Expert: James Michael Roan - 4/22/2008

Question
I have a 2 1/2 year old son and 6 month old daughter who use and move their right arm and leg more than their left arm and leg.  My son's current symptoms are:  1) vestibular balance and coordination problems 2) low muscle tone and little tolerance for physical activity 3) auditory, tactile and visual over-stimulation/sensitivities, 4) communication delay (although his receptive and expressive language are confirmed to be within normal limits for his age, he has difficulty getting the words and initiating the use of them); 5) limited eye contact; 6) parallel play mostly with kids his age, socially he is not sure what else to do 7) some limited imaginative play.  None of his therapists feel that he has ASD even with all of his delays because of how he interacts with them.  He is very affectionate and very responsive when you engage him. Overall, he is very happy, laughs often, participates in school activities with enthusiasm, appropriately plays with toys, loves to learn,  a quick learner with above average IQ and is able to generalize concepts learned fairly easy. My son broke his left leg at 18 months old because of left side weakness which still affects him to this day. My daughter is also showing signs of left sided weakness so we are trying to encourage her to use her left hand and left more to avoid the problems that my son has had (its definitely helping her motor coordination). I saw some of your previous answers where you state that there is a difference between Aspergers and a nonverbal learning disability. My questions are (1) what is the difference between them; (2) How can someone tell if this is Aspergers vs. a nonverbal learning disability? (3) what type of doctor would diagnose it? (4) is the treatment any different for the learning disability versus an autism spectrum disorder?  Thank you so much for your time.

Answer
Hi Beth;

All good questions. I'll be happy to share my opinions based on training and experience:

(1) what is the difference between them.

Individuals with a Nonverbal Learning Disability show significant deficits on an IQ test in the Abstract/Visual Spatial or Nonverbal/Performance subtest but average or above-average verbal scores, where as most children with Asperger's syndrome do not have a visual/spatial delay but rather a verbal delay. A child with a Nonverbal Learning Disability (NVLD) confuses directions and gets disoriented easily and doesn't get the big picture due to low fluid (innate) intelligence and thus shows social thinking delays much in the same way someone with AS does but for different reasons.


(2) How can someone tell if this is Asperger's vs. a nonverbal learning disability?

With the IQ profile I described above; left-side body weakness due to right brain developmental delays; getting lost in frequently encountered locales; and any skill requiring right brain activity.


(3) what type of doctor would diagnose it?
A specialist in the areas of AS and NVLD. This could be a neuropsychologist, psychologist, or educational psychologist specializing in these areas.


(4) is the treatment any different for the learning disability versus an autism spectrum disorder?

Not really, fundamentally, however "how" you teach to skill deficits will vary on the primary cognitive deficits, so you do want to differentiate them and have an educational/intervention plan based on that data.

I hope this helps. Let me know if it does not.

Kind regards,
James