Syndrome Of Nonverbal Learning Disabilities Research Articles

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

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.

La psychopathologie de l’enfant dyspraxique

The term “dyspraxia” was coined by Julian de Ajuriaguerra and Mira Stambak in 1964. This clinical term was treated very differently according to which explanatory model was adopted. Nowadays, it is used to refer to developmental coordination disorder in view of its neuro-developmental origin. In any case, the actual clinical situations vary and are often complex. In our opinion, it is first necessary to examine the differential diagnosis: apraxia in children caused by lesions, dysgraphia, simply delayed motor development, non-verbal learning disability syndrome, hemispheric specialisation deficits, pervasive developmental disorders (autisms, Asperger syndrome, atypical autism and other pervasive developmental disorders), mixed specific developmental disorders, multiple developmental disorder, and children with high potential. Next we focus on co-morbidity. Firstly, we look at psychopathological disorders associated with dyspraxia: autism and pervasive developmental disorders, dyscalculia/math disability, dyslexia/reading difficulties, dysphasia accompanied by verbal dyspraxia, intelligence deficiency, anxiety disorders, and attention-deficit hyperactivity disorder (ADHD). Secondly, we examine psychopathological disorders associated with dyspraxia. Children with developmental coordination disorder are less inclined to participate in collective games. As a result, there is a greater risk of them becoming lonely and isolated. They have higher child behaviour checklist (CBCL) scores in the somatic problems scale as well as for anxiety, depression and social withdrawal. They have low self-perception in sports as well as at school, which is related to their physical appearance and their self-esteem, attention deficit and externalized behaviour. These children are often at risk of academic failure and they suffer from oppositional defiant disorder and functional disorders. And finally, we believe that it is important to touch on the impact of these disorders on the family.

Asperger syndrome: How does it relate to non‐verbal learning disability?

The syndrome of non-verbal learning disabilities (NLD) is associated with prominent non-verbal deficits such as reduced perceptual and spatial abilities, against a background of relatively intact verbal abilities. Asperger syndrome is one of the several developmental disorders for which Byron Rourke has claimed that almost all the signs and symptoms of NLD are present. This study investigated the claim utilizing a battery of neuropsychological tests that were found to be sensitive to NLD in the original learning disordered populations used to describe the syndrome. Children aged between 8 and 14 were recruited to form two groups: (1) children with Asperger syndrome (N=14) and (2) normal healthy schoolchildren (N=20). By contrast to the main principle outlined in the NLD model, children with Asperger syndrome did not display a relative difficulty with spatial- or problem-solving tasks; indeed, they displayed significantly higher performance on some non-verbal tasks in comparison with verbal tasks. It was only in relation to their high levels of psychosocial and interpersonal difficulties, which are also predicted on the basis of their psychiatric diagnosis, that the children with Asperger syndrome were clearly consistent with the NLD model in this study. These results raise questions about the relevance of the syndrome of NLD for children with Asperger syndrome.

Verbal and Visual Short-Term Memory in Children with Arithmetic Disabilities

With the exception of the explication of the Nonverbal Learning Disability Syndrome, our knowledge of cognitive characteristics of children with isolated arithmetic (A) disabilities contrasted with those with comorbid arithmetic and reading (AR) disabilities is limited. Of the existing studies, most suggest that visual deficits are characteristic of Subtype A. This study examined short-term memory in 45 children who were classified into these two subtypes. Children in Subtype A displayed better verbal memory on some tasks than children in the AR subtype, but no subtype differences in visual memory were found. Counter to our hypothesis, children in Subtype A did not display relatively poorer visual memory than verbal memory. These results suggest a mixed neuropsychological profile, and the absence of visual short-term memory weaknesses as descriptive of the A subtype.

Non-Verbal Learning Disabilities in Children with Infantile Hydrocephalus, Aged 4 - 7 Years: A Population-Based, Controlled Study

The aim of this population-based, controlled study was to investigate non-verbal learning disabilities (NLD) in children with infantile hydrocephalus (IH). For this purpose, the results from subtests measuring either assets or deficits within Rourke's model of NLD were analyzed. Children with myelomeningocele (MMC), intracranial tumors, or IQ < 70 were excluded. Of the 52 IH children included in the study, 46 were shunt-treated, whereas 6 were not shunted. The 44 controls were matched according to age, gender, and geographic variables. The Neuropsychological Assessment of Children (NEPSY) was administered to 52 children (age 4-7) with IH; (F = 17, M = 35), and to 44 controls (F = 17, M = 27). The tests used were classified along each of the dimensions "assets" or "deficits", according to Rourke's model of the elements and the dynamics of the NLD syndrome. Differences between sum scores for the subtests classified as "assets", versus "deficits" were significantly higher in the IH group as compared with the controls (p < 0.005). These findings are compatible with a higher frequency of NLD in the IH group, in which neurological confounding factors have been excluded. In addition, the model of the elements and the dynamics of the NLD syndrome may be useful when analyzing neuropsychological test results obtained with traditional and comprehensive test batteries.

