would have been to answer "arm." Increasing comprehension and written output These students frequently and characteristically "shut down" when faced with academic pressures and performance demands which require more than they feel they will be able to do. We can avoid this, or at least minimize it, by recognizing that these youngsters may have much weaker comprehension skills than their grade-placement and decoding skills suggest and setting our expectations for them accordingly. Consistent remedial efforts to help them to gain clear meanings for the many "empty" words they hear, read, and use certainly contrib-
136
ISSUES AND PROGRAMS
ute to improving comprehension. Once these learners interpret words which express semantic relationships accurately, they benefit from being trained to search the text actively, paragraph by paragraph, to find words which signal the nature of the relationship which underlies the content. Working with text material which the student does not consider overwhelmingly difficult, the tutor and student together identify approaches to text which enhance the student's comprehension. Approaches and strategies which are often facilitative include discussing the subject matter before reading in order to establish a set based on the student's prior understanding, reading the selection aloud, prereading end-of-chapter questions and bold-face headings, and pausing at the end of each sentence or paragraph to summarize or paraphrase the information presented to that point. Students are trained to ask themselves questions which lead them to reflect upon their understanding as they read. Active verbalization or subvocalization appear to be important elements in improving performance. Depending upon the student's particular needs for monitoring his own comprehension, such questions as the following might be incorporated in a training procedure: "Are there words here whose meanings are unclear?" (If so, I must determine the appropriate meaning.) "Does this sentence/paragraph make sense in the context of what I have already read?" (If not, I should reread the sentence/paragraph to be sure I understand it. If I am still confused, I should go back to reread the conflicting material.) "Are there signal words here which indicate a relationship I should be thinking about?" (If so, I want to be sure I understand which ideas are connected by these signal words.) The confusions which underlie comprehension difficulties also limit the student's ability to study efficiently and to produce written work of the quality expected of a high school student. To effect growth in these areas we must persist in clarifying semantic confusions and training the student to use the strategies for analyzing written information to identify patterns of organization. As the student develops clear meanings for classes of words which signal meaningful relationships, the tutor then provides many opportunities to practice using these words as a basis for organizing information and communicating in writing. The goals of these practices are to develop automaticity in using words which provide structure and organization and to extend the amount of information which the student will communicate in writing. We must make accommodations in our expectations for the volume and quality of written products while the remedial and strategic trainings are in process. The most important of these accommodations is to set expectations for written output which match closely the student's demonstrated ability to produce such work with respect to
NONVERBAL LEARNING DISABILITIES
137
quantity, quality, and time allowed. Time constraints and expectations regarding the size and scope of the product must be considered carefully. Some students will cease to perform at all if such pressures are felt to be excessive and overwhelming.
Improvingcursive handwriting Verbally mediated practices to improve cursive handwriting result in improvements in such aspects as letter formation, slant, spacing, alignment at the baseline, and in overall control and fluency. Practices involve training the student to give verbal self-directions regarding posture, position of the paper, grasp of the pencil, as well as directions for forming individual letters, for starting at the baseline, etc. Procedures and practices are individually designed by tutor and student who analyze together the student's written products to identify aspects which they will work to improve.
F~u~6.
Training and practice over the period of a school year have resulted in improved legibility of this student's handwriting, as well as an increase in writing rate.
ImprovingSocial Cognition Effective interventions in the social realm also require direct and explicit instruction, practice in a controlled setting, and encouragement and feedback in the unstructured situations which occur in daily living. Our students benefit from direct instruction in which the ele-
138
IssuBs AND PROGRAMS
ments of the communication act are made explicit. They do not apprehend the significance of the nonverbal cues which help to define social situations. Specific training and practice in attending to and interpreting such nonverbal aspects as facial expression, gestures, tone of voice, proximity and distance, status and roles of participants, grooming and use of dress and adornments, and the context of the communication result in improvements in perception and participation. Like the training procedures for developing other skills and understandings, this training depends heavily upon verbal mediation of social interactions and experiences. Young people who have fundamental difficulty labeling their own feelings and attitudes benefit from activities which establish verbally mediated associations for their own affective responses to various situations. Once students understand the basic concepts involved in communication, they practice analyzing interpersonal and social interactions with respect to the nature of the situation, the roles and goals of the participants, and the effectiveness of their messages (including the students' own messages). Direct instruction involves role-plays of situations relevant to the student's own lives. These are videotaped and then viewed and analyzed by students and instructor. Our young people are able to learn new and more appropriate ways to interact with others to the extent that they acknowledge their social difficulties and invest attention and effort to change the quality of their interactions. Training procedures include modeling the language they can use to describe social situations, with particular attention to the cues that define the context of those situations. Students are encouraged to express the outcomes they desire from their interactions with others, to plan and control their participation, and to modify that participation as a result of the feedback of other participants. The setting for such practices must be established as a safe place where feedback is always constructive and encouraging and where negative self-attributions are not acceptable. Discussion of each situation or interaction includes explicit identification of similar situations or settings where the practiced skills will also be appropriate. Developing a sense of personal effectiveness.
