Understanding NVLD Symptoms: What You Should Know

Michele Heimbauer, MA CCC-SLP

Associate Director, Winston Innovation Lab

In recent studies, it has been estimated that 2.2 to 2.9 million children and adolescents in North America are struggling with NVLD (Nonverbal Learning Disorders). That is 3-4% of children and adolescents.

Prevalence of NVLD

One in every 25 to 33 children and adolescents are impacted by NVLD. Most are not identified, struggling needlessly, not receiving appropriate support and remediation. Data about NVLD in adulthood is less clear.

What is NVLD (and what is it NOT)?

Nonverbal Learning Disorders are commonly misunderstood. We at WPS are committed to dispelling the myths and misconceptions connected to NVLD. We accomplish this through our work with students, families, educators, and administrators at local, national, and international forums. We also connect to the community through partnerships with the NVLD Project and university-level NVLD-centered research.

Is NVLD a Disability?

NVLD is a specific learning disability, neurological in origin. It is rooted in weaknesses in visual-spatial processing leading to pervasive and overlapping academic and social challenges.

Though there are notable variations in severity, NVLD is often characterized by challenges in:

Reasoning and comprehension
Socialization and communication
Mathematics
Executive functions

Social emotional skills are often impacted, demonstrating challenges involving:

Adaptation to novelty
Social competence
Emotional regulation

Students with NVLD typically demonstrate strengths in auditory perceptions, rote verbal memory, and detail recall.

Myth #1: People with NVLD are Not Verbal

The name of this specific learning disability unfortunately has contributed to this widely held misconception. ‘Nonverbal’ in Nonverbal Learning Disabilities refers to the cognitive processes that are impacted.

People with NVLD typically have strengths with verbal, or language-based, processing. These involve the more concrete development involved in language acquisition, such as expressive language and decoding.

The challenge comes in with regard to everything related to the ‘nonverbal’ aspects of learning and performance. Namely, conceptual and abstract comprehension and reasoning. Skills related to concrete language and recall of details and facts usually come easily.

Pulling it all together, recognizing patterns, and manipulating the information in abstract ways is what is hard. Because of linguistic strengths, NVLD in adults and young children can look and sound alike. These populations are often quite verbose, while adolescents with NVLD can be prone to withdrawal. Many use language to think aloud to mediate the challenge with visual imagery and visual-spatial integration.

Additionally, people with NVLD find it challenging to synthesize details into main ideas. Rather than sharing ideas based on the ‘big picture,’ they share all of the details at length. If you ask a child with NVLD how their day was, they might very well start with the exact time they awoke and share every detail from there! This is also a common NVLD symptom in adults.

Further, the inability to read nonverbal cues makes it difficult to pick up on the pragmatic rules of conversation. For example, sensing when it is their listener’s turn to contribute to the conversation, or when the listener has lost interest.

Recent efforts aimed at adding NVLD to the DSM (Diagnostic and Statistical Manual of Mental Disorders) have included a proposed name change: Developmental Visual-Spatial Disorder (DVSD). This term more aptly describes the root of the learning disability as well as lessening confusion. You might hear this term used when pursuing your child’s NVLD diagnosis.

Myth #2: People with NVLD are on the Autism Spectrum

Though there are similarities in presentation, NVLD and ASD are two distinct disorders. A person can be diagnosed with both NVLD and ASD but this is not a given.

ASD is a spectrum of disorders related to social processing. As noted above, NVLD is rooted in weaknesses in visual-spatial processing.

Recent fMRI studies have shown that the neural networks differ when comparing those with NVLD and ASD. This demonstrates a distinction between the two disorders.

Oftentimes, people with ASD have significant strengths in visual-processing. It is important to analyze assessment performance to uncover the core deficit area. Understanding where the challenges are stemming from is vital in determining the most appropriate and effective remediation approach.

Myth #3: People with NVLD do not struggle in school because of their knowledge base.

The early elementary years are typically unremarkable in an NVLD student’s academic learning. Young students with NVLD can even thrive in kindergarten through second grade. This is because the day is focused largely on learning concrete skills. For example, learning how to read and write, learning basic math, learning concrete facts about history and science.

