Neuropsychology Central

[awhitmer83]

Hi all,

I am wondering if neuropsychological testing can differentiate between Asperger's Syndrome and Nonverbal Learning Disorder. My son was diagnosed with NLD, but kids with NLD tend to have horrible visual-spatial skills. My son scored at a 13 year-old level on his visual-spatial evaluations, and he's not even 8 yet. I pointed out this discrepancy to the psychologist, who treated me like an idiot and ignored my concerns that the diagnosis was incorrect. (I'm a clinical social worker, so I feel like I know what I'm talking about.)

Anyway, I feel like I need a second opinion, and I would love to go through a neuropsychologist if I knew I would get definite answers there. Is this possible, or are professionals from all disciplines just guessing on these diagnoses?

[lash]

There's actually a lot of overlap on neuropsych tests between Asperger's and NVLD, so most neuropsychologists would probably use the same evidence a "regular" psychologist uses in making such a distinction. Sometimes NVLD is considered to be a "feature" of Asperger's due to the similarity in cognitive and social abilities (although I don't recommend thinking about it like that).

Any differences on testing would be pretty subtle. The visual problems in both conditions tend to be more related to integrating visual and motor abilities, not just seeing things correctly. Also, NVLD kids tend to have difficulty with gross motor ("general" motor activity) and fine motor (like handwriting) behavior, whereas kids with Asperger's tend to be OK with gross motor but not fine motor coordination.

The main things you see in Asperger's but not NVLD are repetitive behaviors and specific and unusual interests. So the psychologist would have had access to the most important distiinguishing information. It sounds like you're very frustrated, but I'm sure everyone's trying to do their best to help your child. If you want a 2nd opinion, by all means go seek one, and make sure it's someone who is willing to explain exactly why they think what they think. Good luck.
_________________
Lee Ashendorf, Ph.D.
Edith Nourse Rogers Memorial VA
Co-Webmaster, Neuropsychology Central

[Jarleigan]

In my completely unprofessional but extensive personal experienced opinion, it's pretty difficult to make a 100% conclusive distinction between AS and NVLD in children who aren't text book cases. A second opinion certainly wouldn't hurt, but it could likely be open to just as much interpretation as the first.
Most of the parents of children with AS that I know (including myself) see specific instances that don't quite "go" with the diagnosis. For instance, my 8 year old has absolutely beautiful handwriting. Just don't ask him to button his pants! He also tests well in comprehension, mostly due to the testing formats. Meanwhile, he's had meltdowns when faced with more general, open ended questions.
The DSM standards for AS are very subjective, imo. Because of the wide range of symptoms, I don't know if that can ever change. But I'm hoping to find out with all of the money I'm about to put into going back to school to research it!
_________________
Carrie

"It seems that for success in science and art, a dash of autism is essential" -Hans Asperger