The more completely we understand these learners, with their widely disparate abilities and weaknesses, the better able we will be to promote their feelings of self-esteem and attitudes of personal effectiveness. They have learned to use their verbal strengths with practiced skill to engage adults in "rescuing" them when demands for performance appear too great or when situations in which they find themselves seem too complex. "Rescuing" them does not foster in them feelings of personal competence and effectiveness. Rather, the
NONWRBAr LEAPaVZNCDISABILITIES
139
result is to reinforce a sense of personal incompetence, while enhancing their view of the one who has "rescued" as being competent and effective. It is vital that we hold expectations for these young people which are commensurate with their demonstrated abilities across a continuum of tasks--receptive, integrative, expressive; verbal, nonverbal; perceptual, linguistic, cognitive. We must be honest and direct in helping them to understand and accept themselves as they are. Acting from these basic principles, we are able to help them to plan and then to act to achieve desired goals. This is true whether the goal is to improve language comprehension, fine motor skills, study skills, organization of ideas, or written composition; or if the goal is to interact with others in more satisfying ways. In addition to setting realistic goals and planning and acting to achieve those goals, they must also evaluate the outcomes of their efforts. If the outcomes of their efforts are not those which were sought, we engage the learner in identifying additional efforts which might improve the situation, while also acknowledging the positive aspects of the efforts they have already made. They must acknowledge their successes and attribute those successes to their own plans and efforts. All of these processes must be verbally mediated for and by these young people, toward the end that eventually they will become verbally self-directed.
Summary There is a characteristic pattern of strengths and weaknesses in perceptual, linguistic, and cognitive abilities which may indicate a disability in nonverbal learning. Many individuals struggle with this disability without benefit of understanding of the reasons for their difficulties, and without appropriate help to overcome those difficulties. Instruction which directly addresses specific weaknesses can result in improvements. Elements which are common to effective interventions include explicit direct instruction, association of verbal and nonverbal aspects, and use of the relatively strong verbal skills to analyze and mediate the task or situation and to promote self-direction in completing a task or performing an action. We must become more skilled in identifying these individuals and more responsive in providing the instruction which can make a difference in their lives. References Baker, H. J. and Leland, B. 1935. Detroit Tests of Learning Aptitude. Indianapolis: BobbsMerrill.
140
I s s ~ s AND PROGRamS
Bannatyne, A. 1974. Diagnosis: A note on recategorization of the WISC scaled scores. Journal of Learning Disabilities 7:272-274. Johnson, D. and Myklebust, H. R. 1967. Nonverbal disorders of learning. In Learning Disabilities Educational Principles and Practices. New York: Grune and Stratton. Rourke, B. P. 1989. Nonverbal Learning Disabilities. New York: Guilford Press. Strang, J. D. and Rourke, B. P. 1985. Adaptive behavior of children who exhibit specific arithmetic disabilities and associated neuropsychological abilities and deficits. In B. P. Rourke (ed.). Neuropsychology of Learning Disabilities. New York: Guilford Press.
Pine RidgeSchool Williston, Vermont
Adolescents with nonverbal learning disabilities who enroll in private, special secondary schools consistently present a pattern of behaviors which prevents achievement of their potentials in academic areas and impedes their abilities to interact effectively with others. With weaknesses in the fine graphomotor skills for writing and poor organization at all levels, they produce limited written output and often fail to complete academic assignments. Their response to pressure to produce is to become less productive. These students perceive social situations inaccurately; they are not successful in their interactions, especially with peers. They have learned to resolve difficult situations by employing their relatively strong verbal skills to enlist parents and other adults in intervening for them. They have not developed the skills to intervene for themselves. Effective remedial interventions include training the students in skills for planning and organizing, for studying, for written expression, and in social cognition and interpersonal communication. Students gain positive feelings of personal effectiveness through a process--at first verbally mediated, ultimately verbally self-directed--in which they are encouraged to plan, risk, and act on their own behalfs to resolve matters of personal concern.
