Nonverbal Learning Disability (NVLD): Possible Signs of NVLD

As a clinician, I became aware of nonverbal learning disability or NVLD in the 1990’s. At that time, little was known about NVLD and the impact it has on people’s lives. Today we know that NVLD is unlike any other learning disability. It affects several areas of daily functioning. Dyslexia, for example, primarily affects reading and written skills. By listening to my NVLD clients, I understood the challenges they faced. I gained valuable firsthand knowledge. I also gathered anecdotal information about the disability. Although the severity and areas of challenge vary from person to person, the symptoms and the struggle are real. The personal stories shared by my clients are fairly consistent. Their challenges are akin to the descriptions provided by current researchers in the field. Based on the accounts of my clients, these are some of the most common symptoms/challenges reported over the years:

Early Signs:

At a young age, children with NVLD  typically achieve developmental language milestones quite early.  They have well developed vocabularies. Children are verbose, articulate and inquisitive. They have a thirst for knowledge and are constantly asking questions. Many parents describe their children as “walking encyclopedias” because of the extensive knowledge they have in areas of interest.

In contrast to their well developed  language skills, motor development is often lagging. One of the early signs of potential problems involves the ability to crawl. Crawling is either absent or atypical. Parents consistently describe crawling as “scooting on their bums” or a type of “military crawl”. As well some report a delay in walking.

NVLD children typically have high levels of anxiety, including separation anxiety. Most infants and toddlers have some level of separation anxiety but NVLD children typically have severe anxiety. Usually, when the parent is no longer in sight, intense meltdowns are common. These meltdowns and tantrums can last for some time and over a long period of time.

The opposite to separation anxiety is also true.  Some children do not have any separation anxiety at all. Instead, they easily and spontaneously approach and talk to strangers. They have little or no fear of strangers. Despite repeatedly reminded, they do not understand the potential dangers and consequences of their friendly behavior.

In school aged children, motor challenges typically surface as fine motor difficulties.  Pencil grip, coloring, cutting, tying shoelaces, and manipulating buttons and zippers are often difficult to learn and acquire. Generally NVLD children have little or no interest in playing with puzzles or constructional toys like Lego’s. Some can creatively build objects with blocks, but have difficulty replicating objects and designs.

Eating is another area of concern most often raised by parents. Many NVLD children are described by their parents as “messy eaters”. Messy eating allows the child to hone in on and develop their fine motor skills and enhances eye-hand coordination. “Messy eating” is a normal and pivotal part of child development and extends into preschool years. Nonetheless, with NVLD children, this phase may last much longer than what is considered representative of the age group.

Sensory issues are also quite common. The child may have sensitivities to certain clothing or textures, sounds, light and/or taste/texture (picky eaters). Tags at the back of their shirts can be burdensome. Seams on their socks, tight shoes, and certain fabrics are also avoided. Loud noises, mushy foods and/or light can be difficult to endure.

Gross motor challenges commonly appear in the form of poor coordination giving rise to clumsiness and/or balance issues. Some children are eventually diagnosed with developmental coordination disorder (DCD). As a result, children with NVLD are either reluctant  or refuse to join in team sports, like soccer or hockey.  If they do join, they often take up the goalie position. Some may have no idea how to play the game. They may not know the direction to run or kick the ball. Learning to ride a bike is also another concern often raised by parents. NVLD children typically take much longer than the neurotypical child to develop this skill. In light of these motor challenges, NVLD children usually prefer individual activities. They choose activities like swimming or dancing.

Socially, NVLD children are quite talkative (when comfortable) and immature relative to their peer group. NVLD children ask a lot of questions in order to fully understand what is going on. Unfortunately, this behavior is often misunderstood and seen as annoying and disruptive, especially in the classroom settings.

Children with NVLD are commonly described as “rude” and inappropriate mainly because of the improper comments they make. Being quite literal, NVLD individuals usually have difficulty understanding jokes and sarcasm. Simply put they are black and white thinkers. Seeing the big picture and understanding situations from someone else’s point of view is quite challenging. Realizing the consequences of their action and the impact it has on others often escapes them.

Understanding personal space, verbal expressions and reading/interpreting body language/nonverbal cues is often underdeveloped. The inability to accurately read social interactions has a profound impact on behavior and level of sensitivity. NVLD children often report feelings of rejection. They may feel they do not fit in or are disliked by their peers. However, this perception may not be accurate. Due to these weaknesses, NVLD children often prefer to watch the social interaction or peer group for a while. They take their time before they are willing to join the group. This behavior is often described as extreme shyness.

