A: Many of the products we use comes from Integrations. Some of the more popular items from there are:

Music for Concentration, Learning, Productivity and Thinking ; Vibrating pillows ; time timer ; weighted vests, etc ; seat cushions ; ball chairs ; special scissors.

You can find more, and request a catalog at their website, www.integrationscatalog.com

A: Handwriting is one of the most complex tasks we ask of ourselves. It requires organization of our thoughts, forming an idea about what we want to write, how to form the letters, then organizing our muscles to cooperate with our minds in the movement of a pencil. It's very complex. In situations like you mention in your question, the neural pathways being asked to perform both composition and mechanics of written production are stressed (overwhelmed) much like a computer that has been given too many commands at once and then asked to print a document. One "remedy" is to use handwriting only when needed to communicate ideas, look for other strategies to get the ideas down (dictation, computers, etc) and to practice handwriting separate from idea communication. That would be considered a compensatory strategy. A strategy that would change the nervous system might include perfect practice of letter formation such as used in the handwriting program Handwriting Without Tears by Jan Olsen, OTR and the increase of motor fluency such as Mary Benbow, OTR outlines in her writing program Loops and Groups. Building the muscle strength and endurance of the hands, shoulders, and muscles of posture are an essential component as well (I told you it was complicated!). You can get help from your school's occupational therapist or use the programs I outlined above. You can check out the "links" section for some tools and materials.

With practice, the motor aspects of handwriting become automatic which is what's missing now. A good book of ideas and activities to develop handwriting use at home is called Games for Writing by Peggy Kaye, a resource teacher and tutor. Also, many parents get professional help for handwriting from an occupational therapist or the school's resource teacher.

Q: How do NLD kids learn math? I read what Byron Rourke said, that kids with NLD never get beyond 4th grade math. Is that true? Is there a good resource or program of instruction?

Q: While my son can do simple computations in his head, it gets to be too much for him when he uses manipulatives. Also, paper and pencil tasks are hard and when he has to "show his work" for 40 problems a night, he's on the floor like a wilted carrot.

A: Ahh, Math... As an Occupational Therapist, I find these kids learn math when given the information in multisensory ways. Look for what your kid is interested in. My son (who has NLD) learned to carry remainders by figuring out how many TIE fighters would be left if Luke Skywalker's Y-wing packed 54 bombs to blow up 37 TIE fighters and so on. Then he was motivated and saw the meaning. Themes or roles give them a frame of rules they understand and from that they can learn new information. I helped tutor a group of 5th graders who were struggling with math and found they benefited from concrete, real world examples of math but lost interest and ability when it was on paper. Resources I like to use include: Mathematical Power by Ruth Parker and Beyond Facts and Flashcards by Jan Mokros. Both of these books and others are described on our Recommended Reading page.

I also find Peggy Kaye's book Games for Math is outstanding for suggesting fun activities that help build the concepts of math. Also, get away from paper a lot and go to real stuff like in money; we don't do the coins on paper, we get out coins. We don't do 1/2 and 1/4 on paper, we get out pies and cookies and cut up circles and so on... Math has to be concrete and real for NLD kids to understand. And it hasn't been my experience that these kids "cant" move beyond 4th grade concepts but that from 4th grade on the teaching methods of drill, repetition and review are not helpful to them. If taught in a way they can understand, they can soar. I can tell you my son is in the advanced math class now at his school and we have many students in the clinic who have taken advantage of a good math tutor or educational therapist to break out of their misunderstanding and move into math as a new, fluent language. Math is an area that many students with NLD need an accommodation for homework. They benefit greatly from showing their work only for limited problems and once they demonstrate they understand the concepts, moving on to just showing the answers. Also looking for ways to eliminate the drudge of handwriting (such as "Copy all the problems and solve") their mental capacity for learning the concepts improves remarkably. Work with your child's teacher to differentiate the curriculum in this area, to accommodate the load of written work and I think you'll see a difference.

Q: I would appreciate any suggestions you have to help an 8 year old boy with non verbal learning disorder learn to multiply. His mother reports that if he wants to multiply 8 x 7, he needs to write out the number 7, 8 times in a column, and add them up. This then becomes very confusing and he tends to get the wrong answer.

A: I had good luck using some of the activities in the book Math Games by Peggy Kaye to teach concepts of multiplication in an OT like methodology -- she uses dice and visual prompts.
Additionally, the math program Making Math Real has been very helpful for kids with NLD to support their visual spatial deficits and, consequently, support their math development.
I've found math is often too abstract for these kids (thus your example) and making it concrete (like Peggy's games) makes a significant difference.