The number of adolescents with deficits in nonverbal aspects of learning who apply for admission to independent special secondary schools has grown significantly in the past several years. Histories based on school records and parents' anecdotes indicate that there has been little understanding of the nature of the difficulties these young Annals of Dyslexia,Vol.41, 1991. Copyright©1991by The Orton DyslexiaSociety ISSN 0736-9387 128
NONVERBAL LEARNING DISABILITIES
129
people have faced. Nor have they received instruction directed toward overcoming their areas of weakness. The limited research on this population indicates that the prognosis for success in adapting and functioning is poor. To change this, professionals must improve diagnostic skills in order to identify these individuals in a more timely way. We must devise and implement interventions to strengthen areas of weakness. We must also teach these young people strategies for adapting and coping when faced with expectations for performance which exceed their skills and abilities. My purposes in this paper are these: 1) to describe such learners and their development sufficiently to promote earlier identification and intervention, and 2) to direct attention to the varied areas which can be strengthened through remedial intervention. Processing Strengths and Weaknesses The pattern of strengths and weaknesses in individuals with learning disabilities involving processing nonverbal information is characteristic and highly recognizable once we are sensitive to it. On the WISC-R or WAIS the verbal scale score often exceeds the performance score by 15 points or more. When subtest scores are grouped as suggested by Bannatyne (1974), the verbal conceptualization factor is usually the strongest, the spatial factor the weakest. Reading skills in word identification, phonetic analysis, and oral reading of passages usually surpass comprehension of implicit semantic relationships among words and of literal and inferrential meanings of passages. Spelling skills are strong, handwriting is poor, and other skills for organizing and producing written work are problematic. All areas of mathematics are weak relative to decoding and spelling. While these students perform arithmetic operations with some success because they can follow the formulae, they lack understanding of mathematics concepts and do not readily solve problems in mathematics. Within the framework of an information processing model and a hierarchy of processes, we hypothesize that the weaknesses these individuals demonstrate in academic skills are rooted in deficits in perception and visual imagery. These deficits result in confusions in language processing and cognition (Johnson and Myklebust 1967). The confusions are manifest in difficulties in interpreting spatial, part-whole, and causal relationships and in expressing such relationships orally and/or in writing. These individuals do not form visual images readily and do not revisualize (see Figure 1). They also tend to focus on details and frequently fail to grasp the complete picture. When asked to produce from memory the design in Figure 2 during administration of the Memory for Designs subtest of the Detroit Tests of Learning Aptitude (Baker and Leland 1935), dyslexic individ-
130
IssvEs AND PROGRAMS
%k
Ob L r l©O.JC ,
F~u~I.
q
Lack of ability to revisualize the most basic of spatial relationships is manifested in errors such as these on an informal task which requires labeling body parts as being on another person's left or right side.
uals usually represent the gestalt and the relationships of the parts to the whole. Individuals with nonverbal learning disabilities usually fail to depict a unified whole, as seen in Figure 3. Even those products which appear to approximate the stimulus were constructed in a partby-part fashion. Given their fundamental difficulty integrating discrete parts with a unifying whole, these individuals also have difficulty grasping classifications and classifying information.
