Nonverbal learning disorder

Source: Wikipedia, the free encyclopedia.
For the autism condition where a person never learns to speak, see Nonverbal autism.

Nonverbal learning disorder
Other namesNonverbal learning difficulties
SpecialtyNeurology/psychiatry
FrequencyCurrently unknown, estimated to be around 3%[1]

Nonverbal learning disability (NVLD) is a proposed category of neurodevelopmental disorder characterized by core deficits in visual-spatial processing and a significant discrepancy between verbal and nonverbal intelligence (where verbal intelligence is higher).[2] A review of papers found that proposed diagnostic criteria were inconsistent.[2] Proposed additional diagnostic criteria include intact verbal intelligence, and deficits in the following: visuoconstruction abilities, speech prosody,[3] fine motor coordination, mathematical reasoning, visuospatial memory and social skills.[4][5][6][7] NVLD is not recognised by the DSM-5 and is not clinically distinct from learning disorder.[8]

NVLD's symptoms can overlap with symptoms of autism spectrum, bipolar disorder, and ADHD. For this reason, some claim a diagnosis of NVLD is more appropriate in some subset of these cases.[3][9]

Signs and symptoms

A plain clock, with the hands pointing to 8:31
Using an analog clock to tell time is difficult for people with symptoms of NVLD.

Considered to be neurologically based,[10][11] nonverbal learning disorder is characterized by:

  • impairments in visuospatial processing
  • discrepancy between average to superior verbal abilities and impaired nonverbal abilities such as:

People with NVLD may have trouble understanding charts,

analog clock to tell time. "Clumsiness" is common in people with NVLD, especially children, and it may take a child with NVLD longer than usual to learn how to tie shoelaces or to ride a bicycle.[9]

At the beginning of their school careers, children with symptoms of NVLD struggle with tasks that require eye–hand coordination, such as coloring and using scissors, but often excel at memorizing verbal content, spelling, and reading once the shapes of the letters are learned. A child with NVLD's Average or Superior verbal skills can be misattributed to attention deficit hyperactivity disorder, defiant behavior, inattention, or lack of effort.[9] Early researchers in the syndrome of NVLD Johnson and Myklebust characterize how the children appear in a classroom: "An example is the child who fails to learn the meaning of the actions of others [...] We categorize this child as having a deficiency in social perception, meaning that he has an inability which precludes acquiring the significance of basic nonverbal aspects of daily living, though his verbal level of intelligence falls within or above the average."[12]

In the adolescent years, when schoolwork becomes more abstract and the executive demands for time management, organization, and social interactions increase, students with NVLD begin to struggle. They focus on separate details and struggle to summarize information or to integrate ideas into a coherent whole, and they struggle to apply knowledge to other situations, to infer implicit information, to make predictions, and to organize information logically.[9]

As adults, tasks such as driving a car or navigating to an unfamiliar location may be difficult. Difficulty with keeping track of responsibilities or managing social interactions may affect job performance.[9]

People with NVLD may also fit the diagnostic criteria of dyscalculia,[13][14] dysgraphia,[15][16][17] or dyspraxia.[18][19]

Cause

Research suggests that there is an association with an imbalance of neural activity in the right hemisphere of the brain connected to the white matter.[10]

Diagnosis

Nonverbal learning disability (NVLD) is characterized by core deficits in visualspatial processing and social impairment.[10] Additional proposed diagnostic criteria include average to superior verbal intelligence and deficits in visuoconstruction abilities, fine motor coordination, mathematical reasoning, visuospatial memory and social skills.[5]

"While NVLD is not classified into any distinct diagnosis in DSM-5 (American Psychiatric Association, 2013) or ICD-10 (World Health Organization, 1992), it does have a robust research base."[20][21][22] "The majority of researchers and clinicians agree that the profile of NLD clearly exists [...] but they disagree on the need for a specific clinical category and on the criteria for its identification." (One researcher notes: "just because we cannot reasonably place such children into our present classification scheme does not mean they do not exist."[23])

Assorted diagnoses have been discussed as sharing symptoms with NVLD. In some cases, especially the form of autism previously called Asperger syndrome, the overlap can be significant; a major clinical difference is that NVLD criteria do not mention the presence or absence of either repetitive behaviors or narrow subject-matter interests,[9] which is part of the diagnostic criteria for autism.[24] These overlapping conditions include, among others:

There is diagnostic overlap between nonverbal learning disorder and autism spectrum, and some clinicians and researchers consider them to be the same condition.[9][7] Some claim that some diagnoses of attention deficit hyperactivity disorder would be more appropriately classified as NVLD.[9]

