Learning and Attention Deficits
Fifty to sixty percent of children with NF1 will have some form of learning disability. NF1 patients typically have normal intelligence, but experience specific problems with reading, writing and the use of numbers.
Over 50% of children with NF1 also have issues with attention and executive function. Many of these children are successfully treated with medication and behavior therapy. In addition, problems with fine and gross motor skills are frequently encountered in children with NF1. Affected individuals are typically managed with physical and occupational therapy.
Learning disabilities in NF1
A learning disability can be thought of as a short circuit or problem (dysfunction) in one or several of channels in the brain. Dysfunction in any of these channels can make it harder for a child to perform up to their potential. These channels are important for getting information into the brain (input), processing that information, or communicating information (output). As a result, children with NF1 may have difficulty with reading, writing, math and memory, or have difficulty staying focused in the classroom.
Children with NF1 who experience difficulty getting information into the brain have a perceptual disability. Children with a perceptual disability can end up feeling confused, anxious and/or frustrated, and this can negatively impact their school performance and social interactions. These children may:
- Reverse letters
- Have problems with positioning objects in space
- Experience difficulties distinguishing subtle differences between similar sounds
- Misunderstand social cues and body language
Many children with NF1 may also have trouble processing information once it gets into the brain, and their brains may have difficulty making sense of the information they receive. These integration problems can include:
- Problems putting things in an order that makes sense
- Trouble figuring out the meaning of symbols and words
- Difficulty in organizing new information
Children with NF1, particularly boys, may additionally have difficulty communicating what they have learned, which is a problem with language and motor output. Children with this type of language problem can talk on and on, often with a great deal of intelligence and expression about a wide range of topics, and then freeze when asked a specific question.
Motor output problems can also be common in NF1, and these children are often regarded as clumsy or uncoordinated. Typically, they have difficulty with gym activities or with the fine motor coordination skills needed for writing.
For additional information about learning disabilities in NF1, check out:
- 11 Things Parents Can Do for Their Children with Learning Disabilities
- Addressing Academic Concerns: A Guide for Parents of Children with NF1 (pdf)
- Addressing Executive Function: A Guide for Parents of Children with NF1 (pdf)
Attention deficits in NF1
In addition to learning problems, a large number of children with NF1 have attention deficit disorder, with or without hyperactivity. Attention problems often co-exist with other learning disabilities. While attention deficit disorder may be obvious in some children with NF1, subtle, but still highly significant problems with attention may be uncovered in many children with NF1 only after formal testing. Those children with attention difficulties and/or hyperactivity benefit from behavioral modification or stimulant medication as well as special accommodations at school.
Supporting growth & learning in children with NF1
Despite these problems, most children have relatively normal intelligence. Importantly, children with learning disabilities are not stupid or lazy. They have significant problems with the way they learn and perceive the world, and require alternative strategies to support their growth and learning.
Their problems should be formally evaluated by a professional either privately or in the school district to develop an appropriate individualized education plan (IEP). Those children who do not qualify for an IEP may receive services through a 504 plan. Children with NF1, who receive these intensive services, will have the greatest chance of living up to their potential.