NONVERBAL LEARNINGDISABILITIES
131
Figure 2. This design is to be drawn from memory following a five-second presentation. Our first, most basic communications are nonverbal. It follows that breakdowns in processing nonverbal information have significant impact on perception and interpretation of social situations and on the behaviors which are responses to those perceptions and interpretations. The young people with whom we are concerned do not attend to nor interpret accurately the nonverbal messages inherent in interpersonal and social interactions. They derive little or no meaning from vocal tone and pitch, facial expressions, gestures, conventions governing touch and distance, nor from relationships implicit in the status and roles of participants and in the nature of an occasion. As a consequence they are likely to misinterpret interpersonal and social interactions and to interact in inappropriate ways. Further, they appear to have formed concepts of self which are based exclusively upon the verbal messages we give in response to them. The histories of such students, as provided by their parents, contain many similarities. As young children these learners were considered precocious by parents and other adults because they were extremely verbal and used language in ways similar to adults. Although these youngsters were awkward and slow to acquire motor skills and did not "fit in" with other children, adults developed high expectations for them based on their verbal precocity. In their early years in school, expectations that these youngsters would succeed in academics were reinforced by their diligent efforts to learn and eagerness to please. These efforts and attitudes diverted attention away from the nagging awareness that they had few or no
132
IssuEs AND PROCRaMS
m
i ,
Figure 3. Thesedrawings are attempts by individuals with nonverbal learning disabilities to reproduce the stimulus design (Figure 2) from memory.
friends. They did not adjust their communications to the interests nor the level of language of peers. They did not seem to share peers" developmental agenda. They did not apprehend fully the context of peer interactions. Instead, they responded on the basis of highly literal in-
NONVERBAL LEARarINC DISABILITIES
133
terpretations of the words used. Parents and teachers tended to minimize or ignore concerns about this lack of peer acceptance and to focus on the youngsters' academic achievements. When academic demands shifted from rote learning of skills, facts, and procedures to more complex integrated learnings and applications, these individuals began to fail and to cease to try. Similarly, as opportunities increased for both structured and spontaneous social interactions with peers, these youngsters' communication difficulties became more evident. They were rejected, frequently and overtly, and became increasingly isolated and withdrawn. Unless the strengths, weaknesses, and needs of these youngsters are recognized and appropriate interventions are initiated, the prognosis is poor for success in school, for accomplishing the goals of adolescence, and for making positive personal and social adjustments in their lives. Without appropriate interventions these students are likely to become passive and unproductive. They are at risk for becoming depressed, isolated, and for presenting many vague somatic complaints which obscure their underlying causes (Rourke 1989; Strang and Rourke 1985).
Interventions Effective remedial interventions can be designed to help such students improve their understanding of and performance in many areas of concern. To be effective, interventions must address the problem areas directly and explicitly. They must also involve the student in planning to apply newly learned behaviors to similar tasks and situations beyond the training exercises. The most effective instructional procedures help the learner to associate verbal labels and descriptions with concrete objects, actions, and experiences. Instruction depends heavily upon verbal mediation and verbal self-direction, both for analyzing information and for organizing to perform a task. These processes are modeled by the instructor while the student learns to direct himself.
Clarifying language concepts The type of learner described above interprets the language which describes space and spatial relationships in vague, confused, or rigid ways. Developing accurate and flexible interpretations of this vocabulary must be a priority for diagnostic remedial instruction. The educational therapist (tutor) continually assesses the student's understandings of spatial and directional concepts in varied contexts and provides explicit multisensory instruction to establish meaningful associations
134
IssuEs AND PROGRAMS
for the language of space and direction. An adolescent student whose responses to a design copying task are represented in Figure 4 reproduced the same designs with improved accuracy (Figure 5) following such training. It is important to note that the training did not include practices with the same or similar designs. Training involved establishing verbal labels for geometric forms and for direction in two and three dimensions. Instruction also involved making linear measurements and estimating distance. The student also practiced a systematic, verbal self-direction procedure for analyzing and reproducing designs, which he and his tutor devised together.
Developing verbal reasoning While such students tend to be concrete and rigid in their thinking, many successfully perform such structured reasoning tasks as completing verbal analogies and can learn to do so with increased flexibility. Instruction must first focus on developing flexible concepts of similarity and difference, of classification and categorization, of part/ whole relationships, of time order and cause-effect relationships, and of spatial relationships. Student and tutor then devise a sequence of steps which includes self-questioning and self-monitoring with regard to understanding the vocabulary, identifying the implicit relationship among the words presented, describing the anticipated definition of Spatial Relationships Reproduce these designs using the dots at the right of each as polnt~ of reference.
Figure 4. Even with the stimulus design and points of reference provided, an adolescent student with a nonverbal learning disability shows great confusion and difficulty copying designs.
NONVERBAL LEARNINGDISABILITIES
135
Spatial Relationships ~eproduee these designs using the dots at the right of of
each as
points
reference.
