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Developing Social Skills Strategies with Students
with Nonverbal Learning Disorder

As a clinical psychologist who treats children in individual and group therapy, my work with NLD students have provided me with the opportunity to understand their unique social issues and intervene effectively. In a group situation, the clinician is witnesses the child’s social gaffes and mishaps as they occur with their peers. During the group time, I teach about body cues, facial expressions, body space and attending to complex interpersonal nuances. I use examples from the peer interactions in the group and reported social incidents at home and in school. During individual sessions, I am able to directly confront the student regarding inadvertently inappropriate behaviors and improve their analytic and reflective skills about social situations.

Students with Nonverbal Learning Disorder are often baffled by social expectations and rules. Thus, although well-meaning, they tend to offend both peers and adults with clumsy, poorly timed statements of “truth” or appear aloof as they have such difficulty joining the group. For example, if a joke depends on physical cues, they may not “get it” and then either be under responsive or laugh at the wrong time, a beat after everybody else's. Even, the physical joining of a group can be tricky and complicated for the NLD student. They may be confused about body space and either stand too close or too far away from peers. Not being able to gauge other people's responses from nonverbal cues is a severe handicap in the classroom situation where much of the communication is carried on in a non verbal manner.

Many students with NLD cannot accurately gauge people’s response to them. Thus, they may over report a story, embellishing their statements with many details not realizing they are boring their audience. During the group, I require that each student reflects on the group's responses to their contributions and discuss how they know if someone is truly interested in the conversation. Exaggerating facial expression and body cues is an effective tool to help children better understand their role and importance. Introducing the students to various computer programs to improve visual skills, facial recognition and reading speed can be enormously helpful. Computer games such as Sim City and Tetrus can improve visual sequencing, organization, speed and processing. These programs can be used at home as well as in the therapist's office as an adjunct to treatment.

Demystifying the role of NLD as a contributor to their social issues is an important part of helping the student develop his or her own strategies to compensate for their disability. For example, an extremely bright, highly verbal student with NLD asked, “Dr. Sorscher, how does my NLD affect me socially?” She had previously discussed how her sloppy toileting habits provoked her mother. I linked her question to her behavior and replied that she had difficulty flushing the toilet because she did not see that it needed to be flushed, she did not mean to provoke her mother but she had difficulty processing visual information and she needed to remind herself to be extra careful in scanning the room. I told her that she typically offends peers without meaning to because she misreads social cues. The student went on to give examples of having difficulty in group work with classmates and wanted feedback from her peers in the group regarding how she could be more successful in school with groups.

In individual treatment with a bright, verbal student with NLD, she was being identified as “rude” by her teachers and parents due to her lack of understanding of social hierarchy. She would often say provocative statements without appreciating their true impact. Thus‚ we worked on untangling the hierarchal nature of relationships and helping her understand where she fits in with her teachers, parents and peers.

In sum, developing social skills strategies is an essential part of child and adolescent development. The student with NLD is hampered by their poor visual processing, organization and sequencing. Group and individual treatment can be enormously effective to help students with NLD develop appropriate social skills and strategies. In addition, use of computer programs and modeling are effective tools for intervention. Understanding the impact of their disability on their social behaviors and improving ability to reflect on the impact of their behavior facilitates appropriate social behavior and provides students with the opportunity to develop strategies and self advocacy skills.

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