Developmental Learning Disabilities of the Right Hemisphere: Emotional, Interpersonal, and Cognitive Components

In 14 patients, we encountered a behavioral syndrome that begins in early life and is characterized by emotional and interpersonal difficulties, shyness, visuospatial disturbances, and inadequate paralinguistic communicative abilities. All 14 patients had at least average intellectual capacity, but each had demonstrated some academic failure, particularly in arithmetic. Examination revealed neurologic and neuropsychological signs consistent with right-hemisphere dysfunction. Most of the patients avoided eye contact and lacked the gestures and prosody that normally accompany and accentuate speech. Although many of them could not convey their feelings, there was no evidence that they were unable to experience affect. Eight of them reported a family history of similar symptoms. Just as developmental involvement of the left hemisphere may produce dyslexia, damage to the right hemisphere suffered early in life, or inherited, may lead to chronic emotional difficulties, a disturbance of interpersonal skills, and poor visuospatial ability.