What Sets It Apart From Autism Spectrum Disorder
While nonverbal learning disorders and autism spectrum disorder may overlap, there are several key differences.
- The main difference is that Autism Spectrum Disorder is a developmental disorder that is associated with delays in learning, rather than academic difficulties.
- Both disorders are associated with problems with motor skills, but it is explained in NVLD by visual-spatial organization while in autism, it is associated with sensory processing difficulties.
- While teens with autism tend to be visual learners, teens with NVLD learn better by hearing information.
- Teens with Nonverbal Learning Disorders typically have higher levels of social intelligence, but struggle with social anxiety and feeling different from others.
Getting Nld Officially Recognised
Despite 40 years of research into the theoretical and neuropsychological underpinnings of NLD including several hundred peer-reviewed journal articles, dozens of books and book chapters, as well as several websites there is still some debate about the essential features necessary to establish a diagnosis.
Formalisation of an NLD diagnosis would provide a framework and language for describing NLD characteristics, interrelationships and behavioural consequences.
Official recognition in the International Classification of Functioning would guide clinical practice and future research. It would also support development of policies and services that better meet the needs of people with NLD in Australia.
Trouble Picking Up On Social Cues
People with these challenges often have strong verbal skills. But they have trouble with communication that isnt verbal. They frequently miss social cues like tone of voice, facial expressions, and body language.
They might not realize theyre standing too close when the person theyre talking to takes a step back. They might not recognize that a frown means theyre talking about something thats inappropriate. Or that a certain tone of voice means the person is teasing.
Not getting the subtle, unspoken messages people send out makes it hard to form relationships. It can also leave people feeling isolated.
Learn more about social cues and nonverbal communication.
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The Main Symptoms Of Nvld
Common Symptoms of NVLD include the following:
- Difficulty determining where objects are in the environment in relation to their self:This includes poor physical awareness, which may show up as clumsiness as the person has difficulty orienting their body to their surroundings. It can also lead to what appear to be inappropriate social interactions, such as standing too close or too far from someone.
- Difficulty following spatial directions and recalling spatial relationships: Problems with spatial processing make it difficult to process directions when traveling or determining where they are in relation to their environment.
- Good verbal skills: They have decent or excellent vocabularies. They may be able to memorize long lists of words, yet have difficulty understanding what the words mean. They may be able to read the words of a story, yet have trouble identifying the overall meaning and main points.
- Frequent difficulties in spatial or visual-spatial processing: This includes difficulty with shape, size or location or direction of objects. This can make it difficult to assemble puzzles or complete hands-on building projects.
How Is Nld Diagnosed
Typically, NLD is diagnosed through a neuropsychological evaluation by a psychologist who will assess all the areas mentioned above. The evaluation would include a measure of intelligence, academic tests, visual-spatial and visual-motor tests, language tests, tests of executive function skills, and measures of social and behavioral functioning. A full test battery can be quite helpful in distinguishing a nonverbal learning disability from other disorders. This sort of specialized testing, which includes a formal diagnosis, is not typically provided by the school system. While testing completed through the public schools will describe the concerns, the evaluator will not give a formal diagnosis, as that is not the typical function of a school psychologist. If having a formal diagnosis and complete documentation of the childs strength and weaknesses is important to you, you will need to get an evaluation completed by a licensed psychologist who works in private practice or in a clinic or hospital setting.
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What Is A Nonverbal Learning Disorder
A nonverbal learning disorder is a neurological condition believed to affect the right hemisphere of the brain. This disorder can significantly impact four major areas of functioning: visual/spatial/organizational, social, motor, and academic. Children with NVLD present a puzzling and challenging profile to their parents and teachers. They have definite strengths but also significant weaknesses. This profile often leads parents and teachers to overestimate the childs ability and set unrealistic demands. This can lead to frustration and other emotional problems in the child. NVLD is frequently misdiagnosed or not diagnosed until late elementary or middle school years. It persists into adulthood and is often accompanied by anxiety, depression, social isolation, and relationship and employment difficulties. It can be present along with other disabilities or conditions. It is a clinical diagnosis and currently there are no standard criteria to define it from the medical or educational fields. It is not a category in special education, but children may receive special services if they meet state criteria for Specific Learning Disabilities , Other Health Impaired , Emotional Behavior Disorders , or Autism.
Diagnosing Nonverbal Learning Disorder
A mental health professional specializing in the condition and familiar with similar disorders, like a neuropsychologist, is the best person to evaluate and diagnose signs of NLD in you or your child. He or she will evaluate a patients speech and language development, verbal IQ, performance IQ, visual-spatial skills, and motor development. A patients score on any one of these individual tests doesnt matter much, in and of itself rather, the specialist will be looking to see whether the patients overall strengths and weaknesses match the most common patterns seen in patients with NLD.
If a clinician mistakes NLD for ADHD, the patient will likely be placed on ADHD medication, which does nothing for NLD symptoms and may even exacerbate them or lead to other complications. Thats why getting the right diagnosis and receiving early intervention is imperative.