/\/x, F~u~5. The student whose initial efforts resulted in the designs shown in Figure 4 demonstrated improved performance as a result of multisensory instruction to establish~clarify concepts of space and direction.
the target word, and retrieving a word to complete the analogy. Until he has internalized the procedure, the student refers to a list of the steps, verbalizing each step. The purpose and effects of such a procedure are to promote analysis and thought and to reduce impulsive responding which tends to be driven by verbal associations rather than understanding of the implicit relationships. For example, as a result of identifying and verbalizing the controlling relationship in the analogy foot:toes:: hand: as being one of a whole to its part, this student provides "fingers." A highly predictable response, without using this procedure, would have been to answer "arm." Increasing comprehension and written output These students frequently and characteristically "shut down" when faced with academic pressures and performance demands which require more than they feel they will be able to do. We can avoid this, or at least minimize it, by recognizing that these youngsters may have much weaker comprehension skills than their grade-placement and decoding skills suggest and setting our expectations for them accordingly. Consistent remedial efforts to help them to gain clear meanings for the many "empty" words they hear, read, and use certainly contrib-
136
ISSUES AND PROGRAMS
ute to improving comprehension. Once these learners interpret words which express semantic relationships accurately, they benefit from being trained to search the text actively, paragraph by paragraph, to find words which signal the nature of the relationship which underlies the content. Working with text material which the student does not consider overwhelmingly difficult, the tutor and student together identify approaches to text which enhance the student's comprehension. Approaches and strategies which are often facilitative include discussing the subject matter before reading in order to establish a set based on the student's prior understanding, reading the selection aloud, prereading end-of-chapter questions and bold-face headings, and pausing at the end of each sentence or paragraph to summarize or paraphrase the information presented to that point. Students are trained to ask themselves questions which lead them to reflect upon their understanding as they read. Active verbalization or subvocalization appear to be important elements in improving performance. Depending upon the student's particular needs for monitoring his own comprehension, such questions as the following might be incorporated in a training procedure: "Are there words here whose meanings are unclear?" (If so, I must determine the appropriate meaning.) "Does this sentence/paragraph make sense in the context of what I have already read?" (If not, I should reread the sentence/paragraph to be sure I understand it. If I am still confused, I should go back to reread the conflicting material.) "Are there signal words here which indicate a relationship I should be thinking about?" (If so, I want to be sure I understand which ideas are connected by these signal words.) The confusions which underlie comprehension difficulties also limit the student's ability to study efficiently and to produce written work of the quality expected of a high school student. To effect growth in these areas we must persist in clarifying semantic confusions and training the student to use the strategies for analyzing written information to identify patterns of organization. As the student develops clear meanings for classes of words which signal meaningful relationships, the tutor then provides many opportunities to practice using these words as a basis for organizing information and communicating in writing. The goals of these practices are to develop automaticity in using words which provide structure and organization and to extend the amount of information which the student will communicate in writing. We must make accommodations in our expectations for the volume and quality of written products while the remedial and strategic trainings are in process. The most important of these accommodations is to set expectations for written output which match closely the student's demonstrated ability to produce such work with respect to
NONVERBAL LEARNING DISABILITIES
137
quantity, quality, and time allowed. Time constraints and expectations regarding the size and scope of the product must be considered carefully. Some students will cease to perform at all if such pressures are felt to be excessive and overwhelming.
Improvingcursive handwriting Verbally mediated practices to improve cursive handwriting result in improvements in such aspects as letter formation, slant, spacing, alignment at the baseline, and in overall control and fluency. Practices involve training the student to give verbal self-directions regarding posture, position of the paper, grasp of the pencil, as well as directions for forming individual letters, for starting at the baseline, etc. Procedures and practices are individually designed by tutor and student who analyze together the student's written products to identify aspects which they will work to improve.
F~u~6.
Training and practice over the period of a school year have resulted in improved legibility of this student's handwriting, as well as an increase in writing rate.
