Examine individual changes

'{{Short description|Neurodevelopmental disorder}} {{for|the autism condition where a person never learns to speak|Nonverbal autism}} {{Use dmy dates|date=October 2014}} {{Infobox medical condition | name = | synonym = Nonverbal learning difficulties | image = | image_size = | alt = | caption = | pronounce = | specialty = Neurology/psychiatry | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} '''Nonverbal learning disability''' ('''NVLD''') is a [[neurodevelopmental disorder]] characterized by core deficits in visual-spatial processing in the presence of intact verbal ability.<ref>{{Cite journal |last1=Fisher |first1=Prudence W. |last2=Reyes-Portillo |first2=Jazmin A. |last3=Riddle |first3=Mark A. |last4=Litwin |first4=Hillary D. |date=2022-02-01 |title=Systematic Review: Nonverbal Learning Disability |url=https://www.jaacap.org/article/S0890-8567(21)00234-3/abstract |journal=Journal of the American Academy of Child & Adolescent Psychiatry |language=English |volume=61 |issue=2 |pages=159–186 |doi=10.1016/j.jaac.2021.04.003 |issn=0890-8567 |pmid=33892110|s2cid=233382776 }}</ref> Additional diagnostic criteria include Average to Superior [[verbal intelligence]] and deficits in visuoconstruction abilities, [[Fine motor coordination|fine-motor coordination]], mathematical reasoning, visuospatial memory and [[social skills]].<ref>{{Cite journal|last1=Mammarella|first1=Irene C.|last2=Cornoldi|first2=Cesare|year=2014|title=An analysis of the criteria used to diagnose children with Nonverbal Learning Disability (NLD)|url=http://www.tandfonline.com/doi/abs/10.1080/09297049.2013.796920|journal=Child Neuropsychology|language=en|volume=20|issue=3|pages=255–280 |doi=10.1080/09297049.2013.796920|issn=0929-7049|pmid=23705673|hdl=11577/2668053 |s2cid=34107811}}</ref>{{sfn|Mammarella|Cornoldi|2014|pages=255–280}}<ref>{{Cite book|last=Doty|first=Nathan|title=The Massachusetts General Hospital Guide to Learning Disabilities: Assessing Learning Needs of Children and Adolescents|date=2019|publisher=Humana|others=H. Kent Wilson, Ellen Braaten|isbn=978-3-319-98643-2|location=Cham, Switzerland|chapter=Nonverbal Learning Disability|oclc=1080078884}}</ref><ref name=":3">{{Cite journal|last1=Fine|first1=Jodene Goldenring|last2=Semrud-Clikeman|first2=Margaret|last3=Bledsoe|first3=Jesse C.|last4=Musielak|first4=Kayla A.|date=March 2013|title=A critical review of the literature on NLD as a developmental disorder|journal=Child Neuropsychology|language=en|volume=19|issue=2|pages=190–223|doi=10.1080/09297049.2011.648923|issn=0929-7049|pmid=22385012|s2cid=12655825}}</ref> In clinical settings, some diagnoses of [[attention deficit hyperactivity disorder]] would be more appropriately classified as NVLD.{{sfn|Doty|2019| pages = 103-106}} ==Signs and symptoms== [[File:Modern functual kept battery driven wall clock.jpg|alt=A plain clock, with the hands pointing to 8:31|thumb|Using an analog clock to tell time is difficult for people with symptoms of NVLD.]] Considered to be neurologically based,<ref name="ramphal 2021">{{Cite journal |last1=Ramphal |first1=Bruce |last2=Pagliaccio |first2=David |last3=Thomas |first3=Lauren V. |last4=He |first4=Xiaofu |last5=Margolis |first5=Amy E. |date=15 April 2021 |title=Contributions of Cerebellar White Matter Microstructure to Social Difficulty in Nonverbal Learning Disability |journal=The Cerebellum |language=en |publication-date=December 2021 |volume=20 |issue=6 |pages=931–937,931 |doi=10.1007/s12311-021-01265-4 |issn=1473-4222 |pmc=8530438 |pmid=33856654 }}</ref><ref name="pmid24215424">{{cite journal |last1=Fine |first1=Jodene Goldenring |last2=Musielak |first2=Kayla A. |last3=Semrud-Clikeman |first3=Margaret |title=Smaller splenium in children with nonverbal learning disability compared to controls, high-functioning