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Treatment Options For Nonverbal Learning Disorder
There is no standard treatment approach for NLD, since so little is known about the condition. As with ADHD, education about NLD is key for all who work with your child. Social-emotional learning , executive function training , and physical therapy can help children manage NLD symptoms.
Unlike other learning disabilities, NLD isnt covered under IDEA. So, even with a formal diagnosis, your child may not qualify for an IEP or 504 Plan from her school unless she has another diagnosis or disability. This doesnt mean your child is ineligible for extra help, however. Useful formal or informal accommodations include social skills groups, occupational therapy, and time-management strategies.
Parents also need support to understand their childs behaviors. Talk therapy has its place in a treatment plan, but it doesnt teach parents, children, or adults the skills to manage moment-to-moment situations at home or at work. Behavioral parent training gives parents the tools to better meet their childs needs. Dialectical behavioral therapy may help some individuals.
What Can Help With These Challenges
There are a number of things that can help people improve skills and manage some of the difficulties. These include:
Social skills groups to teach people how to handle social situations such as greeting someone, joining a conversation, and recognizing and responding to teasing
Occupational therapy to build tolerance for outside experiences, improve coordination, and enhance fine motor skills
Cognitive therapy to help deal with anxiety and other mental health issues that can occur with these challenges
Schools might give kids informal supports in class to help keep challenges from getting in the way of learning. Adults may also be able to get accommodations at work.
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Aspergers Disorder Is Characterized By:
A. Qualitative impairment in social interaction
B. Restricted, repetitive and stereotyped patterns of behavior, interests, and activities.
C. These problems taken together result in significant challenges in the lives of people with AD as they attempt to live in a neurotypical world and meet the expectations of others.
D. There is no general language delay.
E. There is no severe global cognitive impairment.
What Is The Cause
NLD is caused mostly by problems in the right side of the brain. Problems during pregnancy or birth increase the risk that your child will have NLD, such as:
- A mother who smoked, drank alcohol, or was ill while pregnant
- Very long labor at birth
- Having the umbilical cord wrapped around the neck
- Premature birth or low birth weight
Serious infections as a young infant also may increase the risk. NLD affects boys and girls equally.
Children with NLD may also have autistic spectrum disorder, or other learning disorders that sometimes run in families.
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What Are The Symptoms
Your child may talk early and know more words than other children of the same age. However, your child may have trouble with:
- Learning how to make the shapes of the letters, especially letters like K and Y
- Copying and drawing shapes
- Writing on lines and inside of margins, jumbling words together instead of putting spaces between them, and keeping columns of numbers straight
- Spelling words that cannot be sounded out, such as the word enough
- Not recognizing words that he has previously sounded out over and over, which can make him a slow reader
Your child may also:
- Be clumsy and have many small accidents, such as spilling things
- Have trouble learning to kick or catch a ball, ride a bicycle, or tie his shoes
- Be slower than other children to learn to tell left from right
- Miss or not understand facial gestures and body language cues
- Seem out of touch with others in conversations
- Take things too literally and not understand jokes or sarcasm
Nonverbal Learning Disorder Vs Autism Spectrum Disorder
Autism Spectrum Disorder encompasses a wide range of symptoms that sometimes overlap with signs of other neurodevelopmental disorders and learning disorders. While they may involve similar therapeutic approaches, diagnoses like Nonverbal Learning Disorder and Autism Spectrum Disorder are separate conditions. Most children who meet the criteria for ASD also meet the criteria for NVLD, but the opposite doesnt appear to be true.
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What Are The Best Treatments For Nld
Treatments for NLD are as varied as the symptoms themselves. For children who have trouble with motor skills, treatment by an occupational therapist is important. For those who struggle with social language skills, speech and language therapy is typically prescribed. Physical therapy is the treatment of choice for children who have problems with gross-motor coordination and strength. Other prescribed treatments include:
- An appropriate classroom placement with a low student-teacher ratio
- Social skills training
- Tutoring in reading comprehension, math, writing or executive function skills as needed
- Psychotherapy to treat associated symptoms such as anxiety
- Prescribed medication, in some cases, to treat associated problems of attention, mood, and anxiety
How Is It Treated
Several kinds of therapy can help treat NLD:
- Sensory integration therapy, which is a kind of therapy that uses games to improve your childs sense of touch, sense of movement, and sense of body position
- Social skills training, to help your child learn how to respond to people
- Help from your childâs school with math, reading, spelling, and physical education classes
- Physical therapy, which helps improve your childâs strength and balance
Medicines are generally not helpful for NLD, but may help with some symptoms.
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How Common In Nonverbal Learning Disorder
Once considered highly rare, NLD may also be as prevalent as dyslexia though the high incidence of missed diagnoses makes it difficult to estimate its true impact. We do know that NLD affects girls just as frequently as it does boys, and tends to run in families, like most other learning disabilities.
NLD and anxiety tend go hand in hand, because of the inability to understand and connect with parents, teachers, peers, and spouses. Young children with NLD are usually good at hiding or compensating for their challenges and often charm adults with their precocious conversation skills. But once puberty hits, NLD can cause serious trouble teenagers with the condition often develop extreme anxiety over their inability to connect with their peers trouble setting priorities or picking up social cues may cause an adult with NLD to lose jobs or jeopardize relationships. Many students become school-phobic, and adults with NLD have trouble communicating with coworkers and the boss.
