What Is Nonverbal Learning Disorder?
Nonverbal learning disorder is a type of learning disability. Learning disabilities are characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social and practical adaptive skills. Such disabilities typically originate before age 18.
Over the past decade, important changes have been made in disability terminology, resulting in the renaming of mental retardation to intellectual disability. Though this disability, which has a major impact on a patient’s life, is sometimes hard to diagnose, medical science has developed a better understanding of its causes.
Learning disabilities are disorders that affect the ability to:
- Understand or use spoken or written language
- Do mathematical calculations
- Coordinate movements
- Direct attention
Learning disabilities occur in very young children, yet they are usually not noticed until the child reaches school age. Learning disabilities can be lifelong conditions with a range of impacts and accommodation requirements.
In some people, several overlapping learning disabilities may occur, with frequent overlap of attention-deficit disorder (ADD) and attention-deficit/hyperactivity disorder (ADHD) diagnoses. Other people may have a single, isolated learning problem that has little impact on their lives.
There is some incidence of learning disabilities in adults, such as adult-onset dyslexia. This usually occurs as a result of brain injury or dementia. However, some adults with dyslexia were never diagnosed with dyslexia as children or adolescents. Dyslexia can be inherited; recent studies have identified a number of genes that may predispose a person to developing dyslexia.
There are four broad categories of intellectual disabilities:
- Reasoning skills and how ideas and thoughts are communicated and integrated
- Math and calculation concepts
- Reading, writing or spelling
- Speaking and listening
Indicators of nonverbal learning disorder (NLD) include challenges with social cues and comprehension. Additionally, children with NLD struggle with social, motor and visual/spatial skills.
Types of Nonverbal Learning Disorders
Indicators of nonverbal learning disorder (NLD) include challenges with social cues and comprehension. Additionally, children with NLD struggle with social, motor and visual/spatial skills.
The types of issues those with a diagnosis of NLD include:
- Visual and Spatial Awareness: Trouble understanding visual imagery; inability to conceptualize concepts visually as well as trouble understanding the relationships between two objects and their physical proximity
- Higher-Order Comprehension: Grasping the main idea of a concept, the details that support the idea and their relationship to each other
- Social Communication: Trouble reading facial cues and emotions in others, as well as body language; trouble with social communication
- Math Concepts: Trouble solving more advanced math problems, including recognizing concepts, and patterns
- Executive Functions: Trouble organizing plans, thinking, and carrying out actions; projects are challenging as the person can’t break down the larger idea into smaller pieces
Causes of Nonverbal Learning Disorder
Most developmental disabilities are thought to be caused by a complex mix of factors. These factors include genetics, parental health and behaviors (such as smoking and drinking) during pregnancy, complications during birth, infections the mother might have during pregnancy or the baby might have very early in life, and exposure of the mother or child to high levels of environmental toxins, such as lead. For some developmental disabilities, such as fetal alcohol syndrome, which is caused by drinking alcohol during pregnancy, we know the cause. But for most, we don’t.
Studies have shown that NLD typically results in problems with the right side of the brain. Mothers who drank alcohol, were ill, or who smoked during pregnancy increased the risk of NLD in their babies.
Risk Factors for Nonverbal Learning Disorder
Most developmental disabilities are thought to be caused by a complex mix of factors. These factors include genetics, parental health and behaviors (such as smoking and drinking) during pregnancy, complications during birth, infections the mother might have during pregnancy or the baby might have very early in life, and exposure of the mother or child to high levels of environmental toxins, such as lead. For some developmental disabilities, such as fetal alcohol syndrome, which is caused by drinking alcohol during pregnancy, we know the cause. But for most, we don’t.
Following are some examples of what we know about specific developmental disabilities:
- At least 25 percent of hearing loss among babies is due to maternal infections during pregnancy, such as cytomegalovirus (CMV) infection, complications after birth and head trauma.
- Some of the most common known causes of intellectual disability include fetal alcohol syndrome disorder, genetic and chromosomal conditions such as Down syndrome and fragile X syndrome, and certain infections during pregnancy.
- Children who have a sibling with autism spectrum disorder are at a higher risk of also having autism spectrum disorder.
- Low birthweight, premature birth, multiple birth and infections during pregnancy are associated with an increased risk for many developmental disabilities.
