Those with excellent verbal skills but difficulty orienting themselves in space and time may be showing signs of nonverbal learning disorder.

Nonverbal learning disorder (NVLD) is a neurodevelopmental disorder that’s often hard to detect in childhood.

Children with NVLD are typically early talkers and readers. They usually have great verbal skills and excellent memories, but they tend to have difficulty with visual-spatial activities such as doing puzzles, building with blocks, or tying their shoes.

Sometimes mistaken for autism spectrum disorder (ASD), NVLD is a distinct condition that can make daily activities quite difficult, particularly as children grow older.

NVLD, which affects 3%–4% of the population, is a neurodevelopmental disorder characterized by deficits in visual-spatial skills, particularly when compared to one’s verbal abilities.

People with NVLD may have problems with time management, social skills, higher math, and fine motor skills —abilities commonly associated with the right hemisphere of the brain. In fact, NVLD is often described as the reverse syndrome of dyslexia, which is believed to involve “left-brain” deficits.

The verbal skills (e.g., memory, spelling, decoding text) of a person with NVLD are relatively much stronger than their visual-spatial skills, causing a wide discrepancy between the two cognitive areas.

In fact, the visual-spatial skills of a person with NVLD may be average, or even better than average. But these skills are still much weaker than their verbal skills.

NVLD is not currently listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and is not recognized as a disability covered by the Individuals with Disabilities Education Act (IDEA).

People with NVLD may have above average intelligence but still have difficulties with everyday situations, such as finishing a project, going to work, and making friends.

With their strong verbal skills, children with mild NVLD will often fly under the radar and do very well in elementary school. The condition is often identified later, when children begin learning math and science, as these subjects require visualizing and manipulating objects in perceptual space.

NVLD affects every person differently at various degrees, but a child may have NVLD if they:

  • are an early talker; highly verbal
  • have a strong memory
  • have an auditory learning style (learn via the spoken word)
  • are very literal (may have trouble understanding sarcasm or innuendo)
  • are naive or overly trusting
  • aren’t interested in blocks or puzzles
  • can’t understand diagrams
  • pay close attention to detail but have difficulty seeing the big picture
  • have trouble with multi-step directions
  • have difficulty with problem-solving that doesn’t involve written or spoken language
  • have difficulty recognizing nonverbal social cues (body language, facial expressions)
  • have poor fine motor skills (difficulties with tying shoes, using scissors)
  • have difficulty with advanced math problems that require pattern recognition or spatial visualization
  • have difficulty telling time on an analog clock
  • have poor coordination (may be seen as “clumsy” or “in the way”)
  • have difficulty with reading comprehension
  • are fearful of new situations and have difficulty coping with change
  • have difficulty “producing” in situations where adaptability and speed are required

Comparing NVLD to autism

NVLD and autism spectrum disorder (ASD) have some overlapping symptoms, which can sometimes lead to misdiagnosis. However, learning disorders and autism are considered distinct conditions.

Below are just a few differences often seen between children with NVLD and autism:

  • Distinct motor behaviors (rocking, flapping) that are seen in ASD are not present in NVLD.
  • Children with NVLD typically don’t learn by watching — they need everything explained in words (spoken or written language). They do not respond well to physical demonstrations and may not understand diagrams. In contrast, many children with ASD are visual learners and respond well to visuals and diagrams.
  • Due to their excellent verbal skills, children with NVLD often become wordsmiths (writers and teachers). In contrast, due to their visual learning style, many children with ASD do very well in math and eventually work in the fields of technology, architecture, or engineering.

The exact cause of NVLD is unknown, but the disorder is believed to be related to the right hemisphere of the brain, which is involved in imagination, visual awareness, spatial abilities, and the recognition of social cues.

A common hypothesis of NVLD is the “white matter model,” which suggests that NVLD is linked to abnormalities in subcortical white matter (fatty layer surrounding parts of the neuron), which plays an important role in brain communication.

An imaging study of 12 children with NVLD and 15 typically developing children found that differences in white matter in the cerebellum may contribute both to social cognition and to the pathophysiology of NVLD.

NVLD doesn’t respond to medication, and unlike other learning disabilities, it isn’t covered under Individuals with Disabilities Education Act (IDEA). So, your child with NVLD may not qualify for an individualized education plan (IEP) or 504 Plan unless they have another diagnosis or disability.

There’s no standard treatment for NVLD, but there are interventions and strategies that can help.

Interventions may include:

  • Occupational therapy: This can help develop fine motor skills.
  • Physical therapy: This can improve strength and balance.
  • Social skills training: This training can help children who have trouble interpreting facial expressions or nuance in language. It can also help your child learn to stay safe around strangers, make friends, and recognize when they’re being teased.
  • Sensory integration therapy: This is a type of therapy that uses games to improve your child’s sense of touch, movement, and body position.
  • Academic tutoring: Tutoring can help your child improve in difficult subjects, such as visual-spatial math.

Daily strategies for NVLD may include the following:

  • Typing instead of printing: Many children with NVLD have handwriting difficulties, so typing can help them express themselves more easily.
  • Keeping a daily planner: A daily planner can help your child stay organized and build time-management skills.
  • Record classroom lectures: NVLD children often learn best by listening, These recordings can be replayed later at home.
  • Prepare your child for big changes or transitions: Children with NVLD may have difficulty adapting to new situations. Be sure to discuss upcoming changes before they occur (such as a big trip, changing classrooms, or moving to a new home).
  • Pay attention to your words: Some children with NVLD may not understand idioms, sarcasm, body language, or tone changes. Be sure to explain what you’re trying to convey in literal terms or help them understand what you’re implying (such as, “This will be a piece of cake.”)
  • Avoid burnout: Children with NVLD can become overwhelmed during the day, particularly if their usual routine is broken. Be sure that they have the time and space to slow down and do quiet activities.

NVLD is a neurodevelopmental disorder characterized by deficits in visual-spatial skills, particularly when compared to verbal skills.

If you have NVLD, you may have excellent spelling, memory, and decoding skills but have difficulty solving problems that don’t involve written or spoken language. You may have difficulty seeing the bigger picture and staying organized in terms of time and space.

While there’s no specific medical intervention for NVLD, there are numerous strategies and interventions you can use to help optimize your strengths and develop the skills you find more challenging.