Q: My son fits the profile. Which tests should he be given to get a thorough diagnosis?

A: While there is no definitive set of diagnosis tools, there are a number of interdisciplinary evaluations which will help achieve a thorough diagnosis, including the WISC-III, and perhaps evaluations by an occupational therapist, speech therapist, pediatric neurologist, educational therapist, along with observations by the parents and educators. Visit the Power Tools section of the website to find an NLD Assessment Checklist and other helpful tools.

Q: Any suggestions on how to get my son/daughter to remember to clean his/her room in the morning? Or just take responsibility for him/herself? I feel like a nag with no end in site!

A: To say "Clean your room" is really to give a gestalt command and our kids need concrete, specific instructions. I've found it helpful to say things like "go in your room and pick up all the books, put them on the shelf and when you're done, come and give me a hug" or "I'll set the timer and I want you to spend 5 minutes picking up all the clothes and putting them into the dirty clothes hamper". Using a timer can be very helpful and giving specific directions important as well. You can make it a game too such as "Pick up all the round objects and put them into the toy baskets" or "Pick up everything square and put them into their away place."

Kids also benefit from knowing what you expect for a job to be "done" such as "Dusting the table means removing everything from the table, spraying the cloth with Pledge, wiping the table and returning the items back to their original places."

Finally, I think it's very helpful to have routines. We advocate morning and evening routines with about 5 items on each. A morning routine for a 10 year old may look like "Get dressed, brush your teeth, use the cleaning cloth and wipe out the sink and wipe off the counter, put your backpack by the door and after you eat, put your dishes into the sink." Evening: "Set out your clothes for tomorrow, organize your backpack so it's ready to go in the morning, pick up all your clothes from the floor and put them into the hamper, put all books back on the shelf and brush your teeth."

I find the web site www.flylady.com very helpful and Gregory Bodenhammer's book Back in Control (he has a list on the job description of various chores) very helpful. Also, Sal Severe's book How To Behave so your Children Will Too has a chapter of age appropriate chores and rewards that many parents have found instructive.

Q: I am the parent of a child who has NLD. I have come across a new word, "dyspraxia" (also referred to as "clumsy child syndrome"). Can you please tell me, are these two syndromes synonymous, or are there subtle differences between them?

A: Dyspraxia is also known as Developmental Coordination Disorder (the motoric component of NLD). Everyone who has NLD will have some DCD but not everyone who has DCD has NLD. Praxis is the combination of having a thought about a plan of action (called ideation), making a plan (called motor planning) and then executing that plan (execution). Most children with NLD have difficulty with the execution stage of praxis - they can tell you their plan (all day long) but when it comes to starting or getting into action, they just don't. Parents and teachers find this frustrating but it's part of the diagnosis. Building the muscle strength and endurance, developing good organizational skills and practicing "initiating" can be helpful. Parents are delighted to know that chores are a great place to work on this symptom (see question on chores.)

Q: I just received a call saying that the school district was pulling the speech and language portion of my son's evaluation instead leaving it up to the new evaluator. Would you happen to know if that is standard practice?

A: I don't know what the standard is but I would insist that speech be involved. You have the legal right to ask for that area to be assessed with a practitioner who has experience in measuring and interpreting social language delays. Because these kids are so verbally advanced, it is assumed by those who are under-informed, that Speech isn't needed. In fact, the speech therapist might be one of the most important players for a child who has difficulty with tone of voice, language formation at an intellectually equivalent level, pragmatics, etc. I would insist it stay in if I were you. I think the speech therapist and Occupational Therapist were the two most impressive professionals who had the greatest impact on our son's success.

Q: My son/daughter has many of the indications of NLD; however, he/she is an excellent athlete (basketball in particular) and has no noticeable gross motor problems. Does this rule out NLD?

A: According to the experts, the written features and descriptions of NLD children "do not represent a comprehensive picture of the syndrome." In fact, every child has his own NLD profile with his own range and combination of assets and deficits, strengths and weaknesses. Of course each profile and the assets and deficits that go with it will produce its own unique NLD child. Children who have practiced a skill or who live in an environment that encourages athleticism can do well in sports - in fact, that proves the point of intervention being able to make a difference. I think the thing is, most children with NLD avoid sports and so they fail to gain skills that others pick up more naturally.