How Symptoms Can Be Misunderstood
Impairments are lifelong and most students only get diagnosed by psychologists or neuropsychologists in the middle to late years of childhood or young adulthood.
In the US and Canada, NLD reportedly affects 1% of the general population. In these two countries, NLD is widely recognised and formally diagnosed. But the same isnt true for Australia here NLD is not well-known or identified.
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Diagnosing A Nonverbal Learning Disability
What is a Nonverbal Learning Disability ?
In general, NVLD is characterized by the discrepancy between an individuals verbal and nonverbal reasoning abilities. Unlike ADHD or a Specific Learning Disorder , NVLD is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition . However, it provides a framework to explain areas of strength and weakness to better understand why an individual may be struggling academically, socially, emotionally, or behaviorally.
Areas of Strength
When individuals present with a NVLD, they often demonstrate relative strengths in the following areas:
- Simple, repetitive motor movements
- Learning and recall of rote, verbal material
- Single word reading and reading decoding skills
In contrast, those with NVLD present with weaknesses in the following areas:
- Visual perception, visual-spatial organization, and visuo-construction skills
- Complex motor skills
- Learning of novel information and generalizing new learning
- Visual spatial learning and memory
- Reading comprehension/Higher order comprehension and reasoning
- Visual and tactile attention
- Aspects of social, emotional, and behavioral functioning
How Can an Evaluation Be Used to Diagnosis an NVLD?
Following the Evaluation
Resources for NVLD
What Nvld Can Look Like
While trouble with social skills is a key difficulty, challenges may show up in other ways, too. Here are some examples:
Remembers information but doesnt know why its important
Pays attention to details but misses the big picture
Struggles with reading comprehension
Struggles with math, especially word problems
Is physically awkward and uncoordinated
Thinks in literal, concrete terms
Misses social cues and misreads situations
Stands too close to people
Is oblivious to peoples reactions
Changes the subject abruptly in conversation
Has trouble adjusting to changes
Has difficulty organizing thoughts
Learn more about trouble with social skills and what can cause it.
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What Is Nonverbal Learning Disorder
Nonverbal learning disorder , otherwise known as nonverbal learning disability, may be the most overlooked, misunderstood, and under-diagnosed learning disability. The brain-based condition is characterized by poor visual, spatial, and organizational skills difficulty recognizing and processing nonverbal cues and poor motor performance.
The name non-verbal learning disorder is confusing it suggests that those with NLD do not speak, but quite the opposite is true. Approximately 93 percent of communication is non-verbal body language, facial expressions, tone of voice. Those with NLD have trouble interpreting this non-verbal language, relying on the seven percent of communication that is verbal to understand what others mean.
Because individuals with NLD rely so much on verbal expression, given their difficulties with body language, facial expressions, tone of voice and other cues, they often talk excessively to compensate for their difficulties a child or adult with NLD will hold you to every word you say. Most children with NLD, as a result, also have large vocabularies and outstanding memory and auditory retention.
How Children Learn To Discover Their Environment
Hanna Mulder, … Marian J. Jongmans, in, 2017
Nonverbal learning disability is the term used to describe people who have normal or even high verbal skills but show weak skills in nonverbal domains, especially in the visuospatial domain. This disability has been of interest to researchers and clinicians since it was described in 1967 by Johnson and Mykelbust and later extensively studied by Rourke . Despite extensive research, the diagnostic criteria of NLD as well as its prevalence are still unclear. Moreover, the symptoms of NLD often resemble that of other disabilities such as Aspergers syndrome . Mammarella and Cornoldi analyzed 35 studies on children with NLD and concluded that the factor that distinguishes children with NLD most from typically developing children is visuospatial intelligence. Other factors are: discrepancy between verbal and nonverbal intelligence, poor visuoconstructive and fine-motor skills, discrepancy between reading achievement and mathematical achievement. In the last group with smaller effect sizes, but still significant differences they list visuospatial memory and socioemotional skills. Based on this analysis, Mammarella and Cornoldi suggested five criteria for diagnosing NLD. The first criterion has to be met and at least two out of criteria 24 also have to be met. The fifth criterion is possibly an associated criterion. The five criteria are:
Irene C. Mammarella, Cesare Cornoldi, in, 2020
How The Definition Was Determined:
The definition on this site was written by researchers at Columbia University Medical Center in collaboration with members of The NVLD Project advisory board. There are numerous potential features of NVLD that are discussed often in clinical circles and that expert clinicians include in decision making about diagnosing a particular individual that are not included in this current definition. Such features were not included in this definition as they have no empirical evidence base at this time.
The NVLD Project recognizes the need for multiple perspectives in determining the most accurate definition of NVLD toward this goal the NVLD Project supported researchers at Columbia University Medical Center to host the second consensus meeting in October 2018 , the goal of which was to bring together experts to discuss the definition and differentiation of NVLD as a syndrome.