History

While various nonverbal learning difficulties were recognized since early studies in child neurology,[33] there is ongoing debate as to whether/or the extent to which existing conceptions of NVLD provide a valid diagnostic framework.[34][35]

As presented in 1967, "nonverbal disabilities" (p. 44) or "disorders of nonverbal learning" was a category encompassing non-linguistic learning problems.[12] "Nonverbal learning disabilities" were further discussed by Myklebust in 1975 as representing a subtype of learning "disability" with a range of presentations involving "mainly visual cognitive processing," social imperception, a gap between higher verbal ability and lower nonverbal processing, as well as difficulty with handwriting.[36] Later neuropsychologist Byron Rourke[37] sought to develop consistent criteria with a theory and model of brain functioning that would establish NVLD as a distinct syndrome (1989).[38]

Questions remain about how best to frame the perceptual, cognitive and motor issues associated with NVLD.[11][39][40][5]

See also

References

  1. PMID 32275324
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  2. ^
    S2CID 233382776
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  3. ^ a b c "Does your patient have a psychiatric illness or nonverbal learning disorder?" (PDF). Current Psychiatry.
  4. S2CID 34107811
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  5. ^ a b c d Mammarella & Cornoldi 2014, pp. 255–280.
  6. OCLC 1080078884
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  7. ^
    S2CID 12655825
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  8. S2CID 206423076
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  9. ^ a b c d e f g h i Doty 2019, pp. 103–106.
  10. ^
    PMID 33856654
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  11. ^
    S2CID 15495423
    .
  12. ^
    ISBN 978-0-8089-0219-5
    .
  13. S2CID 46413188
    .
  14. PMID 20161681
    .
  15. S2CID 46398326
    .
  16. ISBN 978-0-89862-378-9
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  17. ISBN 978-0-323-26649-9
    .
  18. PMID 15871436
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  19. ^ Solodow, William; Sandy, Sandra V.; Leventhal, Fern; Beszylko, Scott; Shepherd, Margaret Jo; Cohen, Jonathan; Goldman, Shoshana; Perry, Richard; Chang, Jennifer J.; Nass, Ruth (Fall 2006). "Frequency and Diagnostic Criteria for Nonverbal Learning Disabilities in a General Learning Disability School Cohort". Thalamus. 24 (1): 17–33.
  20. S2CID 150281995
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  21. ^ Horn, Nnifer L., PhD, HSPP. "An Overview of Learning Disabilities." http://beaconindiana.com/pdfs/OverviewOfLDs.pdf San Mateo, CA: Schwab Learning, 2002. N. pag. Web.
  22. ^ Mammarella & Cornoldi 2014, pp. 255–280, 256.
  23. S2CID 12655825
    .
  24. ^ CDC (2 November 2022). "Diagnostic Criteria | Autism Spectrum Disorder (ASD) | NCBDDD | CDC". Centers for Disease Control and Prevention. Retrieved 8 April 2023.
  25. ^ a b c Doty 2019, p. 110.
  26. ^ a b Mary Dobbins, M. D.; Theodore Sunder, M. D.; Stephen Soltys, M. D. (1 August 2007). "Nonverbal Learning Disabilities and Sensory Processing Disorders". Psychiatric Times Vol 24 No 9. 24. {{cite journal}}: Cite journal requires |journal= (help)
  27. ISBN 978-1-4833-2268-1
    .
  28. ISBN 978-0-471-67798-7
    .
  29. ISBN 978-1-4419-1698-3
    .
  30. ^ Manoach, Dara Sue; Sandson, Thomas A.; Weintraub, Sandra (April 1995). "The Developmental Social-Emotional Processing Disorder Is Associated with Right Hemisphere Abnormalities". Neuropsychiatry, Neuropsychology & Behavioral Neurology. 8 (2): 99–105. INIST 3510330.
  31. PMID 2181523
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  32. ISBN 978-0-387-79948-3
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  33. ISBN 978-0-930405-26-7
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  34. ^ Pollak, Jerrold (July 2011). "Differentiating NLD". Current Psychiatry. 10 (7). Archived from the original on 16 July 2019.
  35. ^ Admin, LD I. "DSM-V to Exclude Asperger's, PDD-NOS & NLD in 2013; Wait, What? | Life Development Institute." Life Development Institute. N.p., 2 June 2011. Web. 06 Sept. 2016.http://discoverldi.com/dsm-v-to-exclude-aspergers-pdd-nos-wait-what/
  36. ISSN 0079-6387
    .
  37. S2CID 145142840
    .
  38. ISBN 978-0-89862-378-9.[page needed
    ]
  39. S2CID 31974898
    .
  40. ISBN 978-1-4419-8213-1
    .

Further reading

Books

By Authors with NVLD

External links
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