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A Teacher’s Guide to NVLD: How to Support Students with Nonverbal Learning Disability

October 25, 2022

Missing the big picture. Struggling to learn sequences and patterns. Becoming easily distracted. What do these behaviors have in common? They’re all common signs of nonverbal learning disability (NVLD or NLD), a little understood condition characterized by deficits in visual-spatial reasoning that lead to impairment in social and/or academic functioning.

For many reasons – from the condition’s not-so-accurate name to its frequent co-occurrence with other conditions – NVLD is widely misunderstood, overlooked, and misdiagnosed. At the same time, NVLD is thought to affect up to 3% of children and teens.1

NVLD’s symptoms are expansive, affecting students in ways that most teachers may not realize. Nonetheless, children with NVLD need interventions that target all areas affected by the condition.

NVLD: Features and Challenges

To support students with NVLD, teachers must first understand what NVLD is and isn’t, and how the condition might manifest.

NVLD is a proposed neurodevelopmental disorder (meaning it’s not an official diagnosis). It was named as such to distinguish it from language-based verbal learning problems, like dyslexia. Children with NVLD are not nonverbal; in fact, they may have average to strong verbal skills. If anything, a more appropriate name for this condition would be “developmental visual-spatial learning disorder.”

[Could Your Child Have NVLD? Take This Self-Test]

NVLD’s visual-spatial reasoning deficits have been linked with disturbances in the functioning of neural circuits that support visual-spatial processing. These visual-spatial deficits are associated with the following difficulties:

Understanding Part/Whole Relationships

A child with NVLD may…

  • …avoid puzzles, LEGOs, and other activities that depend on arranging small pieces into larger parts.
  • …have trouble with math concepts, like greater than/less than, fractions, etc.
  • …struggle to identify the main idea of the story they’ve read (though they can recount details).
  • …show difficulty grasping cause and effect.

Manipulating Objects in Space

Fine- and gross-motor skills deficits are common in NVLD. This can make tying shoes, using scissors, holding a pencil, using utensils, and even balancing the body difficult.

[Read: What Does Nonverbal Learning Disorder Look Like in Children?]

Thinking of objects and position in abstract is also a challenge. Students with NVLD may have difficulty thinking of and identifying geometric shapes and following two-dimensional maps.

Learning Sequences and Patterns

Math is often a difficult subject for students with NVLD as they struggle to learn procedures, like long division, and apply concepts to multi-step problems.

Other Challenges

NVLD is also sometimes associated with difficulties and challenges with the following:

  • inattention and executive function
  • novel problem-solving (difficulty thinking outside the box)
  • sensory processing
  • pragmatic language (i.e., the social aspects of language like tone, sarcasm, nuance)
  • peer relationships and interactions

In addition, the following conditions commonly co-occur with NVLD:

NVLD: Strategies for Teachers

1. Provide Explicit Instruction

Because of possible pragmatic language weaknesses, students with NVLD may have trouble with inference. In these cases, they need clear instruction to understand what is expected of them. Explicit instruction also supports attention and executive functioning in students with ADHD and NVLD.

  • Discuss in detail information conveyed in content with high visual-spatial processing demands, like charts, graphs, and other diagrams.
  • Tell students exactly what to attend to across all academic tasks. “Check for addition and subtraction errors” is more explicit than, “Double check your work.” For proofreading essays, tell students to ensure that their sentences start with capital letters and end with periods, that they’ve used a comma before introducing quoted material, etc. Checklists work well to help guide a student’s attention, but must not be overly hard to track from a visual-spatial perspective.
  • Provide explicit study guides detailing the types of problems that will appear on a test, along with sample problems and answers. For an upcoming history test, for example, students should know that they’ll have to write essays, interpret pictures, and provide short answers.

2. Reinforce Parts to Whole Relationships

Take a Whole-Parts-Whole Approach

As students with NVLD may miss the big picture, which can affect learning in virtually all subjects, they need help connecting information they’ve learned to larger concepts. Do not assume that students will be able to draw connections on their own, or that links are obvious.

  • When teaching essay writing, for example, reinforce that the topic sentence is the “whole” of a paragraph, that it needs “parts” (supporting evidence) underneath it, and that a concluding sentence must refer again to the whole. Provide model paragraphs and essays and have students practice identifying key components.
  • Graphic depictions of these relationships are unlikely to be as helpful for students with NVLD as they are for typically developing students or those with other disorders that do not involve visual-spatial processing problems such as ADHD or language disorder.

Practice in Multiple Directions

Students with NVLD often need practice accessing information from multiple angles to further reinforce how things relate. When reviewing vocabulary words for a quiz, present students with the word and ask them to provide a definition, and vice versa. In foreign language classes, ask students to translate a word to their native language and back.

Develop Metacognition

Students with NVLD may not always know which skills and information to retrieve from their mental toolbox to answer a question, even if they have demonstrated proficiency in that skill already. Training metacognition, an executive function that involves reflecting on one’s own thoughts, can help.

Encourage students to ask themselves questions like, “What do I notice about this problem?” and “What kind of problem is it?” while doing homework or taking a test. That way, they’ll be able to figure out which skills they must call on to successfully tackle future work.

Make the Intangible Tangible

Especially for math and geography, use manipulatives like Cuisenaire rods, 3D models, and globes when teaching visual-spatial concepts to help students understand how things relate to one another.

3. Focus on Strengths

Provide accommodations and modifications as needed to reduce demands on the skills that students with NVLD struggle with the most. (Students, of course, should undergo a comprehensive evaluation to demonstrate that they qualify for supports.)

  • Craft questions that test the student’s knowledge, not their disability. Avoid questions that rely too much on spatial working memory, visual-spatial skills, and fine- or gross-motor skills. Refrain from framing homework and test questions in novel ways, e.g., those not seen and practiced previously.
  • Provide testing in a separate location to minimize distractions.
  • Allow students more time on all tests and assignments. (To recall and apply concepts, double check their own work, make up for distractions, etc.)
  • Given motor deficits, allow students to type answers and assignments whenever possible, or dictate responses using speech-to-text software.

NVLD in School: Next Steps

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “Could It Be Nonverbal Learning Disorder? An Overlooked LD in Kids with ADHD” [Video Replay & Podcast #173],” with Amy Margolis, Ph.D., which was broadcast on January 26, 2017.


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Sources

1Margolis, A. E., Broitman, J., Davis, J. M., Alexander, L., Hamilton, A. et al (2020). Estimated Prevalence of Nonverbal Learning Disability Among North American Children and Adolescents. JAMA Network Open, 3(4), e202551. https://doi.org/10.1001/jamanetworkopen.2020.2551

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