Overview of Nonverbal Learning Disability
by Leslie E. Packer, PhD
This article last updated February, 2009
Although it is not yet recognized as a formal diagnosis with agreed-upon diagnostic criteria and it appears that it will not be included in the DSM-5, Nonverbal Learning Disability (NLD) is usually described as a syndrome characterized by a pattern of unusual strengths and deficits thought to be due to dysfunction in the right hemisphere of the brain.
In terms of unusual strengths, children and teenagers with NLD often have a history of early speech and vocabulary development. They may have outstanding rote memory skills and attention to auditory detail. They also often have a history of early reading development and advanced or precocious spelling skills.
As gifted as they appear in these aspects of their skills development, however, they tend to have major deficits in other skills and aspects of functioning. For example, while children with NLD can decode text with relative fluency, they may struggle to comprehend what they are reading due to difficulty in organization and higher level reasoning. Do not let their strong rote memory or attention to detail mislead you: these children “see every tree but can’t understand a forest.” Although they may have an excellent retention of material presented orally, they don’t always comprehend or “get” the subtleties and nuances of language. Impaired in problem-solving skills, they may fail to apply or generalize previously learned skills to new situations or materials. Impairments in problem-solving skills also impair the child or teen socially as they are unable to figure out what to do in social situations or how to respond to the unexpected.
The discrepant skills development may also be manifest in mathematics. Because of their advanced rote memorization skills, they may find it easy to memorize their math facts or equations, but when it comes to applying the information, they may struggle, often displaying poor visual attention to the various algebraic signs. Visual-spatial deficits are also reflected in poor visual recall, faulty space perceptions, and poor sense of directionality. Indeed, poor comprehension of visually presented material is one of the hallmark characteristics of NLD, and there is often (but not always) a significant Verbal IQ – Performance IQ discrepancy on intelligence tests (with VIQ significantly higher than PIQ which is impacted by severe visual-spatial deficits).
In general, children and teens with NLD may function relatively normally when presented with verbally mediated information, but they do poorly in coping with nonverbal information. This impairment not only affects their academic functioning, but also impairs them socially. Social anxiety, avoidance behavior, and depression often emerge, particularly in adolescence, where the inability to develop and maintain normal social relationships becomes more obvious to others.
On a motoric level, students with NLD also appear to be clumsy, and many will have balance problems as well as graphomotor or handwriting impairment. Handwriting issues are more pronounced in younger children and tends to improve with age.
Calling NLD a “learning disability” is a bit of a misnomer as the deficits do not seem to be remediated through a typical learning disability approach.
PROFILE OF NLD
The “profile” of a children or teenagers with NLD depends on which author or researcher you read, as there are no agreed-upon diagnostic criteria. Thus, Telzrow and Bonar (2002) identify the profile of an NLD student as one who has:
- Stronger verbal than perceptual cognitive skills
- Weak psychomotor and perceptual motor skills
- Deficiency in arithmetic
- Difficulty with novel and complex tasks
- Poor problem-solving skills
- Social and interpersonal deficits
- Psychosocial adjustment problems
The NLDA, an organization devoted to nonverbal learning disorders, provides its own perspective on the characteristic features of a child or teenager with NLD:
- Bilateral tactile-perceptual deficits
- Bilateral psychomotor coordination deficits
- Outstanding deficiencies in visual-spatial-organizational abilities
- Deficits in the areas of nonverbal problem solving, concept formation, hypothesis testing
- Difficulty dealing with negative feedback in novel or complex situations
- Difficulties in dealing with cause-effect relationships
- Difficulties in the appreciation of incongruities
- Well-developed rote verbal capacities and rote verbal memory skills
- Over-reliance on prosaic rote, and consequently inappropriate, behaviors in unfamiliar situations
- Relative deficiencies in mechanical arithmetic as compared to proficiencies in reading (word recognition) and spelling
- Rote and repetitive verbosity
- Content disorders of language
- Poor psycholinguistic pragmatics (cocktail party speech)
- Poor speech prosody
- Reliance on language for social relating, information gathering, and relief from anxiety
- Misspelling almost exclusively of the phonetically accurate variety
- Significant deficits in social perception, social judgment, and social interaction skills
- Marked tendency for social withdrawal and isolation as age increases
- High risk for social-emotional disturbance if no appropriate intervention is undertaken
As should be clear from the preceding discussion, NLD is a syndrome of assets and deficits. The combination and extent of assets and deficits will vary across individuals. Most individuals with NLD, however, will exhibit a pattern of relative impairment in social perception, visual-spatial abilities, and mechanical arithmetic, with well developed verbal skills and rote memory.