Internalized socioemotional functioning of children and adolescents with nonverbal learning disability and Asperger's syndrome

Visual-spatial skills deficits are one of the primary neuropsychological deficits among children with Nonverbal Learning Disability (NVLD; Rourke, 1989) and Asperger's Syndrome (AS; Ellis, & Gunter, 1999; Klin, Volkmar, Sparrow, Cicchetti, & Rourke, 1995). In addition to affecting written tasks, visual-spatial deficits also have implications for the social functioning of children. Children who are not able to accurately process visual-spatial information will have difficulty processing the visual, nonverbal cues present in social situations including facial expressions, hand movements, and body posture (Nowicki & Duke, 1992). These social perception deficits make social interactions difficult for these children. As a result of their social differences, they are likely to get negative reactions from others, have social skills deficits (Petti, Voelker, Shore, and Hayman-Abello, 2003), and have much difficulty fitting in with same-aged peers. These social skills deficits will likely lead to internalized adjustment problems in which these children feel isolated, withdrawn, and depressed around their peers. This sequence of events, visual-spatial deficits, followed by social perception deficits, followed by social skills deficits, which ultimately lead to internalized emotional problems, is implied, but not empirically proven, in a study by Petti and colleagues (2003). In addition to experiencing greater socioemotional problems than other LD subtypes, visual-spatial and social deficits of children with NVLD have been shown to worsen with age (Casey, Rourke and Picard, 1991). This dissertation study investigated the relation between these four constructs (i.e., visual-spatial skills, social perception, social skills, and internalized emotional functioning). It was hypothesized that social perception and social skills mediate the relationship between visual-spatial skills and internalized emotional functioning. In addition, these deficits were expected to increase as these children get older. As NVLD and AS are commonly co-morbid with Attention Deficit/Hyperactivity DisorderPredominantly Inattentive Type (ADHD: PI; Gross-Tsur & Shalev, 1995; Voeller, 1996), this diagnostic group was compared to children diagnosed with ADHD: PI. An additional aim of this study was to differentiate the classification of Learning Disability (LD) by demonstrating the socioemotional functioning differences between individuals with NVLD/ADHD: PI and their counterparts -- individuals with a Verbal Learning Disability (VLD/ADHD: PI). Seventy-one children, ranging in age from 8-14 participated in the study and were assigned to one of three groups (e.g., NVLD/AS with ADHD: PI, VLD with ADHD: PI, or ADHD: PI) based on pre-determined criteria. The NVLD/AS group, as expected, showed impairments in all areas (i.e., visual-spatial skills, social perception, social skills, and internalized socioemotional functioning) and significantly differed from one or both of the other groups on each of the four domains. Support was not found for the age effects for the NVLD/AS group. That is, visual-spatial and internalized socioemotional scores did not worsen with increasing age as expected. Also, visual-spatial skills were not significantly related to internalizing socioemotional functioning, and the hypothesized mediation variables were not statistically significant. The current study contributes to the understanding of individuals with NVLD, an under-studied population. The proposed visual-spatial skills deficits and social perception deficits in Rourke's (1989) theoretical model were supported. This study also offers some insight into the internalizing socioemotional functioning of children with NVLD. It clarifies the heterogeneity of socioemotional functioning among LD children, suggesting that it is children with the LD subtype, namely NVLD, who are at greater risk for social problems.