autism and ADHD |journal=Child Neuropsychology |volume=20 |issue=6 |pages=641–61 |year=2014 |pmid=24215424 |doi=10.1080/09297049.2013.854763 |s2cid=15495423 }}</ref> nonverbal learning disorder is characterized by: * impairments in visuospatial processing * discrepancy between Average to Superior verbal abilities and impaired nonverbal abilities such as: ** visuoconstruction ** [[fine motor coordination]] ** mathematical reasoning ** visuospatial memory ** socioemotional skills{{sfn|Mammarella|Cornoldi|2014|pages=255–280}} People with NVLD may have trouble understanding charts, [[Map reading|reading maps]], assembling [[jigsaw puzzle]]s, and using an [[analog clock]] to tell time. "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.{{sfn|Doty|2019| pages = 103-106}} 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 [[Memorization|memorizing]] verbal content, spelling, and [[reading]] once the shapes of the letters are learned. 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.{{sfn|Doty|2019| pages = 103-106}} 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."<ref name=":1" /> 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. 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.{{sfn|Doty|2019| pages = 103-106}} As adults, tasks such as driving a car or navigating to an unfamiliar location may be difficult. Difficulty with keeping track of responsibilities or managing social interactions may affect [[job performance]].{{sfn|Doty|2019| pages = 103-106}} People with NVLD may also fit the diagnostic criteria of [[dyscalculia]],<ref>{{cite journal |last1=Rourke |first1=B. P. |last2=Conway |first2=J. A. |title=Disabilities of Arithmetic and Mathematical Reasoning: Perspectives From Neurology and Neuropsychology |journal=Journal of Learning Disabilities |volume=30 |issue=1 |pages=34–46 |year=1997 |pmid=9009877 |doi=10.1177/002221949703000103 |s2cid=46413188 }}</ref><ref>{{cite journal |last1=Geary |first1=David C. |title=Mathematical disabilities: Reflections on cognitive, neuropsychological, and genetic components |journal=Learning and Individual Differences |volume=20 |issue=2 |pages=130–133 |year=2010 |pmid=20161681 |pmc=2821095 |doi=10.1016/j.lindif.2009.10.008 }}</ref> [[dysgraphia]],<ref name="pmid7884301">{{cite journal |last1=Tsur |first1=V. G. |last2=Shalev |first2=R. S. |last3=Manor |first3=O. |last4=Amir |first4=N. |title=Developmental Right-Hemisphere Syndrome: Clinical Spectrum of the Nonverbal Learning Disability |journal=Journal of Learning Disabilities |volume=28 |issue=2 |pages=80–6 |year=1995 |pmid=7884301 |doi=10.1177/002221949502800202 |s2cid=46398326 }}</ref><ref>{{cite book |first1=Byron P. |last1=Rourke |year=1989 |chapter=Patterns of Reading, Spelling, and Arithmetic |pages=[https://archive.org/details/nonverballearnin00rour/page/20 20–9] |chapter-url=https://books.google.com/books?id=W9ttiC0MvP8C&pg=PA20 |title=Nonverbal Learning Disabilities: The Syndrome and the Model |publisher=Guilford Press |isbn=978-0-89862-378-9 |url=https://archive.org/details/nonverballearnin00rour/page/20 }}</ref><ref>{{cite book |first1=Stacey E. |last1=Szklut |first2=Darby Breath |last2=Philbert |chapter=Learning Disabilities and Developmental Coordination Disorder |pages=379–418 |chapter-url=https://books.google.com/books?id=lVJPAQAAQBAJ&pg=PA379 |editor1-first=Darcy A. |editor1-last=Umphred |editor2-first=Rolando T. |editor2-last=Lazaro |editor3-first=Margaret L. |editor3-last=Roller |editor4-first=Gordon U. |display-editors = 3 |editor4-last=Burton |year=2013 |title=Neurological Rehabilitation |edition=6th |publisher=Elsevier |isbn=978-0-323-26649-9 }}</ref> or [[dyspraxia]].