Behavioral profiles of children with infantile nephropathic cystinosis

Children with infantile nephropathic cystinosis have evidence of visuospatial and arithmetic deficits on a background of normal intellectual and verbal skills. This study aimed to define further their behavioral phenotype. The Achenbach Child Behavior Checklist was completed by parents of: 64 children and adolescents with cystinosis (33 females, 31 males; mean age 8y 8mo, range 4 to 16y, SD 2y 11mo); 101 healthy controls (47 females, 54 males; mean age 8y 4mo, range 4 to 16y, SD2y 11mo); 21 children and adolescents with cystic fibrosis (CF), termed chronic‐disease controls (9 females, 12 males; mean age 11y 3mo, age range 4 to 17y, SD 3y 5mo). Compared with healthy controls, individuals with cystinosis had evidence of a significantly higher incidence of behavioral problems, including social problems, somatic complaints, and attention problems. Compared with the chronic‐disease control group, the cystinosis group differed only on the Social Problems scale, with 22% of participants with cystinosis scoring in the‘at risk’range whereas no participant with CF received an elevated score on this scale. We conclude that children and adolescents with cystinosis have evidence of a significant incidence of social difficulties compared with individuals with another chronic illness and healthy participants. The combination of visuospatial problems, difficulty with arithmetic, attention problems, and social difficulties seen in the cystinosis group constitutes a behavioral phenotype of this genetic disorder. This cluster of cognitive and behavioral symptoms is also seen in the nonverbal learning disabilities syndrome, and suggests a possible early difference in brain development in children with cystinosis compared with children who do not share this genetic disorder.

Behavioral profiles of children with infantile nephropathic cystinosis

Children with infantile nephropathic cystinosis have evidence of visuospatial and arithmetic deficits on a background of normal intellectual and verbal skills. This study aimed to define further their behavioral phenotype. The Achenbach Child Behavior Checklist was completed by parents of: 64 children and adolescents with cystinosis (33 females, 31 males; mean age 8 y 8 mo, range 4 to 16y, SD 2 y 11 mo); 101 healthy controls (47 females, 54 males; mean age 8 y 4 mo, range 4 to 16 y, SD 2 y 11 mo); 21 children and adolescents with cystic fibrosis (CF), termed chronic-disease controls (9 females, 12 males; mean age 11 y 3 mo, age range 4 to 17 y, SD 3 y 5 mo). Compared with healthy controls, individuals with cystinosis had evidence of a significantly higher incidence of behavioral problems, including social problems, somatic complaints, and attention problems. Compared with the chronic-disease control group, the cystinosis group differed only on the Social Problems scale, with 22% of participants with cystinosis scoring in the 'at risk' range whereas no participant with CF received an elevated score on this scale. We conclude that children and adolescents with cystinosis have evidence of a significant incidence of social difficulties compared with individuals with another chronic illness and healthy participants. The combination of visuospatial problems, difficulty with arithmetic, attention problems, and social difficulties seen in the cystinosis group constitutes a behavioral phenotype of this genetic disorder. This cluster of cognitive and behavioral symptoms is also seen in the nonverbal learning disabilities syndrome, and suggests a possible early difference in brain development in children with cystinosis compared with children who do not share this genetic disorder.

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.

Nonverbal Learning Disability: Vocational Implications and Rehabilitation Treatment Approaches

The Nonverbal Learning Disability (NLD) syndrome is a disorder characterized by a distinctive profile of neuropsychological, academic, adaptive, and psychosocial functioning. This condition has multiple etiologies and may be unidentified or misidentified because of its unusual combination of characteristics. Of significance to rehabilitation counselors, individuals with NLD have a high probability of being unemployed or underemployed. An overview of NLD is provided, including a description of the disorder's common etiologies and features. Vocational implications of the NLD syndrome are outlined, and rehabilitation counseling approaches to maximize vocational adjustment are described.