Q: We were told we should not pursue NLD as a diagnosis because there is no such thing in the regulations and therefore if such a diagnosis were made, our child would be found ineligible for Special Ed help.

A: Under federal law, every state has an OHI (Other Health Impaired) classification and NLD is a neurological disorder which can fall under this category or LD-NOS (learning disability not otherwise specified) or written expression disorder or math disorder. Those are all acceptable qualifying "labels". Every school system has the right to use an "other" category, it's in their paper work. Some chose to be rigid and that's always been unfortunate, starting back when some professionals insisted that a child in a wheelchair couldn't possibly be educated in a "typical" school to those who insisted that "dyslexia" was a child being lazy and now this. It's just a new category and those who are rigid and who attend to a list and not a child's needs will always do that, no matter what the diagnosis. It's sad, really. With that said, regardless of the diagnosis, it must be determined that NLD impacts the student's ability to function in school. A neurologist can certainly help make this assessment in the form of a diagnosis and other professionals can document a child's inability to access the general curriculum without support. Examples of how NLD impacts some students:

• can't adapt to new situations
• can't find their way around the campus
• can't analyze instructions and demonstrate reliable compliance with expectations
• can't organize materials in a timely manner to complete assignments, homework
• can't organize paperwork in order to turn in assignments on time, resulting in poor grades (despite having done the work)
• can't generalize information from class to class, moment to moment, day to day
• can't organize their written output (poor work product in math and language arts in spite of ability)
• can't engage in small group work
• doesn't ask for clarification
• target of bullies
• unsuccessful during non-structured times of day (small group work, PE, recess.)

Q: Why does my child have a constant monologue when he speaks? Why so many questions?

A: Remember this child learns through verbal mediation. He doesn't learn through observation or trial and error. A good way to look at it is: If he's not talking, he's not learning. This should help you to appreciate his constant questions and monologues. Most of us "talk" to ourselves when we're trying to organize ourselves through a complex or novel task such as, "Let's see, if I thread this wire through here and twist like this then the light should go on…." But for our kids, most of life is a novel task so they need that external organization to compensate for the lack of internal organization.

Q: Who makes up the team that works with my child?

A: Here is a list of people who might be part of the team: educational psychologist, neuropsychologist, pediatrician, neurologist, developmental pediatrician, physical therapist (PT), occupational therapist (OT), occupational therapist specializing in sensory integration (SI), adaptive PE teacher, educational consultants, educational therapists, speech pathologist, optometrist for visual exercises. The "team" is developed to meet the specific needs of a child.

Q: How do I help my NLD child organize in terms of his/her school environment?

A: Poor organization is a marked deficit in the world of a child with NLD and Asperger's and a goal for remediation really should appear on each IEP. Think about organization of self, organization of stuff and organization of the environment. We first have to organize our bodies for good work - an occupational therapist can help with that, helping the child attune to their body in space, how they're moving in an environment and how they modulate themselves as they perform their work. I like the How Does Your Engine Run Program (www.AlertProgram.com) for ideas on organizing the body. Organizing their stuff requires them to have a place for everything and to be able to follow a "rule" for where stuff goes. One binder with a place for everything (including "Show to Mom" and "Show to Teacher" files for example) can make a big difference. Then environmental organization comes in too - where to turn in homework if they miss the teacher's prompt, where to find a pencil in the classroom, and so on. I really like Rick Morris's materials (rick@teachers.net) for helping to organize space and time in a classroom, and I really like the books "Seven Steps for Homework Success" and "Study Strategies Made Easy" by Leslie Davis for organizing space at home for homework.

Q: Any tips, warnings, etc. that you think might be helpful for teachers working with my child during changes in the schedule? (Finals, end of the year, Holidays, etc)

A: I think practicing and anticipating and making the feelings associated with change acceptable is very important to our children. Each of us have "big feelings" at transitions and during goodbyes. It's important to validate that these feelings are normal and expected and to make allowances for your child during this time. For example, this isn't a time to start a new, difficult social skills group or other challenging activity or to change Boy Scout Troops or to rearrange the furniture in your home. Instead, it's a time to support the child with soothing, comforting aspects in his/her life and then, from that base of security, help them weather changes and challenges. I like to think of it this way, if we're increasing a social challenge, we want to maintain or even increase the support we provide in other ways. If we are stable in the social area, we may want to increase the academic challenge or begin to remove some of the external methods of support.