Although they want friends, NVLD children often have difficulty making and maintaining friendships. If they have developed a friendship with one or two children, NVLD children tend to overly rely on these friends. Most often NVLD children prefer interacting with older or younger children and adults rather than same aged peers. Play dates and transitions are quite daunting and overwhelming. Due to their social challenges and what is considered as “awkward behaviors”, NVLD children are often the targets of “bullying”. 

NVLD individuals are often described by parents as extremely sensitive, having difficulty controlling and regulating their emotions. Due to a lack of facial expressions, many teachers raise concerns about possible depression or sadness. This concern causes them to also question aspects of the child’s home environment.

Academically, children with NVLD almost always struggle with mathematics, which generally surfaces in the upper elementary grade levels or later. Certain aspects of math are particularly challenging. Understanding concepts, like geometry, decimals, and fractions are problematic. Reading maps and graphs are confusing. Misreading computational symbols and mis-aligning columns are common. Money and time management as well as telling time using an analog clock are next to impossible.

NVLD students usually have excellent decoding or basic reading skills. Nonetheless, they often have difficulty with reading accuracy. This is particularly true when reading sight words. That is they often misread or guess the word. Tracking issues (unintentionally skipping lines or words) are common. Reading comprehension is often weak due to poor inferential reasoning skills. Hence they have a preference for factually based books rather than fictional books.

Written language is another common area of challenge. Letter and/or number reversals and poor handwriting/letter formation are present.  Weaknesses in visual organization often surface as difficulty writing on the line and to the margin. They also have trouble knowing where to write the date, name, and where to start when an essay.  Spacing between letters and words and the size of letters are often inconsistent. NVLD students almost always prefer to print, as cursive writing is often difficult to master. They have difficulty with punctuation and capitalization, despite repeated attempts at teaching and reminding them of these rules.

Additionally, students with NVLD are reluctant to engage in visually based tasks. These tasks require so much effort and time to complete. Instead they often resort to avoidance and/or disruptive behaviors. Since they are quite verbal and articulate, people often view their reluctance to work as sheer laziness. It can also be perceived as stubbornness, oppositional behavior, or plain defiance. NVLD students are often overwhelmed when faced with too much information on the page. They may even panic during tests. This is especially true when the print is smaller than usual or unfamiliar to them.

Adult Signs:

Many adult clients struggle with significant and at times paralyzing anxiety, particularly social anxiety, depression and/or chronic fatigue. Many have consulted with several therapists specializing in various therapeutic approaches to resolve their emotional distress, yet without much success. Their emotional distress continued. Many then start to question other disorders, including attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD).

A history of school failures is also typical, especially in math and science. They often excel in language based courses and did extremely well in oral presentations and debates. Many are faced with work related challenges. The slightest change in work tasks/demands can cause significant distress and anxiety. NVLD individuals usually work much harder than their peers to achieve the same or similar outcomes. As a result, they have difficulty sustaining the effort needed to finish the task.

Many clients report relationship and intimacy issues. Making and maintaining friendships, crowds, going to shopping malls or grocery stores are quite stressful. Adhering to recipes, measuring ingredients and cooking in general is taxing.  Some manage by cooking the same thing over and over again while others engage in “creative” cooking. Heightened sensitivity to sounds, smells, touch and/or tastes may also be present.

Organizing their personal space and keeping things tidy is challenging. Some live with chaos and clutter. Others are extremely organized and become quite upset when things are moved or positioned differently. Simple things are effortful. Making the bed, tucking in the sheets and blankets, folding laundry, and even grooming need significant effort. Multi-tasking, paying bills, and maintaining a budget require a lot of time and effort. For some, it is just beyond their capability.  

Driving is also another source of stress, especially when traveling to new or uncommon places. Using maps and written directions, and differentiating between left and right are not quite mastered. Parallel  or reverse parking, especially in tight spaces is anxiety provoking and often avoided. As expected, “fender benders” are common.

Intervention:

Unfortunately, NVLD individuals are not fully understood and are often viewed as more capable than they truly are. The discrepancy between well developed verbal skills and an inability to do a variety of tasks, leads to inaccurate perceptions. Many are described as lazy, unmotivated or even stubborn and oppositional. They just do not put in the work and effort needed to succeed. Not understanding and meeting the needs of individuals with NVLD harms their socio emotional well-being. It affects their functioning in society. and can result in years of distress and failure, no matter how smart they are.

A neuropsychological assessment is needed to rule out the presence of NVLD. The assessment must include parent and/or client interviews. But above all else, the psychologist/neuropsychologist must have excellent knowledge of NVLD. They need to have sufficient knowledge to rule out alternative disorders as NVLD symptoms overlap with other disorders. The diagram below sums up at a glance the link between NVLD and other disorders. The need for a precise assessment is critical to the individual’s well-being and future success.

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