Do children with myelomeningocele and hydrocephalus display nonverbal learning disabilities? An empirical approach to classification.

As a group, children with myelomeningocele (MM) and early-onset hydrocephalus demonstrate many of the features of the syndrome of nonverbal learning disabilities (NLD). However, the frequency with which individual children display a pattern of neuropsychological functioning consistent with the NLD syndrome is unknown. We addressed this question by comparing the prevalence of NLD in 32 children with MM and shunted hydrocephalus to that in a group of 27 healthy siblings. Participants, who were between 8 and 15 years of age, completed a neuropsychological test battery that included 11 measures of possible assets and 17 measures of possible deficits that define the NLD syndrome. As a group, children with MM and shunted hydrocephalus displayed many of the specific assets and deficits. However, they also displayed significantly more variability in their patterns of assets and deficits than siblings, reflecting the substantial individual differences that characterize children with MM. About 50% of the children with myelomeningocele displayed a pattern of assets and deficits consistent with the NLD syndrome. Classification as NLD was weakly related to cumulative medical risk, as well as to left-handedness. The findings suggest a need for caution in making generalizations regarding the applicability of the NLD model to children with MM and early-onset hydrocephalus.

Recent developments in the application of the nonverbal learning disabilities model.

Since the original work of Myklebust et al., the concept of a syndrome of nonverbal learning disabilities (NLD) has undergone considerable development and expansion, most notably in the work of Rourke. These authors have proposed a model of white matter dysfunction, predominantly in the right cerebral hemisphere, which is thought to underlie the cognitive and behavioral impairments seen in individuals with NLD. Recent research has focused on assessing the applicability of Rourke's conceptualization of the NLD syndrome and the white matter model to various neurologic, neurodevelopmental, and genetic disorders. This paper highlights recent investigations of the NLD model with respect to velocardiofacial syndrome, Klinefelter syndrome, high functioning autism, neuro-fibromatosis type I, and metachromatic leukodystrophy, and also provides a brief discussion of recent conceptualizations of the NLD model in the broader context of disorders of social and emotional functioning, and of other novel avenues of NLD research.

Responding to Students with Nonverbal Learning Disabilities

COUNCIL FOR EXCEPTIONAL CHILDREN Would you know whether a student of yours has the syndrome of nonverbal learning disability (NLD)? If you were included on a planning committee for this student’s individualized education program (IEP), what would you recommend or plan? Recognizing NLD and providing responsive educational programming for affected students are critical if we are to ameliorate the potentially devastating course of this disorder (Fletcher, 1989; see box, “What Is NLD?”). This article provides an overview of the NLD syndrome to assist educators in identifying this frequently overlooked condition and to describe educational strategies, or interventions, for the special challenges experienced by students with this disability. An NLD Profile Distinctive patterns of strengths and weaknesses in neuropsychological, academic, and social-emotional functioning characterize people with NLD (GrossTsur, Shalev, Manor, & Amir, 1995; Rourke, 1988, 1989; Rourke & Tsatsanis, 2000). One of the hallmark characteristics is stronger verbal than nonverbal cognitive abilities, as evidenced by higher Verbal than Performance IQ scores. This pattern of cognitive strengths and weaknesses extends to attention and memory skills, and students with NLD perform better on such tasks when information is presented verbally rather than through visual or tactile modes (Fisher & DeLuca, 1997; Landau, Gross-Tsur, Auerbach, Van der Meere, & Shalev, 1999; see Table 1). Students with NLD also demonstrate weak psychomotor and perceptual motor skills that persist across time (Rourke, 1988). They tend to be physically awkward and have particular difficulty acquiring gross motor skills that are necessary for age-appropriate self-care and play tasks, such as dressing, skipping, jumping rope, or riding a bicycle (Casey & Strang, 1994). In addition, students with NLD perform significantly below average on standardized motor and visual motor tests (Gross-Tsur et al., 1995) T EA C H IN G E xc ep ti on al C hi ld re n , Vo l. 34 , N o. 6 , pp . 813 . C op yr ig ht 2 00 2 C EC . Responding to Students with Nonverbal Learning Disabilities

Academic and Cognitive Abilities in Children of Parents With Bipolar Disorder: A Test of the Nonverbal Learning Disability Model

