What Is A Nonverbal Learning Disability?

Girl sitting bored in class


Posted in: Grade School, Parenting Concerns, You & Your Family

Topics: Learning + Attention Issues

A nonverbal learning disability (NLD) is a syndrome that includes challenges in visual-spatial organization, nonverbal problem solving, and social skills. Despite often having strong verbal abilities, children with NLD have trouble understanding humor and adapting to new situations. In school, they generally have better reading skills than math skills, and they often struggle with writing skills and executive functions.  Challenges interacting and making good judgement calls in social situations are often considered part of this diagnosis.  

Although this diagnosis is frequently used, there is some disagreement as to its validity and exactly what it means. There is a lot of overlap with this disorder and autism spectrum (especially high-functioning autism), and some experts think this may be the same disorder viewed with different lenses. Other professionals argue that these are two different disorders and that NLD is a valid diagnosis. However, it is not a disorder in the DSM-V, the diagnostic manual used by psychiatrists and psychologists. 

What we do know about NLD is that the deficits that children have are multi-faceted and include at least some or most of the following symptoms: 

  • Lower nonverbal IQ scores (i.e., Perceptual Reasoning on the WISC-V) as compared to verbal IQ scores (i.e., Verbal Comprehension on the WISC-V) 
  • Academic weaknesses in written expression, math and/or reading comprehension 
  • Fine motor skills weaknesses 
  • Poor social skills 
  • Gross-motor coordination weaknesses 
  • Issues with abstract language and pragmatic language 
  • Trouble organizing themselves
  • Problems shifting from one task to another 
  • Associated emotional issues such as anxiety, emotional outbursts, and withdrawal 

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 child’s 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. 

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 casesto treat associated problems of attention, mood, and anxiety 

Many, if not most, children with a nonverbal learning disability are quite capable of succeeding in school and having satisfyingcompetitive careers – particularly if they receive appropriate treatment. Getting an appropriate diagnosis that focuses the treatment on the specific areas of need is important. Finding the right treatment resources can be difficult, as there is a lack of good tutors and allied services providers in many areas of the country – but be persistent! One of the most important things parents can do is to educate themselves on their child’s disability, as it puts them in a much better position to advocate for their child’s services. Working together with the school and service providers, while remaining your child’s primary advocate, is key. Research in the field of learning disabilities is constantly yielding advances in understanding and treating NLD, and there is much reason to stay hopeful in the diagnosis and treatment of children with a wide variety of learning issues.   

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Ellen Braaten, PhD

Ellen Braaten, PhD

Ellen Braaten, PhD, is executive director of the Learning and Emotional Assessment Program (LEAP) at  Massachusetts General Hospital (MGH), an associate professor of psychology at Harvard Medical School, and former co-director for the MGH Clay Cente...

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