Nonverbal Learning Disability

What is a nonverbal learning disability?

Children and teens with a nonverbal learning disability (NLD) have poor visual, spatial, and motor skills. They also have trouble recognizing and understanding nonverbal cues such as body language and facial expression.

Children with an NLD usually start out learning to read fairly well. They also have large vocabularies. They tend to have more trouble after second grade.

NLD is the least recognized among the learning disorders. Children with this problem may not be properly diagnosed and may not get the help they need.

What is the cause?

The brain has 2 hemispheres, right and left. NLD is caused mostly by weaker skills involving the right side of the brain. NLD may be called the "right hemisphere disability." The more common learning disabilities mainly involve problems in the left side of the brain.

Many children and teens with an NLD had medical problems during their mother's pregnancy or birth. Some of the common pregnancy and birth difficulties are:

• very long labor at birth
• having the umbilical cord wrapped around the neck
• premature birth or low birth weight
• serious infections as a young infant

NLD is more common when the mother smoked and drank alcohol during the pregnancy. Mothers who were ill during their pregnancy are also more likely to have children with an NLD.

Nonverbal learning disabilities are much less likely to run in families than other learning disabilities. NLD is as common in girls as in boys.

What are the symptoms?

A child with an NLD does not have trouble with phonics and sounding out words. For this reason the NLD child usually does fairly well with reading words in kindergarten through second grade. NLD children do not have trouble learning to talk or use language. In fact, many children with NLD talk early and have excellent verbal skills.

A child with an NLD usually has trouble:

• learning how to make the shapes of the letters, especially letters like K and Y
• copying and drawing shapes
• writing on lines and remembering to keep margins
• having legible handwriting
• spacing words apart (written sentences often jumble words together)
• keeping columns of numbers straight in long division and multiplication problems
• drawing and doing art projects

Children with NLD often have problems with spelling. Problems are usually with words that cannot be sounded out (like the word "enough") or with words that could be spelled phonetically several ways, such as the word "puzzle."

Many children with a NLD have trouble immediately recognizing words that they have previously sounded out over and over. Trouble visually recognizing words quickly can make the NLD child a slow reader. They often stop to sound out words which others their age recognize right away.

Math is almost always difficult for the NLD child. Visual aids designed to help learn math are often not very helpful. Talking through the steps of math problems is often much more helpful.

Many NLD children also have coordination difficulties. These children are often:

• clumsy and have many small accidents, such as spilling things
• slow in learning to kick or catch a ball, ride a bicycle, or tie their shoes
• older than other children before they can tell left from right

Children and teens with the more severe forms of a NLD often have social difficulties. They often:

• miss or misinterpret facial gestures and body language cues
• have trouble tracking the flow of conversations and social interactions
• seem out of touch with others in social situations and conversations
• take things too literally and so misunderstand jokes or sarcasm

How is it diagnosed?

Your child's healthcare provider or a mental health therapist will ask about the child's symptoms, medical and family history, and any medicines the child is taking. Sometimes a CT scan of the brain or an EEG will be done to screen for any physical problems. Your child will be evaluated to see if there are other problems such as ADHD or other learning disabilities.

The healthcare provider can refer you to a specialist. NLD is diagnosed by a psychologist or an educational expert trained in testing for learning disabilities.

Public schools are required by federal law to test children when a learning disability is suspected. Many public school tests, however, cannot tell whether a child has NLD or some other learning disability.

How is it treated?

There are no cures or direct treatments for an NLD. Medicines are generally not helpful for NLD, but may help with some symptoms.

Tutoring and special instruction in the areas of weakness are helpful. Some children may need special education classes at school for some or all academic subjects.

Seeing a pediatric occupational therapist is often helpful. Occupational therapy helps your child learn better visual processing skills. This will help with drawing, keeping spaces between words, and handwriting. The therapist may also use sensory integration (SI) therapy. SI therapy involves special activities that help children overcome problems with senses such as touch, sight, hearing, and movement. This may improve their behavior and ability to pay attention.

Children who have social skill problems often need training in how to respond socially. Counseling can help to teach social skills and help deal with low self esteem.

How long will the effects last?

Children do not just "grow out of" learning disabilities. They often continue to have problems in adulthood. However, most children with NLD do very well with extra help and learning how to cope with their weaknesses.

NLD children very often excel at music and tasks that use their language skills. They are often very bright and eager to gain and share their knowledge. They often do well with oral presentations and creative writing.

What can I do to help my child?

• Ask your child's school about testing your child for a learning disability.
• Ask if your child can have more time for work that involves handwriting, spelling, and math.
• If your young grade-school child prints poorly, practice printing at home. Also ask the teacher if you can start teaching cursive writing. Many NLD children do better with cursive writing than printing.
• If your young grade-school child has messy handwritten papers, work with them on staying on the lines and putting spaces between words. A handy rule to teach is to keep one pinky-finger-width between words, one-index-finger width between sentences, and 2 finger widths as margins on both sides of the page.
• If your child has messy handwritten papers, start teaching them to use a computer word processor for written papers.
• Teach the steps to math operations (like long division and working with fractions) by talking through the steps. Encourage your child to say the steps aloud as they go.
• Teach the spelling of difficult words by having your child write them over and over. Often writing the words large, like on a white board, is more helpful than writing them on paper.
• Talk with your child's teachers about when your child can use a calculator and spelling checker to help with their work.
• Help your child identify emotions and the meanings that go with facial expressions and body cues and figure out appropriate responses.
• Ask the school counselor or teachers to help teach your child how to interact better with other children and how to interpret the reactions of others.
• Children with NLD may be anxious and depressed. Professional counseling may be helpful

When should I seek help?

If your child or teenager has the symptoms of NLD, contact his or her school about testing. Ask specifically if the tests are sensitive to nonverbal learning disabilities. If the tests available through the school are not designed well for spotting NLD, you may need to find private testing. For more information, see:

NLD on the Web
Web site: http://www.nldontheweb.org/home.html

The Learning Project
WETA Public Television
Web site: http://www.ldonline.org/indepth/nonverbal