THERAPEUTIC THURSDAY: U Ain’t know? What is a Nonverbal learning disability?

What is nonverbal learning disability (NLD)?

Nonverbal learning disability (NLD) is believed by some to be a neuropsychological disability. Although it has been studied for the past 30 years (by Byron Rourke, Ph.D. and others), it has not yet been included as a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV TR). Many characteristics associated with NLD are similar to those that describe other, more “established” disorders, such as Asperger’s Syndrome and specific learning disabilities.

What characteristics are associated with NLD?

NLD is usually defined by a distinct pattern of specific strengths and difficulties.  Individuals thought to have NLD typically demonstrate strengths in the following areas:
• Intelligence quotient (IQ) which is typically in the average to above-average range. Children with NLD tend to have verbal IQ scores that are higher than their performance scores, a factor that distinguishes them from kids with language-based learning disabilities such as dyslexia.
• Rote verbal and expressive and receptive language skills, such as the ability to memorize and repeat a great deal of information presented to them in spoken form. They also exhibit early language development.
• Auditory processing skills, which entail learning better through hearing information, rather than seeing it (visual processing)

Individuals thought to have NLD generally experience difficulties in several broad categories:
• Motor skills, such as graphomotor skills (related to printing and cursive writing), physical coordination, and balance
• Complex conceptual skills involved in problem-solving, understanding cause-effect relationships, and seeing the “big picture” versus focusing on details
• Visual-spatial-organizational skills, such as visualizing information and understanding spatial relations
• Social skills, such as using and understanding nonverbal communication (e.g., gestures, facial expressions), dealing with new information and situations, transitioning between situations, conversation skills, and understanding the nuances of spoken language (e.g., hidden meanings, figurative language)
• Activity level: hyperactivity (when younger), and hypoactivity (as they grow older)

NLD is difficult to diagnose because its manifestations change significantly depending on the child’s age. In general, the deficits involved in NLD get worse as the child gets older. For example, a preschooler with NLD may have exceptional verbal skills and speak like a little adult. During his younger years, the challenges a student with NLD faces are often overlooked because of his high intelligence level and verbal strength.

As the child matures and encounters school work and social situations that require abilities such as abstract thinking and nonverbal communication, his deficits in those areas will become more apparent and problematic.

How might having NLD affect a child’s academic performance?

Students thought to have NLD generally do well in areas that relate to concrete thinking but have difficulty in areas that relate to abstract thinking.  Nevertheless, consider how having NLD might apply to math, reading, and conceptual learning.
• It may be difficult for a child with NLD to understand math concepts and solve problems, but he may have no trouble applying a mathematical formula which he has been explicitly taught. Additionally, due to his poor spatial-organization ability, he may have difficulty aligning problems on a page to solve them correctly.
• With regard to reading, a student with NLD may have strong word decoding skills, but may experience difficulty with reading comprehension, as he may miss inferences, have difficulty visualizing a story, and may not see the “big picture.”
• Children with NLD also experience difficulty when information on assignments and tests is not presented in the exact format in which it was taught. For example, if a child with NLD learned about neighborhoods in social studies using a matching format he may have trouble answering true/false questions about the same information.

How does NLD impact a child’s social life and communication skills?

Because of their uneven profile of strengths and challenges, children with NLD may experience difficulty in their interactions with adults and peers. Children with NLD usually have strong verbal skills; consequently, adults may hold unreasonably high expectations of them. Peers may not understand a child with NLD; for example, peers may be unaware of the child’s inability to understand nonverbal communication and therefore may not know how to interact with him.

A child with NLD tends to take things literally and often misses the point of humor or misinterprets good-natured teasing.

Written by: Anastasia Hubbard, M.S., Brenda Smith Myles, Ph.D.