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. However, we now know that NVLD is unlike any other learning disability, as it affects several areas of daily functioning, while dyslexia, for example, primarily affects reading and written skills. By listening and understanding the challenges faced by my NVLD clients, I gained valuable firsthand knowledge and anecdotal information about the disability. Although the severity and areas of challenge varies from person to person, the symptoms are indeed present and the struggle is real. The personal stories and challenges described by my clients are fairly consistent and similar to the descriptions provided by current researchers in the field. Based on the accounts of my clients, the following 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 demonstrate high levels of anxiety, including separation anxiety. Although most infants and toddlers demonstrate some level of separation anxiety, the anxiety demonstrated by NVLD children is often quite severe. 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 nor do they understand the potential dangers and consequences of their friendly behavior (despite being repeatedly reminded of the potential dangers).
School Age Signs:
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 such as LEGO.
Eating is another area of concern most often raised by parents. Many NVLD children are described by their parents as “messy eaters”. We know that “messy eating” is a normal and pivotal part of child development as it allows the child to hone in on and develop their fine motor and eye hand coordination skills. This phase usually extends into the preschool age. However, 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 a sensitivity to certain clothing/texture, in that tags at the back of their shirts, seams on their socks, tight shoes, and certain fabrics are burdensome and therefore avoided. They may also have a sensitivity to sounds, light, and/or taste/texture (picky eater).
Gross motor challenges commonly appears 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 participate in team sports, such as soccer. If they do participate, they often take up the goalie position or participate with absolutely no idea of how the game is played, the direction in which they should run or kick the ball and so forth. Learning to ride a bike is also another prevalent concern raised. NVLD children typically take much longer than the neurotypical child to develop this skill. In light of these motor challenges, NVLD children usually prefer to participate in individual activities, such as swimming, or dancing rather than team sports.
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, not fitting in or that they are disliked by their peers, which may not be the case. Due to these weaknesses, NVLD children often prefer to observe the social interaction or peer group for some time before they are willing to join the group. This behavior is often seen as extreme shyness.
Although they desire friendships, NVLD children often have difficulty making and maintaining friendships. If they have developed a friendship with one or two children, NVLD children tend to rely too heavily on these friends for support. Play dates and transitions are quite daunting and overwhelming. Most often NVLD children prefer interacting with older or younger children and adults rather than same aged peers. 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. Furthermore, due to a lack of facial expressions, many teachers raise concerns about possible depression or sadness, causing them to also question 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, such as geometry, decimals, and fractions are problematic. Reading maps and graphs are confusing. Misreading computational symbols and misaligning columns are common. Money and time management as well as telling time using an analog clock are next to impossible.
Although NVLD students usually have excellent decoding or basic reading skills, they often have difficulty with reading accuracy, particularly 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, writing to the margin and knowing where to write the date, name and where to start writing their 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 as it requires so much effort and time to complete. Instead they often resort to avoidance and/or disruptive behaviors. Since they are quite verbal and articulate, their reluctance to do the work is often viewed as sheer laziness, stubbornness, oppositional, and/or plain defiance. NVLD students are often overwhelmed and even panic (test anxiety) when faced with too much information on the page, or when the print is smaller than usual and/or unfamiliar to them.
Adult Signs:
Many adult clients seek help because they struggle with significant and at times paralyzing anxiety, particularly social anxiety, depression and/or chronic fatigue. They come to therapy wanting to investigate whether they have attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). Many have consulted with several therapists who have expertise in different therapeutic approaches, but to no avail. The emotional distress continues.
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 also present with work related challenges. The slightest change in work tasks/demands can cause significant distress and anxiety. NVLD individuals usually work so much harder than their peers to achieve the same or similar outcomes and therefore have difficulty sustaining the effort required to complete the task.
Many clients report relationship and intimacy issues. Making and maintaining friendships, crowds, going to shopping malls or grocery stores are quite stressful. Following 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 while others are extremely organized, becoming quite upset when things are moved or positioned differently. Simple things like making the bed, tucking in the sheets and blankets as well as folding laundry and even grooming are effortful. Multi-tasking, paying bills and maintaining a budget requires an inordinate amount of time and effort and for some it is just beyond their capability.
Driving is also another source of stress, especially when traveling to new or uncommon places. Following 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 their well developed verbal skills and their inability to perform a variety of tasks, leads people to conclude that they are lazy, unmotivated or even stubborn and oppositional. They just do not put in the amount of work and effort needed to succeed. Not understanding and meeting the needs of individuals with NVLD is detrimental to their socio emotional well-being and 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 as well as the ability to rule out alternative hypotheses since NVLD symptoms overlap with several other disorders. The diagram below sums up at a glance the link between NVLD and other disorders. The need for an accurate assessment is critical to the individual’s well-being and future success.
Elizabeth Shoiry, M.ED.
Elizabeth Shoiry, M.ED. is an accredited neuropsychologist (OPQ), clinical psychologist, speaker and author who has over 25 years of experience working in the Canadian health and educational sectors, as well as with Canada’s First Nation communities.
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