B - 106 Case Illustration of an Adolescent with Nonverbal Learning Disability and Mosiac Turner Syndrome: Neuropsychological and Personality Assessment.

Abstract

Nonverbal Learning Disability (NLD) is a controversial diagnosis which continues to lack an agreed upon diagnostic taxonomy despite its long existence and overlap with other disorders. NLD is considered a dysfunction of the right hemisphere with neuropsychological, academic, and social-emotional/adaptation deficits along with poor motor coordination. This case study reviews an adolescent diagnosed with NLD and Mosaic Turner Syndrome (MTS) and discusses challenges encountered to emphasize importance of an early diagnostic accuracy and the effect of developmental conditions. A 17-year-old female presented for neuropsychological evaluation for a mental health diagnosis and possible academic accommodations. Chief complaints included lifelong functionally interfering difficulties with attention, organization, and emotional and social functioning. Medical history was significant for MTS. The patient's VCI was in the high-average range (VCI = 114), while her PSI was in the low-average range (PSI = 81). She demonstrated high-average to average visual-spatial, construction abilities, and language skills, while performance ranged low-average for perceptual-motor processing and processing speed. Performance on delayed visual-graphic figures was significantly weaker compared to her superior performance on verbal memory for meaningful information. Finally, her delayed visual-graphic was significantly impaired compared to her general performance visual-spatial and construction abilities. The constellation of symptoms reported by the patient, combined with the results of neuropsychological assessment, was highly congruent with prototypical nonverbal learning disability, except for difficulties in mathematical skills. This case demonstrates the importance of proper diagnosis during childhood, the role of neuropsychological evaluation in specific learning disability (SLD) assessment, and lasting effects of a developmental condition on adult functioning.