Team Collaboration for the Best-Practice Treatment of NVLD across Three Systems: School-Based, Hospital-Based, and Family-Based

Team Collaboration for the Best-Practice Treatment of NVLD across Three Systems: School-Based, Hospital-Based, and Family-Based

John M. Davis (California State University – East Bay, USA) and Jessica Broitman (San Francisco Psychotherapy Group, USA)
DOI: 10.4018/978-1-4666-9539-9.ch005


Inspired by the parable of six blind men and an elephant, the authors have long been struck by the number of specialists who come into contact with children with NVLD. Each profession may emphasize a particular aspect of NVLD and may even have its own professional jargon to name it. Speech and language pathologists often refer to this condition as a semantic-pragmatic disorder; occupational therapists, as a developmental coordination disorder; and special educators, as a developmental math disorder. Many psychologists refer to these students as struggling with social skills problems; and Byron Rourke, a neuropsychologist, used the phrase “nonverbal learning disability.” The authors believe professionals do not communicate enough about how services and perspectives need to be coordinated. This chapter identifies a subtype model for NVLD. It offers a developmental perspective of NVLD across the lifespan, and emphasizes the need for teams and collaborators to organize treatment from three perspectives: hospital, school, and family. Finally, the authors address ways in which parents and other family members can best organize and manage these teams that will change over time due to the nature of the disorder.
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The above parable is widely thought to originate in Jain, Buddhist, Sufi, and Hindu lore. The English writer John Godfrey Saxe first translated it into English in the 19th century as a poem. (Jain lore, n.d.) The tale is not meant to imply that various professionals are either blind or unwise! However, over the last 20 years, the large number of professionals who touch the lives of children with a Nonverbal Learning Disorder (NVLD) but do not view NVLD in its broadest context has prevented clarity. Estimates are that 10–15% of students with a learning disability (LD) have an NVLD. Research within the last three decades is beginning to shed light on NVLD. Although not as much is known about this disability relative to the higher incidence disorder of dyslexia, information on how to diagnose and treat children with suspected NVLD is becoming more prevalent.

In our last book (Broitman & Davis, 2013), we invited representatives from most of these treating professions to write about their understanding of, supports for, and interventions with children and young adults with NVLD. We also emphasized the need for organized efforts over time to support these children, and the need for a coach, case manager, team leader, “wise (wo)man,” or other individual to take the lead in keeping the team organized and productive. In this chapter, we will first present a brief overview of the research on collaboration. Second, we will present our subtype model for understanding the needs of a student with NVLD. Our model is symptom specific and not concerned with etiology. However, as our previous work, Rourke (1995), and this current book make clear, it is very likely that there are differing etiologies for how a child develops NVLD. Our third section will provide a brief model for conceptualizing NVLD primarily as a developmental disorder. This disorder is most often first encountered in the school or private practice fields. Included here will be our approach to the collaboration necessary among school personnel to identify and treat students with NVLD in an educational system. The fourth section will briefly review the number of genetic and disease-oriented ways a child might develop NVLD, which is then usually identified in a hospital-based setting. Here we will also talk about the interdepartmental collaboration needed to treat NVLD within that context. We will elaborate on what we see as the need for team collaboration among a range of professionals in order to facilitate best-practice support of students with NVLD from a family-based system.

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