How to Identify and Manage Nonverbal Learning Disorder

Medically reviewed by Lyndsey Garbi, MD

Nonverbal learning disorder (NVLD) refers to the lack of certain skills that interfere with a child's ability to learn. People with NVLD have strong verbal and reading skills but lack others (like math, organizational, comprehension, and social skills) that are essential to learning.

NVLD is not an official diagnosis but one that characterizes specific shortcomings (deficits) that fall outside of the definition of learning disabilities like dyslexia, mental disorders like attention-deficit/hyperactivity disorder (ADHD), or developmental disorders like autism. Even so, the symptoms of NVLD are frequently confused with those of dyslexia, ADHD, and autism.

This article explains what nonverbal learning disorder is, including symptoms and causes. It also discusses how NVLD is diagnosed and what options there are for treatment.

What Is Nonverbal Learning Disorder?

Nonverbal learning disorder, also known as nonverbal learning disability, is a condition proposed by researchers at Columbia University Medical Center who identified certain deficits in children who otherwise have normal (or even exceptional) reading and verbal skills.

These include problems with:

• Fine motor skills (like handwriting or using scissors)

• Gross motor skills (like throwing a ball or riding a bike)

• Visual-spatial awareness (including hand-eye coordination)

• Organizational skills (including multitasking and planning)

• Reading comprehension (including problems grasping idioms or metaphors)

• Math skills (including more complicated concepts like fractions and geometry)

• Understanding representational images (like maps or graphs)

• Understanding humor or sarcasm (verbal or written)

• Interpreting nonverbal communication (like facial expressions or tone of voice)
  

What makes NVLD distinctive is that a child can often memorize words and numbers with a high level of skill but be unable to organize them into patterns that enable memory retention and learning.

NVLD is ultimately characterized by the inability to organize relationships, concepts, ideas, and patterns into a unified theme. Without these abilities, a child cannot comprehend and learn at the same level as their peers.

Signs of Nonverbal Learning Disorder

Children with NVLD usually have average to above-average intelligence. Because of this, NVLD can often go unrecognized by parents and teachers who may assume that the child is "not applying themselves" or "not studying hard enough."

Signs of NVLD that are frequently missed include:

• Poor handwriting

• Poor physical coordination and eye-hand coordination

• Problems judging distances or the body's position in space (proprioception)

• Not being able to follow complicated instructions
  

• Problems with fractions or decimals despite having good basic math skills

• Problems with reading comprehension despite being a good reader

• Problems writing an essay despite having good grammar and punctuation

• Problems understanding representational images like charts, maps, or graphs

• Being easily distracted or having trouble staying focused

• Difficulty adapting to changes in routines or situations
  

• Social awkwardness and isolation from peers

• An obsessive engagement in chat rooms or video games that don't involve nonverbal communication

What Causes Nonverbal Learning Disorder?

It is estimated that 3% to 4% of people have NVLD. Children are more notably affected, but adults can also have NVLD and not realize it because they may have found ways to "work around" their deficits. Generally, a person with NVLD always has NVLD.

It is unclear what causes NVLD, but it is thought to involve problems with how the brain processes information. Some experts believe that NVLD is caused by the dysfunction of the brain's frontal lobe, which is responsible for planning and memory

Others contend that it involves the disruption of nerve signals from the right side of the brain (which regulates memory, reasoning, problem-solving, and conceptual thinking) to the left side of the brain (which regulates motor skills, language, math, and linear thinking), and vice versa. This can lead to an inability to unify these functions.

More research is needed.

Diagnosing NVLD

NVLD is recognized as a learning disorder by many psychologists and schools. However, it is not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) used to diagnose conditions like dyslexia, ADHD, and autism.

The diagnosis of NVLD can be difficult as the symptoms overlap with other conditions that affect learning, attention, and communication. While there is no consensus as to how NVLD is diagnosed, several health authorities have proposed the following criteria:

• Poor visual-spatial skills paired with relatively good verbal skills

• Poor fine motor skills paired with poor visual-constructive skills (the ability to represent a three-dimensional object in two dimensions)

• A mismatch between good reading skills and poor math skills

• Poor socioemotional skills (such as recognizing emotions or coping with conflict)

Due to the lack of a clear definition, a comprehensive evaluation by a psychologist is needed. As part of the diagnostic workup, other possible causes need to be excluded.

For example:

• ADHD may be excluded if there are no signs of hyperactivity or impulsivity (despite the presence of inattention).

• Dyslexia may be excluded if math skills are poor but reading and writing skills are good (as dyslexia affects all three learning domains).

• Autism may be excluded if symptoms such as repetitive motions ("stimming"), repetitive speech, ritualized behaviors, or sensory overload are not present.
  

Managing NVLD

There is no "cure" for NVLD and no medications that can improve symptoms. Instead, special accommodations can be made in the classroom to address specific learning deficits. Certain therapies may also help overcome physical or behavioral challenges in children with NVLP.

Classroom Accommodations

Classroom accommodations are changes in the teaching environment that can help a child with learning problems succeed along with their peers.

For people with NVLD, this may include:

• Decluttering the classroom: Such as removing decorations and other visual distractions

• Time-management tools: Such as digital timers, alarm reminders, and daily planners

• Laptop learning: Allowing children to type rather than handwrite

• Audio learning: Including audiobooks and recorded sessions a child can return to when needed

• Restructuring assignments: Such as breaking assignments into smaller parts or using “circle the answer” or “fill in the blank” worksheets that don't require long written answers

• Using rubrics: These are outlines that tell a child what is needed for an "excellent," "good," "satisfactory, or "needs improvement" score

• Written agendas: Such an agenda of daily lectures to signpost key takeaway points
  

• Math tutoring: Using one-on-one verbal teaching rather than written math assignments

Therapies

Depending on the child's needs, certain in-school or private therapies may be useful for managing NVLP symptoms:

• Occupational therapy: To help build fine motor skills

• Physical therapy: To help build gross motor skills and improve coordination

• Social skills training: To build social communication and collaboration skills

• Cognitive behavioral therapy: To improve self-esteem and inattentive behaviors

Summary

If your child has strong speech and reading skills but struggles with math, reading comprehension, physical activities, and social interactions, there is a chance they could have nonverbal learning disorder (NVLD). While there are no medications to treat NVLD, there are accommodations and therapies that can help your child cope with and even thrive with NVLD.

Read the original article on Verywell Health.