MGH Home SchoolPsychiatry Home Page
School-Based Interventions : Nonverbal Learning Disability
Interventions for Cognitive Difficulties

  1. Check homework assignments before the student leaves, or
    by e-mail

    Maintain a written homework agenda and have the agenda checked by the teacher or assistant
  2. Provide specific rules and steps for understanding information and working through problems

    Written rules can include: "When someone is bothering me, I can: 1) try to ignore them 2) go somewhere else 3) ask the person to stop or 4) ask an adult for help". Have the student keep a notebook or file of problem-solving strategies so that when the student asks for your help, your first response can be "did you check your notebook for an idea?"
  3. Recognize literal interpretations and explain multiple meanings of words/phrases

    Demonstrate and visually show how the same word can mean different things depending upon the context. Have the student create and keep a dictionary or book of multiple-meaning words.
  4. Point out generalizations or extensions to real-life that can be drawn from assignments

    Apply concepts in many different natural situations. If teaching the concept of color: encourage the student to visit a paint store, do an art project that involves mixing colors, sort laundry, cook, look at magazines and catalogs, visit a toy store, or observe traffic signals on the street.
  5. Verbally emphasize similarities, differences, and connections between past and current assignments

    "Remember how we learned about fractions last month. Well, decimals are just another way of saying the same thing. Look, even baseball cards are changing over from fractions to decimals".
  6. Rehearse transitions between classes

    At the beginning of the school year, complete a physical walk-through of the school and classrooms with the student. Written directions may be needed (rather than a map).
  7. Structure the way in which the student is allowed to ask clarification questions

    Identify that the procedure is to limit him/herself to two questions, then allow others to ask; or proceed with working two problems before asking questions. ("You can ask the two most important questions to begin work, then we will check in after you have completed the first two problems.")
  8. Provide directions in more than one modality

    Write directions in steps on an index card, as well as providing directions orally
  9. Teach "verbal feedback strategies"

    Ask the student to repeat directions or salient information. If possible, let the student re-teach the lesson so you can hear him/her verbalize the concepts and to see if the ideas are understood.
  10. Provide repeated experiences for the student to learn new concepts by using structured material that can be felt, seen and moved around. Model verbal instruction while the student uses the material.

    Teach the student to identify triangles by holding a triangular block and saying a triangle has three sides. ("When I draw a triangle, it has three connected lines.")
  11. Provide opportunities for the student independently to drill and practice spelling or vocabulary words, or math computational problems

    Have the student use a "cover-copy-compare strategy" to independently practice and review work. For example, for spelling words, correctly spelled words are listed on the left of the page, with space on the right for the student to spell each word. The student is instructed to cover the correct spelling word on the left with an index card and to spell the word on the right side of the sheet. Then the student uncovers the correct answer on the left to check his/her work.


  • Provide extra time in the school day for organization and planning

    Schedule a study hall at the beginning or end of the student's day so that he/she has time to review and organize assignments and activities.
  • Modify assignments, assessments and tests to accommodate word retrieval issues

    Allow the student to select an answer from a word bank/list instead of fill-in-the blank problems top

Specialized Instruction

  • Devise mnemonics to help the student adhere to rule/step sequences

    Place "COPER" steps on a laminated card for the student to carry around. "COPER" stands for: "C" catching the problem, "O" listing options, "P" predicting long-term and short-term consequences, "E" evaluating outcomes and taking action based on evaluation; "R" rewarding oneself for following the steps and attempting action.
  • Encourage the student to create mental images of information

    When the student is writing a story about traveling to the moon, ask him/her to "close your eyes and imagine you are in a spaceship on your way to the moon. Tell me everything you see". Write his/her observations on the board so the student is able to integrate the observations into his/her writing assignment.
  • Teach the student how to use self-talk to reinforce routines or procedures that can help him/her complete simple and complex tasks

    Build on the strength of the student's verbal abilities to encourage self-talk. "When first starting work on a new task, ask yourself, 'what does the teacher want me to do?' If you can't come up with an answer, then ask other students who are seated nearby. When you understand what is being asked, write down the steps and then ask 'what do I need to accomplish this task?'"
  • Practice solving real-life problems focusing on how different rules or steps could be applied

    Allow the student to talk him/herself through problem steps as a way of keeping focused on the solution. During homework, teach the student to quietly talk to him/herself: "Okay, Let's see. Where is my pencil? I don't see my pencil. Where are the places I usually put it? Think hard about what I have done with it today, and where I last saw it. Oh, there it is. Now, first I have to add these two numbers."
  • Provide a "verbal map" of the school that the student can use to find rooms

    Videotape a walk-through of the school schedule for the student to review at home, or have the student practice probable schedules, especially in schools where the schedule changes from day-to-day
  • Specify the daily routine, and strategies the student can use when he/she must deviate from routine

    At the end of the day the student should say "What should be in my book bag? Tell yourself what you need, then look to see if it is in there." If in a hurry, teach the student to think about what he/she can do to shorten or accelerate the routine: "Must get my book bag, will check assignments by calling a classmate when I get home, or by checking on the teacher's website."
  • Teach strategies to aid comprehension

    Teach the student to identify topic sentences and highlight important information prior to reading a passage.
  • Use written visuals and tools to help with reading and writing difficulties

    When the student encounters a problem reading, have him/her use a "reading check sheet" to help understand vocabulary and to comprehend a sentence, paragraph or page. Click here for a sample reading check sheet:
  • Teach and have the student practice organizational skills

    Take a photograph of a student locker organized, and show the student step-by-step how to organize his/her locker in the same way. Keep the picture posted on the inside of the student's locker door and check the student's locker weekly for organization. Click here for sample visual for organized desk [DOC40]
  • Provide "homework" to help the student transfer a skill or strategy learned in one setting to other appropriate settings

    Ask the student to keep a "skill diary" to record those situations or settings where he/she has successfully used a strategy. Meet with the student periodically to review entries and reinforce the student's efforts. Ask to see examples of the student's work products that were created using the skill (copies of homework, class notes, completed math problems). top
    ©2010 Massachusetts General Hospital, School Psychiatry Program and MADI Resource Center
    Copyright | Disclaimer | Privacy Policy | Department of Psychiatry  | Site Map