<ref>{{cite journal |last1=Clayton |first1=MC |last2=Dodd |first2=JL |title=Nonverbal neurodevelopmental dysfunctions |journal=Pediatric Annals |volume=34 |issue=4 |pages=321–7 |year=2005 |pmid=15871436 |doi=10.3928/0090-4481-20050401-13}}</ref><ref>{{cite journal |first1=William |last1=Solodow |first2=Sandra V. |last2=Sandy |first3=Fern |last3=Leventhal |first4=Scott |last4=Beszylko |first5=Margaret Jo |last5=Shepherd |first6=Jonathan |last6=Cohen |first7=Shoshana |last7=Goldman |first8=Richard |last8=Perry |first9=Jennifer J. |last9=Chang |first10=Ruth |last10=Nass |date=Fall 2006 |title=Frequency and Diagnostic Criteria for Nonverbal Learning Disabilities in a General Learning Disability School Cohort |journal=Thalamus |volume=24 |issue=1 |pages=17–33 |url=https://www.researchgate.net/publication/235436248 }}</ref> == Cause == Research suggests that there is an association with an imbalance of neural activity in the [[Lateralization of brain function|right hemisphere]] of the brain connected to the [[white matter]].<ref name="ramphal 2021"/> ==Diagnosis== '''Nonverbal learning disability (NVLD)''' is characterized by core deficits in visualspatial processing in the presence of intact verbal ability.<ref name="ramphal 2021"/> Additional diagnostic criteria include Average to Superior [[verbal intelligence]] and deficits in visuoconstruction abilities, [[Fine motor coordination|fine-motor coordination]], mathematical reasoning, visuospatial memory and [[social skills]].{{sfn|Mammarella|Cornoldi|2014|pages=255–280}} "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.''"''<ref>{{Cite journal|last1=Brenchley|first1=Celia|last2=Costello|first2=Shane|date=2018-01-02|title=A model of assessment and intervention for Non-Verbal Learning Disability (NVLD) in the Australian education system: an educational and developmental psychologist perspective|url=https://www.tandfonline.com/doi/full/10.1080/19404158.2018.1467936|journal=Australian Journal of Learning Difficulties|language=en|volume=23|issue=1|pages=67–86|doi=10.1080/19404158.2018.1467936|issn=1940-4158|s2cid=150281995}}</ref><ref>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.</ref>{{sfn|Mammarella|Cornoldi|2014|pages=255–280,256}} "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." (One researcher notes, "just because we cannot reasonably place such children into our present classification scheme does not mean they do not exist."<ref>{{Cite journal|last1=Fine|first1=Jodene Goldenring|last2=Semrud-Clikeman|first2=Margaret|last3=Bledsoe|first3=Jesse C.|last4=Musielak|first4=Kayla A.|date=March 2013|title=A critical review of the literature on NLD as a developmental disorder|url=http://www.tandfonline.com/doi/abs/10.1080/09297049.2011.648923|journal=Child Neuropsychology|language=en|volume=19|issue=2|pages=190–223|doi=10.1080/09297049.2011.648923|issn=0929-7049|pmid=22385012|s2cid=12655825}}</ref>) 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.{{sfn|Doty|2019| pages = 103-106}} (These are not required for a diagnosis of autism.) These overlapping conditions include, among others: * [[attention deficit hyperactivity disorder]] (ADHD) * [[autism spectrum disorder]]s, especially [[high-functioning autism]]{{sfn|Doty|2019| page = 110}} * [[developmental coordination disorder]]{{sfn|Doty|2019| page = 110}} * [[social communication disorder]]{{sfn|Doty|2019| page = 110}} * [[right hemisphere brain damage]] and developmental right hemisphere syndrome{{sfn|Doty|2019| pages = 103-106}}<ref>{{cite book |first1=Linda |last1=Wilmshurst |year=2014 |chapter=Sandy Smith: Marching to the Tune of a Different Drummer |pages=89–99 |chapter-url=https://books.google.com/books?id=TkcXBAAAQBAJ&pg=PA89 |title=Child and Adolescent Psychopathology: A Casebook |publisher=Sage |isbn=978-1-4833-2268-1 }}</ref><ref>{{cite book |first1=Cynthia A. |last1=Riccio |chapter=Dyscalculia |pages=769–70 |chapter-url=https://books.google.com/books?id=wdNpBchvdvQC&pg=PA769 |year=2007 |editor1-first=Cecil R. |editor1-last=Reynolds |editor2-first=Elaine |editor2-last=Fletcher-Janzen |title=Encyclopedia of Special Education |publisher=John Wiley & Sons |isbn=978-0-471-67798-7 |url=https://archive.org/details/encyclopediaofsp0003unse |url-access=limited }}</ref> * [[social-emotional processing disorder]]<ref>{{cite book |first1=Katherine |last1=Tsatsanis |chapter=Right-Hemisphere Syndrome |pages=2596–600 |doi=10.1007/978-1-4419-1698-3_1587 |editor1-first=Fred R. |editor1-last=Volkmar |year=2013 |title=Encyclopedia of Autism Spectrum Disorders |publisher=Springer |isbn=978-1-4419-1698-3 }}</ref><ref>{{cite journal |last1=Manoach |first1=Dara Sue |last2=Sandson |first2=Thomas A. |last3=Weintraub |first3=Sandra |date=April 1995 |title=The Developmental Social-Emotional Processing Disorder Is Associated with Right Hemisphere Abnormalities |journal=Neuropsychiatry, Neuropsychology & Behavioral Neurology |volume=8 |issue=2 |pages=99–105 |id={{INIST|3510330}} |url=http://journals.lww.com/cogbehavneurol/abstract/1995/04000/the_developmental_social_emotional_processing.3.aspx }}</ref> * [[Gerstmann syndrome]]<ref name="pmid2181523">{{cite journal|last1=Semrud-Clikeman|first1=Margaret|last2=Hynd|first2=George W.|year=1990|title=Right hemisphere dysfunction in nonverbal learning disabilities: Social, academic, and adaptive functioning in adults and children|journal=Psychological Bulletin|volume=107|issue=2|pages=196–209|doi=10.1037/0033-2909.107.2.196|pmid=2181523}}</ref><ref>{{cite book |first1=Bonny J. |last1=Forrest |chapter=Developmental Gerstmann Syndrome |pages=[https://archive.org/details/encyclopediaclin00kreu/page/n890 826]–7 |doi=10.1007/978-0-387-79948-3_1540 |editor1-first=Jeffrey S. |editor1-last=Kreutzer |editor2-first=John |editor2-last=DeLuca |editor3-first=Bruce |editor3-last=Caplan |year=2011 |title=Encyclopedia of Clinical Neuropsychology |url=https://archive.org/details/encyclopediaclin00kreu |url-access=limited |publisher=Springer |isbn=978-0-387-79948-3 }}</ref> There is diagnostic overlap between nonverbal learning disorder and [[autism spectrum disorder]], and some clinicians and researchers consider them to be the same condition.{{sfn|Doty|2019| pages = 103-106}}<ref name=":3" /> In clinical settings, some diagnoses of [[attention deficit hyperactivity disorder]] would be more appropriately classified as NVLD.{{sfn|Doty|2019| pages = 103-106}} == History == While various nonverbal learning difficulties were recognized since early studies in child neurology,<ref>{{cite book |first1=David |last1=Gardner-Medwin |chapter=John Walton |pages=862–70 |editor1-first=Stephen |editor1-last=Ashwal |year=1990 |title=The Founders of Child Neurology |publisher=Norman |isbn=978-0-930405-26-7}}</ref> there is ongoing debate as to whether/or the extent to which existing conceptions of NVLD provide a valid diagnostic framework.<ref>{{cite journal |date=July 2011 |title=Differentiating NLD |journal=Current Psychiatry |volume=10 |issue=7 |archive-url = https://web.archive.org/web/20190716133751/https://www.mdedge.com/psychiatry/article/64369/practice-management/differentiating-nld| archive-date = 16 July 2019 |last = Pollak | first = Jerrold |url=http://www.currentpsychiatry.com/the-publication/past-issue-single-view/differentiating-nld/e472880479ab8ab0a615bde5b7b35288.html }}</ref><ref>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/</ref> As presented in 1967, "nonverbal disabilities" (p.&nbsp;44) or "disorders of nonverbal learning" was a category encompassing non-linguistic learning problems.<ref name=":1">{{cite book|last1=Johnson|first=Doris J.|url=https://archive.org/details/learningdisabili00john/page/272|title=Learning disabilities: educational principles and practices|last2=Myklebust|first2=Helmer R.