Nonverbal learning disorder

Nonverbal learning disorder or nonverbal learning disability (NLD or NVLD) is a condition characterized by a significant discrepancy between high verbal and lower performance scores on an IQ test, with deficits in motor, visual-spatial, and social skills. Some proponents of the category believe that this discrepancy is attributable to dysfunction in the right cerebral hemisphere.

NLD involves deficits in perception, coordination, socialisation, non-verbal problem-solving and understanding of humour, along with well-developed rote memory. As most people with Asperger syndrome (AS) fit the criteria for NVLD, a diagnosis of AS is often preferred. In this instance, some researchers assert that an AS diagnosis is more clinically useful than an NVLD diagnosis, and argue that NVLD would be an example of excessive diagnostic splitting. However, NVLD can also occur with other disorders. However, like Asperger syndrome, NVLD exists on a spectrum, and those affected can experience it in a range of ways. Those with an NVLD can experience some or all of the symptoms, and to varying degrees. Ongoing debate surrounds the relationship between Asperger syndrome and NVLD, as research on the condition is ongoing and procedures can differ from AS research.

Symptoms

Non-verbal communication

People with this disability may misunderstand non-verbal communications, or they may understand the communications but be unable to formulate an appropriate response. This can make establishing and maintaining social contacts difficult. Eye contact can also be difficult for people with NVLD, either because they are uncomfortable with maintaining it or because they do not remember that others expect it. Similarly, knowing when and how to use physical contact and recognizing emotions in others and expressing them for oneself can be problematic. Their own emotions may cause them serious confusion.

Verbal communication

People with NVLD will often tend to lapse into "cocktail-speech", talking too much and too quickly, especially when they feel as if they have lost control of their situation. Speaking is a way for them to try to regain control. People with NVLD have strong verbal communication skills and must often rely on verbal communication as their main method of gathering information. Trying to process too many non-verbal stimuli can confuse them.

Numerical and spatial awareness

Arithmetic and mathematics can be very difficult for people with NLD, and they often have problems with spatial awareness. Problematic areas may include:

• Recognizing faces
• Paying attention in noisy environments
• Navigation
• In mathematics: the confusion of X-axis and Y-axis
• Remembering the names and locations of places
• Map reading, or plotting or remembering routes. People with NLD are often best-served by giving landmarks along with repeated directions.
• Estimating the speed of cars while crossing the road

Motor

People with NLVD often have motor difficulties. This can manifest in their walking and running, which are sometimes stiff, or in difficult balancing. They may also be more likely to run into things, due to judging distances poorly. Fine motor skills can also develop abnormally, causing difficulty with writing, drawing, and tying shoelaces. NVLD sufferers are often labeled as "clumsy" or "stiff".

Anxiety

People with NLD, more than many others, fear failure. They often can not size up their situation, feel that they have to do too much at once, and then do not know where to start. This allows them to stagnate, and then do nothing. Sometimes they try to multitask and again end up doing nothing, which can lead to frustration or even aggressive behavior. Because they lack the ability to take an overarching view of tasks, they experience the world around them as a chaos, the actions that they must perform well and so quickly creating a paralyzing sense of helplessness. Clumsiness in performing tasks is often criticized by teachers or in the workplace, causing further fear of failure.

Treatment

Sometimes antidepressants are prescribed, but an effect has not been scientifically proven. Many people with NVLD also suffer with chronic fatigue from the constant chaos that they experience around them. Medication such as Ritalin and Concerta can help some more grip on the world. If these medications can help the person manage the perceived chaos, this also has a positive psychological impact on the NLD sufferer. The person feels that there are opportunities to break the vicious circle of anxiety.

However, for all NVLD cases, any drug treatment is a matter of trial and error. Most people who are newly diagnosed with NVLD benefit from special education or specialized psychological support, which can help them get a better view on what their strengths are and how to work toward minimizing their weaknesses.

Management

NVLD is not curable, but patient outcomes depend greatly on how the condition is approached. Assistance strategies may include:

• Giving verbal (and only verbal) instructions
• Maximizing positive interaction
• Paying attention to what patients do rather than only what they are saying, to prevent patients from becoming overwhelmed
• Providing structure in daily activities
• Preparing for new things and situations
• Creating a peaceful environment
• Repetition of what may be said and what may not. It takes a relatively long time for NLD sufferers to obey the rules. Realize that while children with NLD will not deliberately disobey, they are overwhelmed by a maze of what they perceive as unclear information. Caregivers becoming angry only heightens the sense of failure
• Avoiding symbolic language, like "give me your hand". NVLD'ers will take it literally
• Providing highly-structured courses with plenty of space between each piece and clear numbering, titles, and subtitles
• Avoiding the use of sarcasm, as patients often take it literally and are hurt by it

References

Sources

Nonverbal learning disability

• Silver CH, Ring J, Pennett HD, Black JL (2007). "Verbal and visual short-term memory in children with arithmetic disabilities". Developmental Neuropsychology. 32 (3): 847–860. doi:10.1080/87565640701539717. ISSN 8756-5641. PMID 17956185. {{cite journal}}: Unknown parameter |doi_brokendate= ignored (|doi-broken-date= suggested) (help)CS1 maint: multiple names: authors list (link)
• Plotts CA, Livermore CL (May 2007). "Russell-Silver syndrome and nonverbal learning disability: a case study". Applied Neuropsychology. 14 (2): 124–34. doi:10.1080/09084280701322684. ISSN 0908-4282. PMID 17523887. {{cite journal}}: Unknown parameter |doi_brokendate= ignored (|doi-broken-date= suggested) (help)