Medicine:Nonverbal learning disorder

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Nonverbal learning disorder
Other namesNonverbal learning difficulties
SpecialtyNeurology/psychiatric

Nonverbal learning disorder (NLD or NVLD) or visual-spatial learning disorder[1] is a proposed classification of neurodevelopmental disorder primarily characterized by deficits in visuospacial processing.[2] Additional proposed diagnostic criteria include Average to Superior verbal intelligence and decreased visuoconstruction abilities, fine-motor coordination, mathematical reasoning, visuospatial memory and social skills.[3] "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."[4] "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."[5] One researcher notes, "just because we cannot reasonably place such children into our present classification scheme does not mean they do not exist."[6]

There is diagnostic overlap between Nonverbal learning disorder and autism spectrum disorder, and some clinicians and researchers consider them to be the same condition.[7][8] In clinical settings, some diagnoses of attention deficit hyperactivity disorder would be more appropriately classified as NVLD.[7]

Cause

Research suggests that there is an association with an inbalance of neural activity in the right hemisphere of the brain connected to the white matter.[7]

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,[9] nonverbal learning disorder is characterized by:

  • impairments in visuospacial processing,
  • discrepancy between Average to Superior verbal abilities and impaired nonverbal abilities such as:
    • visuoconstruction,
    • fine-motor coordination,
    • mathematical reasoning,
    • visuospatial memory; and,
    • socioemotional skills.[10]

People with NVLD have trouble understanding charts, reading maps, assembling jigsaw puzzles, and using an analog clock to tell time.[7] "Clumsiness" is not unusual 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.[7]

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.[7] 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.[7] 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."[11]

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.[7] 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.[7]

As adults, tasks such as driving a car or navigating to an unfamiliar location may be difficult.[7] Difficulty with keeping track of responsibilities or managing social interactions may affect job performance.[7]

People with NVLD may also fit the diagnostic criteria of dyscalculia,[12][13] dysgraphia,[14][15][16] or dyspraxia.[17][18]

Diagnosis

The DSM-5 (Diagnostic and Statistical Manual) and ICD-10 (International Classification of Diseases) do not include NVLD as a diagnosis.[19][20]

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 so significant as to render NVLD a pointless duplication in the mind of its detractors, with the only difference being that NVLD criteria do not mention the presence or absence of either repetitive behaviors or narrow subject-matter interests.[7] (These are not required for a diagnosis of autism.) These overlapping conditions include, among others:

History

While various nonverbal learning difficulties were recognized since early studies in child neurology,[28] there is ongoing debate as to whether/or the extent to which existing conceptions of NVLD provide a valid diagnostic framework.[29][30]

As presented in 1967, "nonverbal disabilities" (p. 44) or "disorders of nonverbal learning" was a category encompassing non-linguistic learning problems.[11] "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.[31] Later neuropsychologist Byron Rourke[32] sought to develop consistent criteria with a theory and model of brain functioning that would establish NVLD as a distinct syndrome (1989).[33]

Questions remain about how best to frame the perceptual, cognitive and motor issues associated with NVLD.[9][34][35][36]