Come third grade this shifts and the day begins to get more challenging for students with NVLD. Students are now expected to synthesize information, connect prior knowledge to new information, apply and generalize skills in new ways, form predictions and conclusions.

Socially, their peers are becoming more sophisticated. Social language becomes riddled with nuance and increasingly complex humor.

As you grow, so do the school buildings. You’re expected to quickly learn how to navigate new, complex spaces and changing classrooms. Moving from class to class while also managing social interactions and responsibilities can be overwhelming.

Furthermore, a student with NVLD approaches each day as a new day. They may be unable to pick up on the patterns embedded in all aspects of the day. This is often when we begin to see anxiety developing.

Some students will be diagnosed with ADHD because of their difficulty managing it all. But when you digest the world as a long list of discreet, disconnected details, each experience novel, it is tremendously difficult to make sense of it all.

Myth #4: People with NVLD are not trying hard enough to be social.

Working with hundreds of students with NVLD through my work as an SLP, WPS Admissions Director, and WPS instructor, I can confidently say that students with NVLD want to develop and maintain friendships more than anything.

People with NVLD are often ostracized because they struggle navigating the physical space of conversations. Many have difficulty figuring out how to physically enter a circle of peers chatting, where to go in the cafeteria, how to hold themselves to portray appropriate and expected body language and facial expressions. At a young age they might find it challenging to learn physical skills like riding a bicycle, catching a ball, or navigating the baseball field.

Further, when they try to insert themselves into conversations and social situations, their attempts fall flat. They put in miles of effort. Due to the nature of NVLD, they can not figure out what they are doing ‘wrong’. They are challenged to pick up on tones of voice, facial expressions, context, and linguistic nuance in order to accurately interpret what someone is saying while recognizing and appreciating a perspective other than one’s own.

Relying on only the actual words said, one misses the majority of the message.

Myth #5: People with NVLD will outgrow their challenges.

The challenges and characteristics of NVLD might shift as expectations and responsibilities change as one ages but, like all specific learning disabilities, it does not disappear.

However, we can significantly lessen the impact of NVLD with explicit skill remediation. That is why it is so important to fully assess students who are demonstrating difficulty rather than quickly label students as ADHD or anxious based on external manifestations.

If NVLD is at the root of the external struggles, medication and/or therapy alone will not be effective. Support needs to focus on making all of life’s abstractions more concrete. As a result, people with NVLD can learn to make connections, recognize patterns, and understand information at a conceptual level. This focus improves not only academics, but more importantly, social emotional wellness.

How Does Winston Approach Remediation?

We often say ‘when you meet one person with NVLD, you’ve met one person with NVLD’. Though there are patterns in demonstrated academic and social-emotional characteristics, severity and impact vary amongst individuals.

As with all of our programming design, remediation objectives, methods, and overall approach are highly individualized. They are always based upon the distinct needs and strengths of each student. That said, here are a few examples of how we might approach remediation when working with a student with NVLD.

Overarching Instructional Objectives: Examples

Improve comprehension as related to pattern recognition and conceptual relationships

- Increase utilization of pre-reading strategies to integrate background knowledge and contextual information

- Identify causal relationships in fiction and non-fiction texts

Develop mathematical thinking skills as related to pattern recognition and part-whole relationships

Strengthen social emotional skills to support independent learning

- Develop Social Communication skills by improving understanding of nonverbal language cues with focus upon the impact of vocal tone, facial expression and body posture, and the impact upon communicative intent and messages

- Develop Resilience by consistently identifying and following through with one effective strategy to support an ability to recover from a challenge

Develop executive functioning skills as related to applying a strategic approach to tasks and responsibilities as related to pattern recognition and conceptual relationships (e.g., part-whole concepts, causal reasoning)

Approaches to Achieve Objectives: Examples

Build metacognition through verbalizing the thought process, reflective discussions and explicit modeling while explicitly incorporating development of academic and social emotional skills.

Explicitly target conceptual comprehension (e.g., pattern recognition, part-whole relationships, causal relationships) across all content areas

Incorporate spatial language and gestures across all content areas

Ongoing modeling, guided practice, and support throughout instruction

Winston Prep is a community where students with NVLD symptoms can thrive. Learn more about how Winston Prep can help your student get the most out of learning. Begin by viewing a location near you.

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