Nonverbal learning disorder

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Nonverbal learning disorder
Other namesNonverbal learning disability

Nonverbal learning disorder (also known as NLD, or NVLD) is a learning disorder characterized by verbal strengths as well as visual-spatial, motor, and social skills difficulties. It is sometimes confused with attention deficit hyperactivity disorder and autism spectrum disorder, and some overlap with these disorders seems to exist.[1] Nonverbal learning disorder has never been included in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders or the World Health Organization's International Classification of Diseases.


Considered to be neurologically based,[2][3] nonverbal learning disorder is characterized by verbal strengths as well as visual-spatial, motor, and social skills difficulties.[4][5] People with this disorder may not at times comprehend nonverbal cues such as facial expression or tone of voice.[6] Challenges with mathematics and handwriting are common.[7]

Associated conditions[edit]

Labels for specific associated issues include visual-spatial deficit,[8][9][10] dyscalculia,[11][12] dysgraphia,[13][14][15] as well as dyspraxia.[16][17]


The DSM-5 (Diagnostic and Statistical Manual) and ICD-10 (International Classification of Diseases) do not include NLD as a diagnosis.[18][19][20] Assorted diagnoses have been discussed as sharing symptoms with NLD—these conditions include Right hemisphere brain damage and Developmental Right Hemisphere Syndrome,[13][21][22][23] Developmental Coordination Disorder,[24][25] Social-Emotional Processing Disorder,[26][27] autism spectrum disorders, Gerstmann syndrome[23][28] and others.

In their 1967 book Learning Disabilities; Educational Principles and Practices, Doris J. Johnson[29] and Helmer R. Myklebust[30] characterize how someone with these kinds of disabilities appears 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." (p. 272).[31] In their chapter "Nonverbal Disorders Of Learning" (p. 272-306) are sections titled "Learning Through Pictures," (274) "Gesture," (281) "Nonverbal Motor Learning," (282) "Body Image," (285) "Spatial Orientation," (290) "Right-Left Orientation," (292) "Social Imperception," (295) "Distractibility, Perseveration, and Disinhibition." (298)

While various nonverbal impairments were recognized since early studies in child neurology,[32][33][34][35] there is ongoing debate as to whether/or the extent to which existing conceptions of NLD provide a valid diagnostic framework.[36][37] As originally presented "nonverbal disabilities" (p. 44) or "disorders of nonverbal learning" (p. 272) was a category encompassing non-linguistic learning problems (Johnson and Myklebust, 1967).[38] "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 performance IQ, as well as difficulty with handwriting.[39] Later neuropsychologist Byron Rourke[40] sought to develop consistent criteria with a theory and model of brain functioning that would establish NLD as a distinct syndrome (1989).[41] Questions remain about how best to frame the perceptual, cognitive and motor issues associated with NLD.[3][42][43][44]

See also[edit]