See also

References

  1. ↑ [1]
  2. ↑ Mammarella, Irene C.; Cornoldi, Cesare (2014-05-04). "An analysis of the criteria used to diagnose children with Nonverbal Learning Disability (NLD)" (in en). Child Neuropsychology 20 (3): 255–280. doi:10.1080/09297049.2013.796920. ISSN 0929-7049. http://www.tandfonline.com/doi/abs/10.1080/09297049.2013.796920. 
  3. ↑ Mammarella, Irene C.; Cornoldi, Cesare (2014-05-04). "An analysis of the criteria used to diagnose children with Nonverbal Learning Disability (NLD)" (in en). Child Neuropsychology 20 (3): 255–280. doi:10.1080/09297049.2013.796920. ISSN 0929-7049. http://www.tandfonline.com/doi/abs/10.1080/09297049.2013.796920. 
  4. ↑ Brenchley, Celia; Costello, Shane (2018-01-02). "A model of assessment and intervention for Non-Verbal Learning Disability (NVLD) in the Australian education system: an educational and developmental psychologist perspective" (in en). Australian Journal of Learning Difficulties 23 (1): 67–86. doi:10.1080/19404158.2018.1467936. ISSN 1940-4158. https://www.tandfonline.com/doi/full/10.1080/19404158.2018.1467936. 
  5. ↑ Mammarella, Irene C.; Cornoldi, Cesare (2014-05-04). "An analysis of the criteria used to diagnose children with Nonverbal Learning Disability (NLD)". Child Neuropsychology 20 (3): 255–280,256. doi:10.1080/09297049.2013.796920. ISSN 0929-7049. PMID 23705673. https://doi.org/10.1080/09297049.2013.796920. 
  6. ↑ 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" (in en). Child Neuropsychology 19 (2): 190–223. doi:10.1080/09297049.2011.648923. ISSN 0929-7049. http://www.tandfonline.com/doi/abs/10.1080/09297049.2011.648923. 
  7. ↑ 7.00 7.01 7.02 7.03 7.04 7.05 7.06 7.07 7.08 7.09 7.10 7.11 7.12 Doty, Nathan (2019). "Nonverbal Learning Disability". The Massachusetts General Hospital Guide to Learning Disabilities: Assessing Learning Needs of Children and Adolescents. H. Kent Wilson, Ellen Braaten. Cham, Switzerland: Humana. pp. 103–106. ISBN 978-3-319-98643-2. OCLC 1080078884. 
  8. ↑ 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" (in en). Child Neuropsychology 19 (2): 190–223. doi:10.1080/09297049.2011.648923. ISSN 0929-7049. PMID 22385012. 
  9. ↑ 9.0 9.1 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. 
  10. ↑ Mammarella, Irene C.; Cornoldi, Cesare (2014-05-04). "An analysis of the criteria used to diagnose children with Nonverbal Learning Disability (NLD)" (in en). Child Neuropsychology 20 (3): 255–280. doi:10.1080/09297049.2013.796920. ISSN 0929-7049. http://www.tandfonline.com/doi/abs/10.1080/09297049.2013.796920. 
  11. ↑ 11.0 11.1 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. https://archive.org/details/learningdisabili00john. 
  12. ↑ 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. 
  13. ↑ 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. PMID 20161681. 
  14. ↑ 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. 
  15. ↑ 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. https://books.google.com/books?id=W9ttiC0MvP8C&pg=PA20. 
  16. ↑ 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.. Neurological Rehabilitation (6th ed.). Elsevier. pp. 379–418. ISBN 978-0-323-26649-9. https://books.google.com/books?id=lVJPAQAAQBAJ&pg=PA379. 
  17. ↑ Clayton, MC; Dodd, JL (2005). "Nonverbal neurodevelopmental dysfunctions". Pediatric Annals 34 (4): 321–7. doi:10.3928/0090-4481-20050401-13. PMID 15871436. 
  18. ↑ Solodow, William; Sandy, Sandra V.; Leventhal, Fern; Beszylko, Scott; Shepherd, Margaret Jo; Cohen, Jonathan; Goldman, Shoshana; Perry, Richard et al. (Fall 2006). "Frequency and Diagnostic Criteria for Nonverbal Learning Disabilities in a General Learning Disability School Cohort". Thalamus 24 (1): 17–33. https://www.researchgate.net/publication/235436248. 
  19. ↑ 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.
  20. ↑ Tannock, Rosemary (January 2014). "DSM-5 Changes in Diagnostic Criteria for Specific Learning Disabilities (SLD): What are the Implications?". International Dyslexia Association. https://eida.org/dsm5-update/. 
  21. ↑ 21.0 21.1 21.2 Doty, Nathan (2019). "Nonverbal Learning Disability". The Massachusetts General Hospital Guide to Learning Disabilities: Assessing Learning Needs of Children and Adolescents. H. Kent Wilson, Ellen Braaten. Cham, Switzerland: Humana. pp. 110. ISBN 978-3-319-98643-2. OCLC 1080078884. 
  22. ↑ 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. https://books.google.com/books?id=TkcXBAAAQBAJ&pg=PA89. 
  23. ↑ Riccio, Cynthia A. (2007). "Dyscalculia". in Reynolds, Cecil R.; Fletcher-Janzen, Elaine. Encyclopedia of Special Education. John Wiley & Sons. pp. 769–70. ISBN 978-0-471-67798-7. https://books.google.com/books?id=wdNpBchvdvQC&pg=PA769. 
  24. ↑ Tsatsanis, Katherine (2013). "Right-Hemisphere Syndrome". in Volkmar, Fred R.. Encyclopedia of Autism Spectrum Disorders. Springer. pp. 2596–600. doi:10.1007/978-1-4419-1698-3_1587. ISBN 978-1-4419-1698-3. 
  25. ↑ 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. http://journals.lww.com/cogbehavneurol/abstract/1995/04000/the_developmental_social_emotional_processing.3.aspx. 
  26. ↑ 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. 
  27. ↑ Forrest, Bonny J. (2011). "Developmental Gerstmann Syndrome". in Kreutzer, Jeffrey S.; DeLuca, John; Caplan, Bruce. Encyclopedia of Clinical Neuropsychology. Springer. pp. 826–7. doi:10.1007/978-0-387-79948-3_1540. ISBN 978-0-387-79948-3. https://archive.org/details/encyclopediaclin00kreu. 
  28. ↑ Gardner-Medwin, David (1990). "John Walton". in Ashwal, Stephen. The Founders of Child Neurology. Norman. pp. 862–70. ISBN 978-0-930405-26-7. 
  29. ↑ "Differentiating NLD". Current Psychiatry 10 (7). July 2011. http://www.currentpsychiatry.com/the-publication/past-issue-single-view/differentiating-nld/e472880479ab8ab0a615bde5b7b35288.html. 
  30. ↑ 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/
  31. ↑ 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. 
  32. ↑ Donders, Jacobus (2011). "Obituary for Dr. Byron Rourke". Child Neuropsychology 17 (5): 417. doi:10.1080/09297049.2011.617105. 
  33. ↑ Rourke, Byron P. (1989). Nonverbal Learning Disabilities: The Syndrome and the Model. Guilford Press. ISBN 978-0-89862-378-9. https://archive.org/details/nonverballearnin00rour. [page needed]
  34. ↑ Spreen, Otfried (2011). "Nonverbal learning disabilities: A critical review". Child Neuropsychology 17 (5): 418–43. doi:10.1080/09297049.2010.546778. PMID 21462003. 
  35. ↑ 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. 
  36. ↑ 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

Books

  • Thompson, Sue (1997). The Source for Nonverbal Learning Disorders. East Moline, IL: LinguiSystems. ISBN 978-0760601631. 
  • Palombo, Joseph (2006). Nonverbal Learning Disabilities: A Clinical Perspective. New York: W.W. Norton. ISBN 9780393704785. 
  • Broitman, Jessica; Davis, John M. (2013). Treating NVLD in Children Professional Collaborations for Positive Outcomes. New York: Springer. ISBN 978-1461461791. 

By Authors with NVLD




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