Although the concept of NVLD (nonverbal learning disabilities) has been around for decades, it is still not fully understood. The DSM-5, the psychiatric diagnostic manual commonly used in the US, does not include the NVLD diagnosis and there is still ongoing debate over the definition of NVLD. Yet there is no question that visual-spatial challenges can greatly affect learning, as well as well the ability to function well beyond the academics.
Visual-spatial deficits in the presence of stronger language reasoning abilities are at the core of NVLD. Some argue that the diagnosis should be limited to the visuospatial difficulties and their impact on academic functioning, much like dyslexia impacts specifically reading. Others believe that the core symptoms of NVLD also include deficits in visual executive functions, math, motor, and social skills, making it a more general disability.
NVLD as a Specific Learning Disability
If NVLD is a specific learning disability, it must affect functioning in the academic setting. What might that look like? Math is often an area of difficulty. If learning math is affected specifically by the visual-spatial weakness, certain aspects of math should be more affected than others. For instance, it would be reasonable to expect that geometry would be more affected than word problems. Calculations relying heavily on the spatial arrangement of the numbers, such as long division, would be more challenging that mental math, such as quick retrieval of math facts. Subjects that rely on 3D visualization, such as organic chemistry, or architecture, may feel particularly insurmountable. Even some aspects of reading and writing, such as inferring non-literal meaning or organizing paragraphs and spacing words properly in an essay can be a challenge.
NVLD as a General Disability
Visual-spatial weaknesses can affect functioning well beyond the school setting. Reading maps, diagrams, and assembly instructions can be puzzling and frustrating to someone with NVLD. Misjudging space while driving can result in broken side mirrors or even accidents. Having to rely on verbal skills to facilitate functioning is commonplace. For instance, a person with NVLD will often try to verbalize aspects of a picture, as remembering that “a triangle is above the rectangle” is much easier than trying to recall the visual image of the two. One client shared that she learned to knit by listening to a podcast as observing someone else knit was not at all helpful.
Social Challenges in NVLD
Problems in a social setting may arise from the visual-spatial difficulties. Difficulty gauging interpersonal space, trouble understanding subtle changes in facial expression or repeatedly stepping on others’ toes when walking may create social challenges. However, many children and adults experience social problems that are not directly related to visuospatial skills. Some worry about saying the wrong thing, being too loud, perceived as weird or having a strange sense of humor. Others may have trouble understanding humor or sarcasm. Anxiety is common among those with NVLD and many social difficulties can be related to the anxiety rather than the underling neurological deficits of NVLD.
Some researchers argue that because social skills deficits are a core feature of autism spectrum disorder (ASD), autism must be ruled out before an NVLD diagnosis can be considered. Others allow that NVLD and ASD may coexist if the diagnostic criteria are met for both conditions.
Diagnosing NVLD
While we hope that the field will eventually reach a diagnostic consensus, as clinicians, we look for a pattern of non-verbal cognitive weaknesses and their impact on learning and functioning as we assess for NVLD. With many possible features, every person with NVLD faces many similar challenges yet has an individual profile of strengths and weakness. A neuropsychological evaluation is often particularly helpful in identifying the unique challenges and strengths and helping develop and implement interventions to best support a child, teen, or adult with NVLD.
For more information: https://nvld.org/