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Re: Non-Verbal Learning Disorder/Frontal Lobe Brain Injury

Posted By CCF Neuro[P] MD, RPS on November 14, 1998 at 19:03:19:

In Reply to: Non-Verbal Learning Disorder/Frontal Lobe Brain Injury posted by Mattie on November 14, 1998 at 18:01:53:

My 14 soon to be 15 year old son has been through the gammat of testing for a special
education coding.  He was diagnosed as having a learning disability in math at age
8 with a secondary coding in speech/language for receptive language at that time
as well.
Over the past several years he was questioned as to having an auditory perception
disorder and was found to have a significant one.  Later on attention deficit was
questioned and was started on ritalin then cylert, both with very devastating
side effects that included violent behavior.  Then we tried behavior
modfication which helped a great deal with his focusing at school and at home.
Then he excelled in the 5th and 6th grade including making high honors.  At the end
of the 6th grade he was attacked by a class mate who was extremely violent which
including him wailing a knife at my son.  Soon after he started demonstrating
symptoms of OCD and then began pulling his hair out by the roots with 3 inch by 3 inch
bald spots.  I had him seen by a our GP, a psychologist and eventually a
psychiatrist.  He was diagnosed with OCD, and trictillomania.  Seventh grade was
a nightmare....until he was started on 30mg of prozac and 50 mg of clomipramine
he could not stop pulling his hair, checking items around him, checking the time
and the list goes on.  He is currently in the 9th grade.
This school year was a huge transition for him adn I was concerned about the social
aspects of it for the most part.  Well socially he has soared and making good
judgement calls with friends.  Academics, however he shut down the first 5 weeks of
school.  We have since started a daily assignment and homework list acquiring
teacher and parent signatures daily that my son keeps track of solely with
earned rewards at home such as computer time.

Now here is the clincher....after all these years....all the testing and current
testing for his 3 year up date with special education the team has unfolded
a new diagnosis one which his doctors agree is the key to what makes my son tick
He was diagnosed with Non Verbal Learning Disorder.  I was asked was he ever
hit on the head, about his birth, about his toddler years.  Well, his head was
stuck in my pelvis during the c-section which required forceps to remove him.
He weighed almost 10 pounds and his head apparently had been in the down
position for at least several days.  He was born with 2 hematomas on his head.
One frontal and one posteriorally.
I guess now that I have rambled...my question is aside from the OCD/trict traits
he continues to exhibit (although much more milder than prior to meds) and the
behavior/goal oriented regimen we are trying now with school...that is working....but
sometimes my son still has that vacant look like...."What, what do you mean,
How come, I don't understand look on his face....is there anything else I should
be doing or investigating?
Thanks in advance.....Mattie
Dear Mattie:
Wow, you have done such a great job with your son, you need to be congradulated.  OCDs are very difficult to control.  It sounds like your son has responded well to medications, which for many have little effect.  It is not unusual for a teenager to tune you out, even if all have been normal in their lives.  Part of what you are seeing could be a normal teenage response.  Some of it may be from his cognitive and attention disorders you discribe.  Likely, a combination of both.  I wouldn't be too worried.  Although frontal lobe injury can give a disorder as you describe, small hematomas from forceps is generally not traumatic enough to induce such symptoms.  But, that was awhile ago and I wasn't there to view the damage.  Hang-in there with your son, your doing a great job.
Let us know if we can help.
CCF Neuro:Pediatrics MD, RPS
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