We report the clinical characteristics of the developmental right-hemisphere syndrome (DRHS), a nonverbal learning disability, in 20 children (9 girls and 11 boys; mean age = 9.5 years) who also manifested attention-deficit/hyperactivity disorder (ADHD), severe graphomotor problems, and marked slowness of performance. Diagnostic criteria for this study included (a) emotional and interpersonal difficulties; (b) paralinguistic communication problems; (c) impaired visuospatial skills, verbal IQ > performance IQ, and verbal IQ · 85; and either (d) dyscalculia or (e) neurological signs on the left side of the body. In this group, verbal IQ was significantly higher than performance IQ (106.6 · 13.0 vs. 85.1 · 13.1, respectively, p < .01). Arithmetic was the lowest score among the verbal subtests (7.8 · 3.5, p < .01) and Geometrical Design was the lowest score among the performance subtests (5.8 · 1.7). Thirteen children had soft neurological signs on the left side of the body. ADHD was seen in all 20 children, marked slowness of performance in 16, and severe graphomotor problems in 18. The latter two features have not been previously described as part of DRHS.
Get full access to this article
View all access options for this article.
References
1.
Abramson, J. H., Gofin, R., Habir, J., Pridan, H., & Gofin, J. (1982). Indicators of social class: A comparative appraisal of measures for use in epidemiological studies. Social Science Medicine, 16, 1739–1746.
2.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.
3.
Bender, L. (1938). A visual motor gestalt test and its clinical use. American Orthopsychiatric Association Research Monographs, No 3.
4.
Brumback, R. A., & Staton R.D. (1982). Right hemisphere involvement in learning disabilities, attention deficit disorder and childhood major depressive disorder. Medical Hypothesis, 8, 505–514.
5.
Conners, C. K. (1973). Rating scales for use in drug studies with children. Psychopharmacology Bulletin, 9 (Special Issue: Pharmacotherapy of Children), 24–29.
6.
Flor-Henry, P. (1979). On certain aspects of localization of the cerebral systems regulating and determining emotion. Biological Psychiatry, 14, 677–698.
7.
Gaddes, W. (1985). Neuropsychological basis of problems in writing, spelling and arithmetic. In Learning disabilities and brain function: A neuropsychological approach (pp. 335–369). New York: Springer.
8.
Goldberg, E., Costa, L. D. (1981). Hemisphere differences in the acquisition and use of asymmetries in the brain. Brain and Language, 14, 144–173.
9.
Gross-Tsur, V., Manor, O., & Shalev, R. S. (1993). Developmental dyscalculia, gender and the brain. Archives of Diseases of Childhood, 68, 510–512.
10.
Harnadek, M. C. S., & Rourke, B. P. (in press). Principal identifying features of the syndrome of nonverbal learning disabilities in children. Journal of Learning Disabilities.
11.
Heilman, K. M., Bower, S. D., & Valenstein, E. (1985). Emotional disorders associated with neurological diseases. In K. M. Heilman & E. Valenstein (Eds.), Clinical neuropsychology (2nd ed., pp. 377–402). New York: Oxford University Press.
12.
Heilman, K. M., & van den Abell, T. (1980). Right hemisphere dominance for attention: The mechanism underlying hemispheric asymmetries of inattention (neglect). Neurology, 30, 327–330.
13.
Heilman, K. M., Voeller, K. S., & Nadeau, S. E. (1991). A possible pathophysiologic substrate of attention deficit hyperactivity disorder. Journal of Child Neurology, 6, 576–581.
14.
Hynd, G. W., & Willis, W. G. (1988). Pediatric neuropsychology.Orlando, FL: Grune & Stratton.
15.
Kaufman, A. S., & Kaufman, N. L. (1983). Kaufman assessment battery for children.Circle Pines, MN: American Guidance Service.
16.
Mesulam, M. M. (1985). Principles of behavioral neurology. Philadelphia: Davis.
17.
Myklebust, H. R. (1975). Nonverbal learning disabilities: Assessment and intervention. In H. R. Myklebust (Ed.), Progression in learning disabilities (Vol. 3, pp. 85–121). New York: Grune & Stratton.
18.
Osterrieth, P. A. (1944). Le test de copie d'une figure complexe. Archives de Psychologie, 30, 206–356.
19.
Ross, E. D. (1981). The aprosodias: Functional anatomic organization of the affective components of language in the right hemisphere. Archives of Neurology, 38, 561–569.
20.
Rourke, B. P. (1989). Nonverbal learning disabilities: The syndrome and the model. New York: Guilford.
21.
Rourke, B. P. (1993). Arithmetic disabilities, specific and otherwise: A neurological perspective, Journal of Learning Disabilities, 26, 214–226.
22.
Semrud-Clikeman, M., & Hynd, G. W. (1990). Right hemisphere dysfunction in nonverbal learning disabilities: Social, academic, and adaptive functioning in adults and children. Psychological Bulletin, 107, 196–209.
23.
Sunder, T. R., & Demarco, S. (1992). Developmental right hemisphere dysgraphia. Annals of Neurology, 32, 477–478.
24.
Touwen, B. C. L., & Prechtl, H. F. R. (1970). The neurological examination of the child with minor nervous dysfunction.London: Spastic International.
25.
Tranel, D., Hall, L. E., Olson, S., & Tranel, N. N. (1987). Evidence for a right hemisphere developmental learning disability. Developmental Neuropsychology, 3, 113–120.
26.
Voeller, K. K. S. (1986). Right hemisphere deficit syndrome in children. American Psychiatry, 143, 1004–1009.
27.
Voeller, K. K. S., & Heilman, K. M. (1988). Attention deficit disorder in children: A neglect syndrome? Neurology, 38, 806–808.
28.
Wechsler, D. (1967). Manual for the Wechsler preschool and primary scale of intelligence.San Antonio, TX: Psychological Corp.
29.
Wechsler, D. (1974). Manual for the Wechsfer intelligence scale for children-Revised.San Antonio, TX: Psychological Corp.
30.
Weinberg, W. A., & Harper, C. R. (1993). Vigilance and its disorders. Neurological Clinics, 11, 59–78.
31.
Weintraub, S., & Mesulam, M. (1983). Developmental learning disabilities of the right hemisphere. Archives of Neurology, 40, 463–468.
32.
Winer, B. J. (1981). Statistical principles in experimental design (2nd ed.). New York: McGraw-Hill.