|publisher=Grune & Stratton|year=1967|isbn=978-0-8089-0219-5|location=New York|pages=272|chapter=Nonverbal Disorders of Learning|chapter-url=https://archive.org/details/learningdisabili00john}}</ref> "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.<ref>{{cite journal |first1=Helmer R. |last1=Myklebust |year=1975 |title=Nonverbal learning disabilities: Assessment and intervention |pages=85– |editor1-first=Helmer R. |editor1-last=Myklebust |journal=Progress in Learning Disabilities |publisher=Grune and Stratton |volume=3 |issn=0079-6387 }}</ref> Later neuropsychologist Byron Rourke<ref>{{cite journal |last1=Donders |first1=Jacobus |title=Obituary for Dr. Byron Rourke |journal=Child Neuropsychology |volume=17 |issue=5 |year=2011 |pages=417 |doi=10.1080/09297049.2011.617105|s2cid=145142840 }}</ref> sought to develop consistent criteria with a theory and model of brain functioning that would establish NVLD as a distinct syndrome (1989).<ref>{{cite book |first1=Byron P. |last1=Rourke |year=1989 |title=Nonverbal Learning Disabilities: The Syndrome and the Model |publisher=Guilford Press |isbn=978-0-89862-378-9 |url=https://archive.org/details/nonverballearnin00rour }}{{page needed|date=October 2015}}</ref> Questions remain about how best to frame the perceptual, cognitive and motor issues associated with NVLD.<ref name="pmid24215424" /><ref>{{cite journal |last1=Spreen |first1=Otfried |title=Nonverbal learning disabilities: A critical review |journal=Child Neuropsychology |volume=17 |issue=5 |pages=418–43 |year=2011 |pmid=21462003 |doi=10.1080/09297049.2010.546778 |s2cid=31974898 }}</ref><ref>{{cite book |first1=John M. |last1=Davis |first2=Jessica |last2=Broitman |year=2011 |title=Nonverbal Learning Disabilities in Children: Bridging the Gap Between Science and Practice |publisher=Springer |isbn=978-1-4419-8213-1 }}</ref>{{sfn|Mammarella|Cornoldi|2014|pages=255–280}} ==See also== * [[Alexithymia]] – difficulty with understanding emotions * [[Children's Nonverbal Learning Disabilities Scale]] * [[Deficits in attention, motor control and perception]] ==References== {{Reflist|30em}} == Further reading == === Books === * {{cite book|last=Thompson|first=Sue|title=The Source for Nonverbal Learning Disorders|location=East Moline, IL|publisher=LinguiSystems|year=1997|isbn=978-0760601631}} * {{cite book |last=Palombo |first=Joseph |title=Nonverbal Learning Disabilities: A Clinical Perspective |location=New York |publisher=W.W. Norton |year=2006 |isbn=9780393704785}} * {{cite book |last1=Broitman |first1=Jessica |first2=John M. |last2=Davis |title=Treating NVLD in Children Professional Collaborations for Positive Outcomes |location=New York |publisher=Springer |year=2013 |isbn=978-1461461791}} === By Authors with NVLD === * {{cite book |last=Murphy |first=Michael Brian |title=NLD from the Inside Out: Talking to Parents, Teachers, and Teens about Growing Up with Nonverbal Learning Disabilities |edition=Third |publisher=Jessica Kingsley Publishers |year=2016 |url=http://nldfromtheinsideout.com/}} * {{cite book |last=Fast |first=Yvona |location = London & Philadelphia|others = with other writers |year=2004 |title=Employment for Individuals with Asperger Syndrome or Non-Verbal Learning Disability: Stories and Strategies|publisher = Jessica Kingsley Publishers |oclc = 61493670 | url = https://archive.org/details/employmentforind0000fast|isbn=9781846420153}} * {{cite book |last=Flom |first=Peter |title=Screwed up Somehow but Not Stupid, Life with a Learning Disability |publisher=Peter Flom Consulting |year=2016 |isbn=9780692611692}} == External links == * [https://nvld.org/ NVLD Project] {{Pervasive developmental disorders}} {{Nonverbal communication}} [[Category:Learning disabilities]] [[Category:Pervasive developmental disorders]]'