It has been hypothesized that children who are at genetic risk to develop bipolar disorder demonstrate deficiencies consistent with the syndrome of nonverbal learning disabilities (NLD); however, this hypothesis has never been tested directly. In the present study, a group of at-risk children (AR group; N = 28) was compared to a demographically matched control group of children of healthy parents (HC group; N = 24) for evidence of a constellation of features associated with NLD. Some characteristic features of NLD were evident, including significant Verbal IQ (VIQ) > Performance IQ (PIQ) discrepancies and psychomotor deficits. However, academic deficiencies in mechanical arithmetic relative to reading and spelling abilities were not demonstrated. These findings replicate and extend the current literature on the cognitive functioning of children of parents with Bipolar disorder (BPD). The results, however, do not support the presence of NLD in these children.

Child clinical/pediatric neuropsychology: some recent advances.

The neuropsychological assets and deficits of several types of pediatric neurological disease, disorder, and dysfunction are described. These are examined from the perspective of the syndrome of nonverbal learning disabilities (NLD) and the "white matter model" designed to explain its complex manifestations. It is concluded that children with some of these diseases exhibit the NLD phenotype, whereas others do not. For the most part, the diseases in which the NLD phenotype is particularly evident are those wherein it has been demonstrated that perturbations of white matter (long myelinated fibers) are particularly prominent.

Asperger syndrome: tests of right hemisphere functioning and interhemispheric communication.

The primary aim of this investigation was to assess to what extent Rourke's (1989, 1995) nonverbal learning disabilities syndrome (NLD) model resembles the pattern of assets and deficits seen in people with Asperger syndrome (AS). NLD can be characterized by a cluster of deficits primarily affecting nonverbal aspects of functioning, in the presence of proficiency in single word reading and a superior verbal memory. The neurological underpinnings of this syndrome may be dysfunction of white matter affecting right hemisphere functioning and interhemispheric communication. To explore this hypothesis, eight participants with AS (ages 10 to 41 years) were assessed in the following areas: the pragmatics of language and communication, verbal and visual memory, visual-spatial abilities, and bimanual motor skills. Results confirmed the close similarity in the neuropsychologic profiles of NLD and AS.

Effects of amiodarone administration during pregnancy on neonatal thyroid function and subsequent neurodevelopment.

Amiodarone, a benzofuranic derivative, iodine-rich drug, has been used in pregnancy for either maternal or fetal tachyarrhythmias. Amiodarone, its main metabolite (desethylamiodarone) and iodine are transferred, albeit incompletely, through the placenta, resulting in a relevant fetal exposure to the drug and iodine overload. Since the fetus acquires the capacity to escape from the acute Wolff-Chaikoff effect only late in gestation, the iodine overload may cause fetal/neonatal hypothyroidism and goiter. Among the reported 64 pregnancies in which amiodarone was given to the mother, 11 cases (17%) of hypothyroidism in the progeny (10 detected at birth, 1 in utero) were reported, 9 non-goitrous (82%) and 2 (18%) associated with goiter. Hypothyroidism was transient in all cases, and only 5 infants were treated short-term with thyroid hormones. Only 2 newborns had transient hyperthyroxinemia, associated with low serum TSH concentrations in one. Neurodevelopment assessment of the hypothyroid infants, when carried out, showed in some instances mild abnormalities, most often reminiscent of the Non-verbal Learning Disability Syndrome; however, these features were also reported in some amiodarone-exposed euthyroid infants, suggesting that there might be a direct neurotoxic effect of amiodarone during fetal life. Breast-feeding was associated with a substantial ingestion of amiodarone by the infant, but in the few cases followed it did not cause changes in the newborn's thyroid function. In conclusion, amiodarone therapy during pregnancy may cause fetal/neonatal hypothyroidism and, less frequently, goiter. Thus, the use of amiodarone in pregnancy should be limited to maternal/fetal tachyarrhythmias which are resistant to other drugs or life-threatening. If amiodarone is used during gestation, a careful fetal/neonatal evaluation of thyroid function and morphology is warranted. It seems prudent to advise that fetal/neonatal hypothyroidism be treated, as soon as the diagnosis is made, even in utero, to avoid neurodevelopment abnormalities, although the latter may occur independently of hypothyroidism. If breast-feeding is allowed, careful evaluation of the infant's thyroid function and morphology is required because of the continuing exposure of the infant to the drug.

The differential diagnosis of impaired reciprocal social interaction in children: a review of disorders.