ImprovingSocial Cognition Effective interventions in the social realm also require direct and explicit instruction, practice in a controlled setting, and encouragement and feedback in the unstructured situations which occur in daily living. Our students benefit from direct instruction in which the ele-
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IssuBs AND PROGRAMS
ments of the communication act are made explicit. They do not apprehend the significance of the nonverbal cues which help to define social situations. Specific training and practice in attending to and interpreting such nonverbal aspects as facial expression, gestures, tone of voice, proximity and distance, status and roles of participants, grooming and use of dress and adornments, and the context of the communication result in improvements in perception and participation. Like the training procedures for developing other skills and understandings, this training depends heavily upon verbal mediation of social interactions and experiences. Young people who have fundamental difficulty labeling their own feelings and attitudes benefit from activities which establish verbally mediated associations for their own affective responses to various situations. Once students understand the basic concepts involved in communication, they practice analyzing interpersonal and social interactions with respect to the nature of the situation, the roles and goals of the participants, and the effectiveness of their messages (including the students' own messages). Direct instruction involves role-plays of situations relevant to the student's own lives. These are videotaped and then viewed and analyzed by students and instructor. Our young people are able to learn new and more appropriate ways to interact with others to the extent that they acknowledge their social difficulties and invest attention and effort to change the quality of their interactions. Training procedures include modeling the language they can use to describe social situations, with particular attention to the cues that define the context of those situations. Students are encouraged to express the outcomes they desire from their interactions with others, to plan and control their participation, and to modify that participation as a result of the feedback of other participants. The setting for such practices must be established as a safe place where feedback is always constructive and encouraging and where negative self-attributions are not acceptable. Discussion of each situation or interaction includes explicit identification of similar situations or settings where the practiced skills will also be appropriate. Developing a sense of personal effectiveness.
The more completely we understand these learners, with their widely disparate abilities and weaknesses, the better able we will be to promote their feelings of self-esteem and attitudes of personal effectiveness. They have learned to use their verbal strengths with practiced skill to engage adults in "rescuing" them when demands for performance appear too great or when situations in which they find themselves seem too complex. "Rescuing" them does not foster in them feelings of personal competence and effectiveness. Rather, the
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result is to reinforce a sense of personal incompetence, while enhancing their view of the one who has "rescued" as being competent and effective. It is vital that we hold expectations for these young people which are commensurate with their demonstrated abilities across a continuum of tasks--receptive, integrative, expressive; verbal, nonverbal; perceptual, linguistic, cognitive. We must be honest and direct in helping them to understand and accept themselves as they are. Acting from these basic principles, we are able to help them to plan and then to act to achieve desired goals. This is true whether the goal is to improve language comprehension, fine motor skills, study skills, organization of ideas, or written composition; or if the goal is to interact with others in more satisfying ways. In addition to setting realistic goals and planning and acting to achieve those goals, they must also evaluate the outcomes of their efforts. If the outcomes of their efforts are not those which were sought, we engage the learner in identifying additional efforts which might improve the situation, while also acknowledging the positive aspects of the efforts they have already made. They must acknowledge their successes and attribute those successes to their own plans and efforts. All of these processes must be verbally mediated for and by these young people, toward the end that eventually they will become verbally self-directed.
Summary There is a characteristic pattern of strengths and weaknesses in perceptual, linguistic, and cognitive abilities which may indicate a disability in nonverbal learning. Many individuals struggle with this disability without benefit of understanding of the reasons for their difficulties, and without appropriate help to overcome those difficulties. Instruction which directly addresses specific weaknesses can result in improvements. Elements which are common to effective interventions include explicit direct instruction, association of verbal and nonverbal aspects, and use of the relatively strong verbal skills to analyze and mediate the task or situation and to promote self-direction in completing a task or performing an action. We must become more skilled in identifying these individuals and more responsive in providing the instruction which can make a difference in their lives. References Baker, H. J. and Leland, B. 1935. Detroit Tests of Learning Aptitude. Indianapolis: BobbsMerrill.
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Bannatyne, A. 1974. Diagnosis: A note on recategorization of the WISC scaled scores. Journal of Learning Disabilities 7:272-274. Johnson, D. and Myklebust, H. R. 1967. Nonverbal disorders of learning. In Learning Disabilities Educational Principles and Practices. New York: Grune and Stratton. Rourke, B. P. 1989. Nonverbal Learning Disabilities. New York: Guilford Press. Strang, J. D. and Rourke, B. P. 1985. Adaptive behavior of children who exhibit specific arithmetic disabilities and associated neuropsychological abilities and deficits. In B. P. Rourke (ed.). Neuropsychology of Learning Disabilities. New York: Guilford Press.
