Nonverbal learning disorder

Nonverbal learning disorder (NLD) is a neurological disorder that accounts for 1 to 10% of all cases of learning disabilities. Find out all about the symptoms, causes, diagnosis and treatment of this unusual condition.

Nonverbal learning disorder Definition

It is a form of developmental disability in some young children, having excellent verbal proficiency and well-developed vocabulary, but otherwise unable to understand nonverbal signals and clues.

The condition is generally abbreviated as NLD.

Nonverbal learning disorder Incidence

It has a low occurrence rate. As aforementioned, approximately 1 to 10% of individuals with learning disabilities are found to suffer from NLD. It is a gender-specific disorder that affects the females more than the males.

Nonverbal learning disorder Symptoms

In affected individuals, visualization of objects and spatial organization is quite poor. They also suffer from complete impairment of neurological functions such as planning, decision-making and social judgment.

Although children affected with NLD have good academic progress, they are unable to react in situations that demand speed and flexibility. Socializing with children of the same age group also becomes quite difficult for them. Such kids perform exceptionally well during the early elementary years but start encountering severe issues on entering upper or middle school.

Learning disability symptoms in the nonverbal domains usually surface at various stages of the developmental process.

Preschool/Nursery level

A wide variety of symptoms are visible in children between the ages of 3 and 5, such as:

  • Difficulties in understanding instructions
  • Frequent pauses before naming an object or color
  • Inconvenience while drawing or coloring
  • Inability to concentrate on something for a longer duration of time
  • Poor abstract reasoning

Secondary school level

The condition takes a serious form during the secondary stage of schooling where NLD sufferers are not able to perform even simple tasks despite having high verbal skills. Some of the common symptoms manifested in this category include:

  • Inability to differentiate between “right” and “left”
  • Poor memory
  • Illegible handwriting
  • Difficulty in solving math and word problems
  • Misidentification of words
  • Tendency to reverse letters and numbers
  • Lack of motor coordination while playing, walking, or holding a pencil
  • Frequent misplacement of homework
  • Inability to understand the concept of time
  • Lack of common sense
  • Clumsiness
  • Lack of self-awareness
  • Low self-esteem
  • Depression
  • Anxiety
  • Fear of new situations or changes

Nonverbal learning disorder Causes

Mild abnormalities of the right cerebral hemisphere may cause functional loss or motor skill impairment of the left side of the body. Unlike other forms of neurological disorders, NLD does not have any genetic origin and could be a result of the following causes:

Mild to severe head injury

Traumatic impact on the head, or any form of brain injury, may disable the major function of the right cerebral hemisphere. Affected patients may misinterpret visual information and lack spatial abilities. Brain tumors may also give rise to loss of movement control as well as behavioral changes.

Radiation therapy

Prolonged exposure to radiation on or near the brain can be attributed to NLD. Loss of memory, poor mathematics skills and changes in personality are the most common symptoms observed in such patients.

Absence of corpus callosum

Agenesis of the corpus callosum (ACC) is a very rare, congenital brain disorder where the corpus callosum (an arched bridge of nervous tissue) that connects the two cerebral hemispheres is completely or partially absent. This particular disorder generally gives rise to a host of neurologic manifestations including nonverbal disabilities.


The condition is marked by excess accumulation of fluid in the cavities deep within the brain, causing tremendous pressure. This may in turn damage the cerebral tissues, causing cognitive complications such as NLD.

Brain surgery

Surgical treatment required for traumatic brain injury may lead to a number of side effects that mainly comprises of neurological conditions affecting the speech, memory and movement.

Diffused white matter disease

White matter is a crucial portion of the brain that consists of myelinated nerve fibers for facilitating communication within the nervous system. Damage to the nerve tissues may cause varying degrees of severity on the brain. NLD is a common problem encountered during this condition, which affects the visual and auditory integration.

Nonverbal learning disorder Diagnosis

The various symptoms of NLD may vary from patient to patient and is generally not defined as a separate entity in the Diagnostic Statistical Manual (DSM). Therefore, diagnosis is usually performed on the basis of the age of an affected individual and type of symptoms present in him/her. The general techniques include:

Speech and language assessment

The test helps in ruling out the possibility of any sort of language-based disorders. In this exam, physicians can detect any form of linguistic errors or any form of difficulty with the act of speech production in children with neurologic impairment. However, children with NLD have good articulation skills and tend to perform well during the evaluation.

Neuropsychological tests

These are specially designed tasks that are used to detect any form of neurologic deficits. Intelligence testing, memory assessment, language examination, executive functioning, and visuospatial skills test fall under this category. Neuropsychological assessment is also carried out to determine the region of the brain that is damaged. Patients with NLD tend to perform poorly in all of these tests, owing to motor dysfunction.

Neuroimaging studies

In this examination, brain imaging techniques such as MRI, CAT and diffuse optical imaging are essentially utilized to examine the structure and function of the organ. Structural imaging and functional imaging of the brain may help in visualizing the right hemisphere critically, to diagnose any type of abnormality.

Nonverbal learning disorder Treatment

NLD is challenging to physicians and in most cases, often goes undetected. Treatment cannot be initiated unless specific symptoms are visible. Medications or surgical interventions are generally not available to alleviate these symptoms. However, some therapeutic measures could be taken in order to change the behavioral pattern in children with NLD. These involve:

Changing social environment

Affected patients appear to be unsocial and lacking in self-confidence. Placement must be in a surrounding that is well-established and interactive. Cooperative learning situations can also evoke proper social development in these patients.

Educational therapy

A series of intensive and individualized interventions have been designed to remediate learning disabilities. Individuals are put under the guidance of an experienced education therapist who creates and implements a strategy, using information from several resources. It also strengthens the academic skills of the patients and gradually helps in overcoming the obstacles faced while learning. Modification in the teaching strategies is very essential and should follow an organized, structured, and sequenced pattern.

Occupational therapy

It focuses on routine activities in order to restore the motor skills and perceptual abilities. These tasks generally assist in improving physical, social, psychological and intellectual development. Patients are often required to adapt a new task or environment to achieve maximum independence.

Nonverbal learning disorder is definitely a serious impairment of the brain that requires immediate attendance and early treatment. Parents should also help their children in coping with this condition and make them learn organizational and time management skills. With proper therapeutic strategies, management of NLD is possible.


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