Executive function (skills needed for purposeful, goal-oriented activity) is a common cognitive difficulty in individuals with NF1.
- Working memory, planning, organization, and complex problem solving may be difficult.
- Intellectual development, academic achievement, personality, social skills, relationships, and communication with others may be effected.
- These difficulties impact all areas of learning, sometimes subtly.
- Planning and organization difficulties may make it hard to decide on a starting point at school/home. Children may be overwhelmed with projects. They might be described as inflexible and concrete thinkers.
- Attention is one of the most frequent concerns of parents and poses significant challenges in academics and a child’s achievements.
Math challenges can result from difficulties in reading and languages, visual perceptual problems, confused arrangement of numbers and letters, and difficultly with abstract information.
- Word problems can be an area of weakness. Problems with many steps may place a heavy load on working memory (algebra, long division), comprehension, and language.
- Difficulties can lead to math illiteracy later in life. This can affect daily living and vocational skills.
Gross and fine motor skill delays are found in many children with NF1. These may impact a child’s everyday life. For example, it may be difficult to keep up with their peers on the playground, in sports, or in written tasks.
- This can lead to coordination problems that can persist into adolescence. They may find it hard to perform tasks that require skilled control of movements.
Language skills may also be an area of weakness. There can be difficulties with both receptive and expressive language.
- Some expressive language difficulties may include difficulty:
- Coming to a point, organizing speech, or finding the right word
- Having a conversation
- Recalling or retelling information
- Completing oral and written assignments
- Some receptive language difficulties may include:
- Following directions
- Understanding complex sentence structure
- Understanding meaning and/or content of speech
- Discriminating between sounds, understanding word meanings, and understanding lengthy or complex speech
- Children may appear to be ignoring directions. They may not be able to keep up with classmates (academically or socially).
Children who have NF1 may have difficulty in reading (literacy). This may lead to problems in math as well.
- They may have difficulty with reading skills (i.e. letter recognition).
- Many children who have NF1 have a weakness in their ability to sound out words when reading. This is known as Developmental Phonological Dyslexia. They may find it hard to learn phonics or rules about which sounds correspond to letters.
- This can lead to lack of motivation, confidence, and self-esteem.
- Subtle aspects of language, such as phonological awareness, can lead to problems with learning rhymes, or hearing sounds properly. This can cause difficultly in separating words into syllables and making individual units of sound.
- Children with reading difficulties often have spelling problems.
- Those with phonological dyslexia have problems with spelling because of the challenge of sounding out words.
- Children who have visual perceptual problems have a hard time processing visual information. They may struggle with spatial awareness tasks. These problems often go unnoticed.
- They may have problems coordinating what they see with their motor skills (visual motor integration).
- Visual perceptual problems may lead to problems with comprehension, following task instructions, copying, and handwriting.
- Copying text is difficult because coordination and holding information in memory for the short term is needed.