NVLD: Unseen disorder of visual-spatial processing

Deb Browne
Speech-Language Pathologist

The myriad issues surrounding Nonverbal Learning Disorder have been a challenge to characterize. Finally, someone nailed it for a book title: “Misnamed, Misdiagnosed, Misunderstood,” perfectly encapsulates the problem. But this blog is here to tell you, at Brehm we see it, we understand, and we know how to help individuals with this debilitating disorder.

Folks with NVLD have a range of struggles, but they are not “nonverbal!” In fact, language and speaking are strengths — that’s the misnamed part. They have trouble processing nonverbal information — visual-spatial stuff like faces and places. They can’t always make good sense of what they see, they mis-read social signals, get lost, lose things, are often very disorganized. Many have bad handwriting and trouble with math.

“Misdiagnosed” refers to the unfortunate truth that NVLD is not (yet) officially recognized in the DSM (the Diagnostic and Statistical Manual of Mental Disorders), which is the psychologist’s book of criteria required to give a diagnostic label. Therefore, folks with the characteristics have been instead labeled with ADHD, Autism Level 1, neurodevelopmental disorder, and others. What appears to be misdiagnosis results in misunderstanding of what they need from special education, causing their core deficits to be unseen and untreated.

We must give big thanks to Linda Karanzalis, author of “Misnamed, Misdiagnosed, Misunderstood: Recognizing and Coping with NVLD (Nonverbal Learning Disorder) from Childhood Through Adulthood.” She just gave her book to a Brehm colleague at a conference! Thank you, Linda, for the book, your openness about your own challenges, and the best paraphrase of the conundrum of NVLD!

That kind of “get the word out” enthusiasm and desperation happen when you experience how folks with NVLD have been hurt by lack of awareness and the resulting void in appropriate services.

Let me back up. I’m an SLP, Speech-Language Pathologist working at Brehm Preparatory School. Early in my career here, I was graced and challenged with a student who had the diagnosis of NVLD. This young man was the antithesis of nonverbal; he talked so much that he was often hoarse, and what he said was usually hilarious or insulting or both. His vocabulary and memory for facts that he heard or read were off the charts high. Yet his social skills, writing, and executive functioning — big problems.

As happens with many students with this disability, his teachers (prior to coming to Brehm) thought his great language skills meant that he could and should do it all. His inability to get his homework done, organize essays, and hand write legibly were obviously, they wrote in reports, due to his poor attitude. Teacher expectations were high; his academic performance fell short, despite his whip smart intelligence.

Parents sought answers and took him for neurocognitive testing. What was found was a big difference between his verbal and visual spatial skills. Fortunately, from an intervention standpoint, he was given the diagnosis of NVLD, and I was determined from then on to figure out what could be done to make life and learning easier for students like him.

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