NonVerbal LearningDisability:Evidenceforadiscreteclinicalentityinacommunitysample.

Margolis,A.1,Pao,L. 1,Herbstman,J.B. 2,Rauh,V. 2,&Peterson,B.S.31TheDivisionofChildandAdolescentPsychiatryintheDepartmentofPsychiatry,ColumbiaUniversity

2TheMailmanSchoolofPublicHealth,ColumbiaUniversity3TheDivisionofChildandAdolescentPsychiatry,KeckSchoolofMedicine,UniversityofSouthernCalifornia

Hypothesis:LargerVIQ>PIQdiscrepancyscoreswillassociatewithincreasedlevelsofdifficultywithattention,executivefunction,anxiety,andsocialdifficulty,symptomspurportedtobeconsistentwithNonVerbal LearningDisability.

NonVerbal LearningDisability(NVLD),adebilitatingconditionderivingfromdeficitsinspatialperception,accompaniedbypoorexecutivefunctions,inattention,anxiety,andsocialdeficits,wasfirstdescribedin1967byJohnsonandMykelbust1.Whethertheconditionisavalidanddiscreteclinicalentityremainsanopenquestion2.Adiscrepancybetweenverbalandspatialability,oftenoperationalizedbyaVerbalgreaterthanPerformanceIQ(VIQ>PIQ)discrepancyisthehallmarkfeatureofNVLD3.Ourstrategyfordemonstratingthevalidityoftheconditionhasbeentoexaminetheneural4,5 andbehavioralcorrelatesoftheVIQ>PIQdiscrepancyinanepidemiologicsample,freeofascertainmentbiasinherentincase-controlstudies.

StudyPopulation:WestudiedthebehavioralcorrelatesoftheVIQ>PIQdiscrepancyinacommunitysampleof433children(8-14years)participatinginaprospectivelongitudinalcohortstudy(ColumbiaChildren’sCenterforEnvironmentalHealth).

Inhealthy,highIQchildren,largerVIQ>PIQdiscrepanciescorrelatedwithgreaterimpairmentincognitivecontrol,attention,anxietyandsocialdifficulties,thecoresymptomsofNVLD.ThesedataprovideevidencethatNVLDasdescribedinclinicalpracticeandcase-controlstudiesmaybeavalidclinicalentity.

1.Johnson,D.J.,&Myklebust,H.(1967).Learningdisabilities:Educationalprinciplesandremedialapproaches.NewYork,NY:Grune &Stratton.2.FineJG,Semrud-ClikemanM,BledsoeJC,Musielak KA.AcriticalreviewoftheliteratureonNLDasadevelopmentaldisorder.Childneuropsychology :ajournalonnormalandabnormaldevelopmentinchildhoodandadolescence.2013;19(2):190-223.3.GrodzinskyGM,ForbesPW,BernsteinJH.Apractice-basedapproachtogroupidentificationinnonverballearningdisorders.Childneuropsychology :ajournalonnormalandabnormaldevelopmentinchildhoodandadolescence.2010;16(5):433-460.4. MargolisA,Bansal R,Hao X,etal.UsingIQDiscrepancyScoresToExaminetheNeuralCorrelatesofSpecificCognitiveAbilities.TheJournalofneuroscience:theofficialjournaloftheSocietyforNeuroscience.Aug282013;33(35):14135-14145.5. MargolisA,Pao,L.,Tau,G.Zhao,G.,Wang,Z.,Peterson,B.S.,Marsh,R.AssociationsofIQDiscrepancieswithBrainActivationDuringConflictResolutionPaperpresentedat:SocietyofBiologicalPsychiatry;May14-16,2015;TorontoCanada.Acknowledgements:R01DA027100, RS015579 Lemle FamilyFoundation,NVLDProject.

Measures:VIQ-PIQDiscrepancyScoreswerecalculatedbasedoneachparticipant’sVerbalComprehensionIndexandPerceptualReasoningIndexScoreobtainedfromtheWISC-IV.TocreatetheVIQ-on-PIQscore,weregressedVCIontoPRIwithaninterceptofzeroandsavedtheresidual.Thesescoreswerenormallydistributed.NEPSYInhibitionassessestheabilitytoinhibitautomaticresponsesinfavorofnovelresponses.Thechildlooksataseriesofblackandwhiteshapesorarrowsandnameseithertheshapeordirectionoranalternateresponse,dependingonthecoloroftheshapeorarrow.NEPSYAuditoryAttentionassessesselectiveauditoryattentionandtheabilitytosustainit(vigilance). Thechildlistenstoaseriesofwordsandtouchestheappropriatecirclewhenheorshehearsatargetword.RCMASOversensitivityassesses obsessiveconcernsaboutavarietyofthings,mostofwhicharetypicallyvagueandill-defined,aswellasfearsaboutbeinghurtoremotionallyisolated,asmeasuredthroughan11-itemselfreportsubscaleoftheRCMAS.CBCLSocialProblemsassessesachild’sbehaviorwithrespecttoseemingdependent,lonely,notgettingalongwithothers,beingteased,notbeinglikedbypeers,andgettingalongbetterwithyoungerchildren,asmeasuredthrough11-itemparentreportform.

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FIGURES1-4:WedetectedsignificantFSIQbydomaininteractions.AmongchildrenwithFull-ScaleIQ(FSIQ)greaterthan110,wedetectedaninverserelationshipbetweenthemagnitudeoftheVIQ>PIQdiscrepancyandperformanceon:• attention(NEPSY-AuditoryAttention,p

<.047),Figure1• Inhibitorycontrol(NEPSY-Inhibition,p<.049),

Figure2.andapositiverelationshipbetween themagnitudeoftheVIQ>PIQdiscrepancyandlevelsof:• anxiety(RCMAS,p<.005),Figure3.• socialproblems(CBCL;p<.09)Figure4Overall,alargerVIQ>PIQdiscrepancywasassociatedwithgreaterfunctionalimpairment.InlowerFSIQchildren,therelationshipwaseithernotsignificant,orwassignificantintheoppositedirection.

BACKGROUND

METHODS

CONCLUSION

REFERENCES

StatisticalAnalyses:GenerallinearmodelingwasusedtoassessthebehavioralcorrelatesoftheVIQ-PIQdiscrepancyscore,controllingforageattest,sex,andethnicitywhensignificant.

RESULTS

Figure1.Attention

Figure2.InhibitoryControl

Figure3.Anxiety

Figure4.SocialProblems