- Untreated newborn jaundice (high levels of bilirubin in the blood during the first few days after birth) can cause a type of brain damage known as kernicterus. Children with kernicterus are more likely to have cerebral palsy, hearing and vision problems, and problems with their teeth. Early detection and treatment of newborn jaundice can prevent kernicterus.
Studies have shown that NLD typically results in problems with the right side of the brain. Mothers who drank alcohol, were ill, or who smoked during pregnancy increased the risk of NLD in their babies.
Screening for & Preventing Nonverbal Learning Disorder
Healthcare providers can play an important part in collaborating with schools to help a child with learning disorders or other disabilities get the special services they need. The American Academy of Pediatrics (AAP) has created a report that describes the roles that healthcare providers can have in helping children with disabilities, including learning disorders:
- Identifying children in need of early intervention or special education services
- Sharing relevant information with early intervention or school personnel
- Meeting with early intervention or school personnel and parents or guardians
- Using early intervention or school information in medical diagnostic or treatment plans
- Working within an early intervention, school or school-based health clinic
- Working at an administrative level to improve school functioning around children with special needs
Screening tools include common achievement tests that focus on skills such as math, writing and reading, such as the Woodcock-Johnson Tests of Achievement (WJ), the Wechsler Individual Achievement Test (WIAT), the Kaufman Test of Educational Achievement (KTEA) and the Wide Range Achievement Test (WRAT).
Signs & Symptoms of Nonverbal Learning Disorder
This disorder affects the ability to recognize and interpret nonverbal communication, including facial expressions and body language.
Some symptoms of NLD include:
- Poor organization skills
- Poor planning
- Hyper-talkativeness
- Difficulty with projects, and reducing the big picture down to smaller parts
- Poor problem-solving skills
- Inability to read social cues
- Trouble judging distance
- Poor physical coordination
Diagnosing Nonverbal Learning Disorder
Children with learning disorders may feel frustrated that they cannot master a subject despite trying hard, and they may act out, act helpless or withdraw. Learning disorders can also be present with emotional or behavioral disorders, such as attention-deficit/hyperactivity disorder (ADHD), or anxiety. The combination of problems can make it particularly hard for a child to succeed in school. Properly diagnosing each disorder is crucial so that the child can get the right kind of help for each.
Many children may struggle in school with some topics or skills from time to time. When children try hard and still struggle with a specific set of skills over time, it could be a sign of a learning disorder. Having a learning disorder means that a child has difficulty in one or more areas of learning, even when overall intelligence or motivation is not affected.
Children with a displayed lack of achievement may be diagnosed just as commonly as those of average or above-average intelligence. Discrepancies may exist from one type of diagnosis to another, with variations depending on the individual. Learning disabilities and deficiencies in information processing can make learning and communication challenging or impossible.
Screening tools for diagnosing NLD include common achievement tests that focus on skills such as math, writing and reading, such as the Woodcock-Johnson Tests of Achievement (WJ), the Wechsler Individual Achievement Test (WIAT), the Kaufman Test of Educational Achievement (KTEA) and the Wide Range Achievement Test (WRAT).
Treating Nonverbal Learning Disorder
Symptoms of NLD vary from one case to another, but a diagnosis will help develop a plan to meet each child’s needs. While medication is not a solution for NLD, the following interventions may be helpful in treating symptoms:
- Academic tutoring
- Sensory integration therapy
- Occupational therapy
- Physical therapy
- Social skills training
Additionally, these strategies or workarounds can be helpful for development:
- Avoiding burnout
- Typing instead of printing
- Keeping a planner to help your child stay organized
- Recording classes
- Prepare your child for transitions
- Speaking plainly, avoiding sarcasm and being very literal
Living with Nonverbal Learning Disorder
The following strategies or workarounds can be helpful for development:
- Avoiding burnout
- Typing instead of printing
- Keeping a planner to help your child stay organized
- Recording classes
- Prepare your child for transitions
- Speaking plainly, avoiding sarcasm and being very literal
To develop a better understanding of your diagnosis, consider participating in a clinical trial so clinicians and scientists can learn more about learning disabilities and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat or prevent disease.
All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.
For information about participating in clinical research, visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for participants at Clinicaltrials.gov.