Impairment in reciprocal social interaction in children that is less severe than autism can be difficult to diagnose due to the variety of developmental pathways that may lead to this problem. Seven childhood disorders are reviewed that include impaired reciprocal interaction: multisystem developmental disorder, nonverbal learning disability syndrome, semantic-pragmatic disorder, attachment disorders (including a developmental theory of limbic system damage), multiplex developmental disorder, schizoid personality disorder, and pervasive developmental disorder not otherwise specified. Clarification is needed for most of the disorders in the areas of operationalized criteria, assessment tools, and documenting causal relationships.

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.

Periventricular Leukomalacia (PVL): An Identical Twin Case Study Illustration of White Matter Dysfunction and Nonverbal Learning Disability (NLD)*

This paper discusses the implications of Periventricular Leukomalacia (PVL) lesions for the development of Nonverbal Learning Disabilities (NLD) as illustrated through an identical twin case study. PVL lesions were identified in an 8-year-old child, but were not detected in his identical twin brother who served as a matched comparison. While the nonclinical twin displayed a largely unremarkable neuropsychological profile, the clinical twin evidenced a distinct pattern of social, intellectual, academic, and neuropsychological test results often identified among children with PVL and those with the NLD syndrome. The clinical and theoretical implications for this case study are discussed.

Neuropsychological and psychosocial subtyping: A review of investigations within the University of Windsor laboratory.

Donald O. Hebb Award for Distinguished Contributions to Psychology as a Science (1999) -- Prix Donald O. Hebb pour contributions remarquables a la psychologie en tant que science (1999)AbstractSubtyping studies that have addressed a variety of theoretical and clinical issues are reviewed. The syndrome of Nonverbal Learning Disabilities, especially with respect to its manifestations in many forms of pediatric neurological disease, disorder, and dysfunction, is emphasized. It is concluded that the establishment of reliable and valid subtypes holds considerable promise for contributions to model-building as well as providing avenues to clinical relevance.In this paper, a brief outline of our program of research is reviewed from a particular vantage point, viz., the relevance of establishing subgroups and subtypes for the testing of important hypotheses and model- building in developmental and clinical neuropsychology. The nomothetic versus idiosyncratic controversy, especially as it applies to the neuropsychology of learning disabilities (LD), is addressed first. This is followed by a description of the subtyping enterprise and its role as a kind of middle ground between these two extremes. Then, a summary of the results that we and others have generated using this methodology is framed in a series of research questions. Also, a brief description of one subtype, the syndrome of Nonverbal Learning Disabilities (NLD) is outlined, together with an examination of the incidence and relevance of this syndrome for various types of neurological disease, disorder, and dysfunction.LD AS AN HOMOGENEOUS ENTITYThere is an important similarity between the history of the neuropsychological study of LD in children and the investigation of frankly individuals. This similarity lies in the fact that most early investigators in both of these areas of scientific endeavour ascribed to a particular viewpoint -- one that managed to hold sway for a protracted period of time during the development of these fields. This viewpoint held that impaired individuals (be they or brain-damaged) have very much in common with others who are so afflicted. Thus, investigators who ascribed to this position felt comfortable in maintaining, either explicitly or implicitly, that there was such a unitary entity as the brain-damaged or the learning-disabled child. In turn, they felt that significant advances in our understanding of the neuropsychological dimensions of these disorders would accrue from studies that involved comparisons of children suffering from either of these two types of disorder with appropriately matched control (i.e., normal) children on carefully selected variables of theoretical interest.As can be gleaned from any systematic review of the learning- disabilities literature prior to the late 1970s (e.g., Benton, 1975; Rourke, 1978a), this comparative populations (Applebee, 1971) or contrasting investigative strategy was the almost exclusive approach adopted by North American and European researchers. Studies involving comparisons of groups of youngsters with LD with groups of age-and otherwise-matched normal controls were employed to determine the deficit(s) that characterize the neuropsychological ability structure of the child with LD (Doehring, 1978). The use of this method for the determination of the neuropsychological abilities and deficits of children with LD assumed, implicitly or explicitly, that such children formed an univocal, homogenous diagnostic entity.This approach was also characterized by rather narrow samplings of areas of human performance that were thought to be related to the learning (primarily reading) disability. For example, some researchers who were convinced that a deficiency in formed the basis for LD in youngsters would follow a rather straightforward research tack: for example, they would measure and compare memory in groups of children with LD and matched control children. …