The Development Profile
As infants:
• They are passive, fall to engage in exploratory play, and do not respond as expected.
As toddlers:
visual-spatial-motor problems emerge;
• Many cannot use toddler toys or enjoy coloring or drawing. They are unable to put puzzles together (Johnson 1987);
• They appear clumsy and ill coordinated. Caregivers must watch them closely because they bump into furniture, are unsteady on their feet, break toys and endanger themselves;
• They appear to not have a good sense of the relationship of their bodies to their spatial surrounding;
They are slow to learn limits and instructions from their caregivers,
• They appear unable to understand casual relationships;
• Caregivers must intervene and correct them constantly, to which they respond with frustration and anger. Often, their frustration escalates so that temper tantrums emerge that are much more intense than those normally occurring at this age;
• Their self-help skills do not develop comparably to those of children their age. They are slow to learn to feed and dress themselves. They do not master tasks such as hand-washing, or grooming;
• They must be helped and reminded to complete tasks that other children already perform independently.
By the age of three:
• They go through an initial stage when their speech is difficult to understand because of articulation problems. These problems dissipate and their verbal skills emerge as an area of strength. They then become quite adept at verbal communication. This channel becomes reinforced by caregivers who become over reliant on it to relate to the child.;
• They have difficulties interacting with other children in groups.
• They seem not to know how to play with others.
• They cling to their caregivers and find it difficult to separate. If this strategy is unsuccessful then they isolate themselves.
By the time they reach kindergarten or first grade other problems become evident:
• They appear to be quite bright and to have excellent verbal abilities, but their behaviors do not match the expectations for a child this bright and verbal;
• They have major problems is the area of peer relationships. They are unable to form friendships or to sustain being with other children even for brief periods of time without an eruption ensuing;
• Academically, they start out having difficulty decoding letters and words, but once they discover the rules they become good readers;
• Their writing is quite illegible. Their small motor problems and their visuospatial difficulties make this task particularly difficult;
• Arithmetic difficulties emerge once simple computation is introduced.
• Caregivers notice that this child is different from their other children. But they are hard put to pinpoint what it is about the child they feel to be different:
• They find themselves frustrated in their efforts to understand the child. They seem unable to decode the child’s cues, and find the child to be socially unresponsive;
• They feel placed in the position of constantly having to correct, limit, or punish the child;
• They are puzzled when the child in turn responds with fury at what the child experiences as unfair treatment.
• The family feels controlled by the child in all its activities;
• They often feel guilty, and blame themselves for what they believe to be their failure to parent properly. This frustration may initiate a cycle in which the caregivers feel rejected by the child and in turn distance themselves emotionally from the child;
• Some caregivers are intuitively able to read the child’s messages and soon find themselves being the only ones who can communicate effectively with the child. If that does not occur then the difficulties are compounded by the child’s increasing demands on the caregiver and their inability to cope.
• Some caregivers unwittingly contribute to the confusion because of their own personal difficulties:
• Some caregivers themselves have NVLD;
• The household then appears like that of a family which each member speaks a different language. While a measure of communication occurs there are large areas which are fraught with misunderstandings. The level of frustration, the anger resulting from constant injury, the lack of gratification in having such a difficult child, all contribute to the ensuing chaos.
By the age of seven or eight the full-fledged "syndrome" manifests itself. It is often at this point that children are referred for therapy.
The "clinical presentation" of the latency age child with NVLD
Children with NVLD are generally referred for a variety of problems:
• Boys are often referred because of behavioral problems while girls may be referred because of their social isolation;
• Both boys and girls often present with clinical signs of severe anxiety, depression, attentional problems, obsessional preoccupations, and self-esteem problems;
• They perform poorly in some academic areas, but not in all. They are good readers, but have great difficulty with tasks involving writing or arithmetic.
• They are passive, fall to engage in exploratory play, and do not respond as expected.
As toddlers:
visual-spatial-motor problems emerge;
• Many cannot use toddler toys or enjoy coloring or drawing. They are unable to put puzzles together (Johnson 1987);
• They appear clumsy and ill coordinated. Caregivers must watch them closely because they bump into furniture, are unsteady on their feet, break toys and endanger themselves;
• They appear to not have a good sense of the relationship of their bodies to their spatial surrounding;
They are slow to learn limits and instructions from their caregivers,
• They appear unable to understand casual relationships;
• Caregivers must intervene and correct them constantly, to which they respond with frustration and anger. Often, their frustration escalates so that temper tantrums emerge that are much more intense than those normally occurring at this age;
• Their self-help skills do not develop comparably to those of children their age. They are slow to learn to feed and dress themselves. They do not master tasks such as hand-washing, or grooming;
• They must be helped and reminded to complete tasks that other children already perform independently.
By the age of three:
• They go through an initial stage when their speech is difficult to understand because of articulation problems. These problems dissipate and their verbal skills emerge as an area of strength. They then become quite adept at verbal communication. This channel becomes reinforced by caregivers who become over reliant on it to relate to the child.;
• They have difficulties interacting with other children in groups.
• They seem not to know how to play with others.
• They cling to their caregivers and find it difficult to separate. If this strategy is unsuccessful then they isolate themselves.
By the time they reach kindergarten or first grade other problems become evident:
• They appear to be quite bright and to have excellent verbal abilities, but their behaviors do not match the expectations for a child this bright and verbal;
• They have major problems is the area of peer relationships. They are unable to form friendships or to sustain being with other children even for brief periods of time without an eruption ensuing;
• Academically, they start out having difficulty decoding letters and words, but once they discover the rules they become good readers;
• Their writing is quite illegible. Their small motor problems and their visuospatial difficulties make this task particularly difficult;
• Arithmetic difficulties emerge once simple computation is introduced.
• Caregivers notice that this child is different from their other children. But they are hard put to pinpoint what it is about the child they feel to be different:
• They find themselves frustrated in their efforts to understand the child. They seem unable to decode the child’s cues, and find the child to be socially unresponsive;
• They feel placed in the position of constantly having to correct, limit, or punish the child;
• They are puzzled when the child in turn responds with fury at what the child experiences as unfair treatment.
• The family feels controlled by the child in all its activities;
• They often feel guilty, and blame themselves for what they believe to be their failure to parent properly. This frustration may initiate a cycle in which the caregivers feel rejected by the child and in turn distance themselves emotionally from the child;
• Some caregivers are intuitively able to read the child’s messages and soon find themselves being the only ones who can communicate effectively with the child. If that does not occur then the difficulties are compounded by the child’s increasing demands on the caregiver and their inability to cope.
• Some caregivers unwittingly contribute to the confusion because of their own personal difficulties:
• Some caregivers themselves have NVLD;
• The household then appears like that of a family which each member speaks a different language. While a measure of communication occurs there are large areas which are fraught with misunderstandings. The level of frustration, the anger resulting from constant injury, the lack of gratification in having such a difficult child, all contribute to the ensuing chaos.
By the age of seven or eight the full-fledged "syndrome" manifests itself. It is often at this point that children are referred for therapy.
The "clinical presentation" of the latency age child with NVLD
Children with NVLD are generally referred for a variety of problems:
• Boys are often referred because of behavioral problems while girls may be referred because of their social isolation;
• Both boys and girls often present with clinical signs of severe anxiety, depression, attentional problems, obsessional preoccupations, and self-esteem problems;
• They perform poorly in some academic areas, but not in all. They are good readers, but have great difficulty with tasks involving writing or arithmetic.
- Diagnostic interviews disclose social emotional distress.