Cognitive Issues

Turner Syndrome Foundation has webinars that can help parents and educators to understand how TS impacts cognition and the accommodations that can be provided in school. These webinars can be viewed on-demand with captions.

What are the Cognitive Issues that may be Associated with TS?

Some cognitive issues with TS include difficulty with visual-spatial tasks, such as mentally rotating objects in space, which is a problem shared by those with nonverbal learning disability (NLD). This is a problem that is present to some degree in 99% of females with TS. Those with NLD and girls with TS may have trouble with math, particularly geometry. Challenges may also involve using visual maps to navigate.  Since the problems are so specialized, the problems are known as “Turner neurocognitive phenotype;” this terminology refers to the fact that the complete or partial absence of the X chromosome impacts the development of parts of the nervous system which affect the cognitive processes.

What are the Typical Services Needed by Age Group:  Infant, Toddler, Pre-School, Elementary, Middle School, High School, and College?

Because the particular strengths and weaknesses of those with NLD and TS vary from person to person, we list services which may be useful. These are organized by school age group.

For Infancy:

If TS is identified during this period, the child may qualify for early intervention services, depending upon the severity of their problems.

For Preschool:

    • Occupational therapy to develop fine motor skills such as coloring, buttoning clothes, tying shoes, and cutting paper.
    • Speech therapy to work on speech sounds
    • Training in social skills

Elementary School:

    • Continued occupational and physical therapy.
    • Continued speech therapy
    • Specialized gym classes designed for those with physical or other disabilities instead of being in a regular gym class
    • A “resource room” environment with more individualized help in subjects where academic difficulties have been identified
    • If necessary, the student may need to be in a special education classroom for part of the day. However, the benefits of remaining in a mainstream classroom with non-disabled students may be more important to the development of social skills.

Middle School:

    • Specialized gym classes
    • Speech therapy if there is still any difficulty with speech sounds.

High School and College:

    • Allowing the student to use a word processor for any assignments that require writing since students with NLD may have issues with handwriting.
    • Time management training
    • Extended time on tests
    • Tape recorder to record lectures.

What is a 504-education plan?

A 504-education plan is an education plan designed for a child who has a mental or physical disability that significantly limits one or more major life activities.

    • These may include specific learning disabilities, physical disabilities, physical abnormalities, or disabilities that affect the way the body functions.
    • Difficulties with major life activities may include taking care of oneself, performing manual tasks,  walking,  seeing, hearing, speaking, learning, and working.

What is an IEP?

An IEP (or Individualized Education Plan) is a plan for all students who are enrolled in special education programs in public schools. The plan is designed by a team of staff members from the child’s school, the child’s parents, and special education personnel to provide for services and accommodations for the child. The IEP itself describes the specific issues of the disability, the goals the child is expected to attain, including specific academic skills, services that will be provided by the school; and the type of educational setting for the child (e.g., special education classroom, a regular classroom, etc.)

What are some of the Psycho-social Implications that may Impact School Performance?

Some of the psycho-social implications of NLD include difficulties in adapting to new situations which could involve inappropriate behavior in a new situation; issues with social skills and making new friends; possible anxiety and depression (that could develop as a consequence of these difficulties); and possible decreases in physical activity levels with age.

Insights to Learning:

To read more about COGNITION scroll to page(s) G43-G48 in the Clinical Guidelines found here: 

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