  1. ^ Fine, Jodene Goldenring; Semrud-Clikeman, Margaret; Bledsoe, Jesse C.; Musielak, Kayla A. (March 2013). "A critical review of the literature on NLD as a developmental disorder". Child Neuropsychology. 19 (2): 190–223. doi:10.1080/09297049.2011.648923. ISSN 0929-7049. PMID 22385012.
  2. ^ Rourke, Byron P. (1987). "Syndrome of nonverbal learning disabilities: The final common pathway of white-matter disease/dysfunction?". Clinical Neuropsychologist. 1 (3): 209–34. doi:10.1080/13854048708520056.
  3. ^ a b Fine, Jodene Goldenring; Musielak, Kayla A.; Semrud-Clikeman, Margaret (2014). "Smaller splenium in children with nonverbal learning disability compared to controls, high-functioning autism and ADHD". Child Neuropsychology. 20 (6): 641–61. doi:10.1080/09297049.2013.854763. PMID 24215424.
  4. ^ Humphries, Tom (Autumn 1993). "Nonverbal Learning Disabilities: A Distinct Group Within Our Population". Communique. Learning Disabilities Association of Ontario. Archived from the original on 28 November 2010.
  5. ^ "Nonverbal Learning Disorders". Stanford School of Medicine. Archived from the original on 8 September 2015. Retrieved 2 July 2015.
  6. ^ Mamen, Maggie (Summer 2000). "Non Verbal Learning Disabilities: Impact on Social Functioning; And Interpersonal Skills". Communique. Learning Disabilities Association of Ontario. 29 (5).
  7. ^ Zieman, Gayle (February 2000). "Nonverbal Learning Disability: The Math and Handwriting Problem". Parenting New Mexico. Archived from the original on 4 March 2016. Retrieved 1 July 2015.
  8. ^ Forrest, Bonny J. (2004). "The Utility of Math Difficulties, Internalized Psychopathology, and Visual-Spatial Deficits to Identify Children With the Nonverbal Learning Disability Syndrome: Evidence for a Visual spatial Disability". Child Neuropsychology. 10 (2): 129–46. doi:10.1080/09297040490911131. PMID 15590491.
  9. ^ Harnadek, M. C. S.; Rourke, B. P. (1994). "Principal Identifying Features of the Syndrome of Nonverbal Learning Disabilities in Children". Journal of Learning Disabilities. 27 (3): 144–54. doi:10.1177/002221949402700303. PMID 8040632.
  10. ^ Wilson, Peter H.; McKenzie, Beryl E. (1998). "Information Processing Deficits Associated with Developmental Coordination Disorder: A Meta-analysis of Research Findings". Journal of Child Psychology and Psychiatry. 39 (6): 829–40. doi:10.1111/1469-7610.00384. PMID 9758192.
  11. ^ Rourke, B. P.; Conway, J. A. (1997). "Disabilities of Arithmetic and Mathematical Reasoning: Perspectives From Neurology and Neuropsychology". Journal of Learning Disabilities. 30 (1): 34–46. doi:10.1177/002221949703000103. PMID 9009877.
  12. ^ Geary, David C. (2010). "Mathematical disabilities: Reflections on cognitive, neuropsychological, and genetic components". Learning and Individual Differences. 20 (2): 130–133. doi:10.1016/j.lindif.2009.10.008. PMC 2821095. PMID 20161681.
  13. ^ a b Tsur, V. G.; Shalev, R. S.; Manor, O.; Amir, N. (1995). "Developmental Right-Hemisphere Syndrome: Clinical Spectrum of the Nonverbal Learning Disability". Journal of Learning Disabilities. 28 (2): 80–6. doi:10.1177/002221949502800202. PMID 7884301.
  14. ^ Rourke, Byron P. (1989). "Patterns of Reading, Spelling, and Arithmetic". Nonverbal Learning Disabilities: The Syndrome and the Model. Guilford Press. pp. 20–9. ISBN 978-0-89862-378-9.
  15. ^ Szklut, Stacey E.; Philbert, Darby Breath (2013). "Learning Disabilities and Developmental Coordination Disorder". In Umphred, Darcy A.; Lazaro, Rolando T.; Roller, Margaret L.; et al. (eds.). Neurological Rehabilitation (6th ed.). Elsevier. pp. 379–418. ISBN 978-0-323-26649-9.
  16. ^ Clayton, MC; Dodd, JL (2005). "Nonverbal neurodevelopmental dysfunctions". Pediatric Annals. 34 (4): 321–7. doi:10.3928/0090-4481-20050401-13. PMID 15871436.
  17. ^ 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.
  18. ^ Horn, Nnifer L., PhD, HSPP. "An Overview of Learning Disabilities." San Mateo, CA: Schwab Learning, 2002. N. pag. Web.
  19. ^ Tannock, Rosemary (January 2014). "DSM-5 Changes in Diagnostic Criteria for Specific Learning Disabilities (SLD): What are the Implications?". International Dyslexia Association.
  20. ^ "2015/16 ICD-10-CM Diagnosis Code F81.9: Developmental disorder of scholastic skills, unspecified".
