Understanding Nonverbal Learning Disorder (NVLD)

Nonverbal Learning Disorder (NVLD or NLD) is a proposed neurodevelopmental disorder characterized by core deficits in nonverbal skills, especially visual-spatial processing. It is a less well-known type of learning disorder that’s not about verbal communication. While language-based learning disorders like dyslexia involve difficulty decoding language and learning to read, NVLD presents challenges in processing nonverbal information.

Defining NVLD

The signs and symptoms of a nonverbal learning disorder are difficult to pinpoint, as many deficits potentially fall under this umbrella term. The condition can manifest differently in each child, and most children will not exhibit all possible symptoms. It is important to note that NVLD is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), although some advocates believe it should be included. This lack of a standardized definition makes research and diagnosis challenging.

Overlapping Conditions

NVLD symptoms can overlap with symptoms of autism, bipolar disorder, and attention deficit hyperactivity disorder (ADHD). Because of this overlap, children with NVLD may be diagnosed with other conditions, such as autism or ADHD. However, these diagnoses may not fully explain the child's difficulties with higher-order comprehension, math concepts, and visual-spatial relations.

Core Characteristics of NVLD

Despite the variations in presentation, individuals with NVLD typically exhibit a specific profile of strengths and weaknesses.

Strengths

Children with NVLD often possess strong verbal skills, including:

Read also: Key Differences: NLD and ASD

Large vocabulary
Strong language skills
Good memory for verbal content
Excellent spelling and reading skills (once letter shapes are learned)
Rote learning abilities

Weaknesses

The core deficits in NVLD lie in nonverbal skills, particularly visual-spatial processing. This can manifest in several ways:

Difficulty understanding charts, reading maps, and assembling jigsaw puzzles
Trouble using an analog clock to tell time
Poor sense of direction
Struggles with tasks requiring eye-hand coordination, such as coloring and using scissors
Challenges with reading comprehension and advanced math problems that require spatial visualization or pattern recognition
Difficulty managing money

Five Key Areas of Weakness

Experts have identified five key areas in which children with NVLD commonly exhibit weaknesses:

Visual and Spatial Awareness: Many kids with NVLD have trouble understanding visual imagery. For example when they are asked to copy a shape like a cube they produce “profound distortions,” says Bezsylko. “These kids can’t accurately perceive the cube, the forms that make up the cube, and the relationships between them. Hence they can’t copy it.” They also have difficulty evaluating visual-spatial information. This means they have trouble grasping the relationships between things they see and having a clear sense of where they are. This can make them physically awkward.
Higher-Order Comprehension: Higher-order comprehension is the ability to identify the main idea in something, the details that support the main idea, and the relationships among them. This affects kids’ ability to comprehend reading, and write or tell a story effectively. It also affects taking notes. Bezsylko observed that some kids essentially take down everything the teacher says because they don’t know what’s important and what not to take down. Other kids don’t know what’s important so they take down nothing, and people think they aren’t paying attention. Or they take down all the wrong things.
Social Communication: Most kids with NVLD have trouble reading emotion in facial cues and body language, so they often don’t know what’s going on in social interactions. They miss the social patterns that other kids pick up automatically, so they don’t know what’s appropriate behavior in a given situation. Difficulties with social communication is one reason why kids with NVLD often focus - sometimes obsessively -on technology. “In chat rooms or in a video game they don’t have to deal with all the nonverbal stuff,” Bezsylko notes.
Math Concepts: Many kids with NVLD are very good at rote learning, and they are able to do well in math just by memorizing data. But as they get older they struggle to solve more advanced mathematical problems that are based on recognizing concepts and patterns. Even with a problem they’ve seen before, if it’s approached differently or modified slightly, they have trouble recognizing it.
Executive Functions: Executive functions are a set of skills we use to organize our thinking, plan and carry out actions, and figure out how to solve problems. Most kids with NVLD have weaknesses in these organizing and planning functions. For instance they struggle with breaking down a project into smaller pieces, or conceiving steps that need to be taken to get something done. “These kids have trouble figuring things out-in fact they don’t really know what figuring something out means,” Bezsylko says.

Social Challenges

Socially, some children with NVLD have trouble recognizing the nonverbal cues of body language and facial expressions. Social skills that others learn by observation may not come easily, although verbal instruction may help. Some of these social struggles are a byproduct of their deficits: As they may rely on the spoken word for social information, they may ask questions incessantly, or interrupt others, frustrating teachers and peers. Difficulties with social communication is one reason why kids with NVLD often focus - sometimes obsessively - on technology.

Manifestation Across the Lifespan

The challenges associated with NVLD can manifest differently at various stages of life.

Early Childhood

At the beginning of their school careers, children with symptoms of NVLD struggle with tasks that require eye-hand coordination, such as coloring and using scissors, but often excel at memorizing verbal content, spelling, and reading once the shapes of the letters are learned.

Read also: NVLD: A Detailed Symptom Guide

Adolescence

In the adolescent years, when schoolwork becomes more abstract and the executive demands for time management, organization, and social interactions increase, students with NVLD begin to struggle.

Adulthood

As adults, tasks such as driving a car or navigating to an unfamiliar location may be difficult.

Diagnosis of NVLD

Healthcare providers diagnose nonverbal learning disability by talking to you about your child. They’ll ask about areas of difficulty and what you’re observing. They’ll also ask when you first noticed these signs. With your permission, providers may also speak with your child, their teachers or others.

There’s no set criteria for diagnosing NVLD. This is because NVLD isn’t an official diagnosis in the DSM-5 (the book providers use to diagnose neurodevelopmental and mental health disorders). This condition might be included in future editions of the DSM. It takes lots of time and many steps for experts to add a condition to the DSM.

Even though NVLD isn’t yet an official medical diagnosis, providers will decide if your child fits the “NVLD profile.” This means they have the features of the condition and may benefit from resources and support.

Providers may also look for signs of other neurodevelopmental conditions, like autism, specific learning disorders or ADHD. This is because some kids with NVLD also have one or more co-occurring conditions.

Your child’s provider will tell you exactly how they reach (or rule out) a given diagnosis. Typically, providers observe your child while they play or do other simple tasks. They may also interact with your child - for example, by talking with them or playing a game with them. You’ll be involved every step of the way, and your insights about your child will help guide the process.

The NVLD Profile

Co-occurring Conditions

The Importance of Recognizing NVLD

NVLD is not one of the official diagnoses mental health professionals and schools use to categorize kids with psychiatric or learning problems. Kids who have it usually have other diagnoses - often autism or ADHD. For instance, if a child is disorganized and inattentive, they are likely to be diagnosed with ADHD. But they may well be disorganized and inattentive because they don’t understand what’s being discussed, what they read, or the problem they’ve been asked to solve. Similarly, a child diagnosed with autism spectrum disorder will be described as having social and communication deficits. Those behaviors, too, can reflect NVLD - not being able recognize patterns in facial expression, body language, and other forms of nonverbal communication can make kids unresponsive socially.

Unless their NVLD is recognized, they’re not likely to get help that strengthens or compensates for weaknesses in those core areas.

NVLD vs. Autism Spectrum Disorder

NVLD is a separate condition defined by challenges with visual and spatial information. NLD has some of the same symptoms as autism spectrum disorder. Both children on the autism spectrum and children with NLD may have trouble with social skills and communication, like recognizing facial expressions and body language patterns. Children with NLD are often diagnosed with autism as well.

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