  21. ^ Wilmshurst, Linda (2014). "Sandy Smith: Marching to the Tune of a Different Drummer". Child and Adolescent Psychopathology: A Casebook. Sage. pp. 89–99. ISBN 978-1-4833-2268-1.
  22. ^ Riccio, Cynthia A. (2007). "Dyscalculia". In Reynolds, Cecil R.; Fletcher-Janzen, Elaine (eds.). Encyclopedia of Special Education. John Wiley & Sons. pp. 769–70. ISBN 978-0-471-67798-7.
  23. ^ a b Semrud-Clikeman, Margaret; Hynd, George W. (1990). "Right hemisphere dysfunction in nonverbal learning disabilities: Social, academic, and adaptive functioning in adults and children". Psychological Bulletin. 107 (2): 196–209. doi:10.1037/0033-2909.107.2.196. PMID 2181523.
  24. ^ "Recognizing and Referring Children with Developmental Coordination Disorder: The Role of the Psychologist". CanChild.
  25. ^ Jongmans, M. J.; Smits-Engelsman, B. C. M.; Schoemaker, M. M. (2003). "Consequences of Comorbidity of Developmental Coordination Disorders and Learning Disabilities for Severity and Pattern of Perceptual Motor Dysfunction" (PDF). Journal of Learning Disabilities. 36 (6): 528–37. doi:10.1177/00222194030360060401. PMID 15493435. Archived from the original (PDF) on 23 July 2018. Retrieved 30 September 2018.
  26. ^ Tsatsanis, Katherine (2013). "Right-Hemisphere Syndrome". In Volkmar, Fred R. (ed.). Encyclopedia of Autism Spectrum Disorders. Springer. pp. 2596–600. doi:10.1007/978-1-4419-1698-3_1587. ISBN 978-1-4419-1698-3.
  27. ^ 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.
  28. ^ Forrest, Bonny J. (2011). "Developmental Gerstmann Syndrome". In Kreutzer, Jeffrey S.; DeLuca, John; Caplan, Bruce (eds.). Encyclopedia of Clinical Neuropsychology. Springer. pp. 826–7. doi:10.1007/978-0-387-79948-3_1540. ISBN 978-0-387-79948-3.
  29. ^ "Pioneering Presence, Spring 2007, Northwestern Magazine".
  30. ^ "Archived copy". Archived from the original on 14 September 2016. Retrieved 2 September 2016.CS1 maint: archived copy as title (link)
  31. ^ Learning disabilities; educational principles and practices by Doris J. Johnson and Helmer R. Myklebust. Published 1967 by Grune & Stratton in New York
  32. ^ Gardner-Medwin, David (1990). "John Walton". In Ashwal, Stephen (ed.). The Founders of Child Neurology. Norman. pp. 862–70. ISBN 978-0-930405-26-7.
  33. ^ Walton, J. N.; Ellis, E.; Court, S. D. M. (1962). "Clumsy children: developmental apraxia and agnosia". Brain. 85 (3): 603–12. doi:10.1093/brain/85.3.603. PMID 13998739.
  34. ^ Gerstmann, Josef (1940). "Syndrome of finger agnosia, disorientation for right and left, agraphia and acalculia: local diagnostic value". Archives of Neurology & Psychiatry. 44 (2): 398–408. doi:10.1001/archneurpsyc.1940.02280080158009.
  35. ^ Orton, S. T. (1937). Reading, writing and speech problems in children. New York: W W Norton.pp. 99 & 120
  36. ^ "Differentiating NLD". Current Psychiatry. 10 (7). July 2011.
  37. ^ 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.
  38. ^ Johnson, Doris J.; Myklebust, Helmer R. (1967). "Nonverbal Disorders of Learning". Learning disabilities: educational principles and practices. New York: Grune & Stratton. pp. 272–. ISBN 978-0-8089-0219-5.
  39. ^ Myklebust, Helmer R. (1975). Myklebust, Helmer R. (ed.). "Nonverbal learning disabilities: Assessment and intervention". Progress in Learning Disabilities. Grune and Stratton. 3: 85–. ISSN 0079-6387.
  40. ^ Donders, Jacobus (2011). "Obituary for Dr. Byron Rourke". Child Neuropsychology. 17 (5): 417. doi:10.1080/09297049.2011.617105.
  41. ^ Rourke, Byron P. (1989). Nonverbal Learning Disabilities: The Syndrome and the Model. Guilford Press. ISBN 978-0-89862-378-9.[page needed]
  42. ^ Spreen, Otfried (2011). "Nonverbal learning disabilities: A critical review". Child Neuropsychology. 17 (5): 418–43. doi:10.1080/09297049.2010.546778. PMID 21462003.
  43. ^ Davis, John M.; Broitman, Jessica (2011). Nonverbal Learning Disabilities in Children: Bridging the Gap Between Science and Practice. Springer. ISBN 978-1-4419-8213-1.
  44. ^ Mammarella, Irene C.; Cornoldi, Cesare (2014). "An analysis of the criteria used to diagnose children with Nonverbal Learning Disability (NLD)". Child Neuropsycholog. 20 (3): 255–80. doi:10.1080/09297049.2013.796920. PMID 23705673.

Further reading[edit]


By Authors with NLD[edit]