Nonverbal Learning Disorder: An Academic and Social One-Two Punch

Learning differences don’t just affect school performance

I always knew there was something a little different about my daughter. Looking back, I can trace a line from the earliest age — when she was unwilling to be cared for by anyone besides me — to today, when despite all the growth she’s made over the years, she still struggles with a wide array of skills on both the academic and social sides of life.

Family members and friends shrugged off her idiosyncrasies. Kids are all different, they’d say. She’ll catch up. And, kind of, she did. It never failed: As soon as I called in an expert about one aspect of her development, she’d leap ahead in that domain and then begin to fall behind in another. She was a moving target.

In the academic setting, she struggled with specific skills like pencil grip and word recognition, as well as broader abilities like following the most familiar of routines and lasting the entire school day without breaking down into tears.

Socially, things were often harder. She loves other kids and wants them to be her friend, but she often doesn’t know how to relate to them. She can be overbearing, which can turn other kids off, and she also tends to overinterpret their reactions. She might say someone yelled at her, for example, when in reality they just asked her for a turn on the swing.

There were so many areas of struggle, we could never figure out how to help her. Assessment after assessment showed her as a really sweet, empathetic kid who was just ever so slightly off. The early intervention assessment when she was 2, followed by her school assessments at ages 3 and 6, all confirmed she needed some kind of help in a lot of different areas: speech, fine motor, gross motor, attention, number sense, social skills. Teachers and family members would work with her to address each individual concern, but there were so many seemingly unrelated deficits, every activity felt like whack-a-mole.

I started thinking about taking her to a developmental pediatrician for an outside evaluation when she was about three. She was nearly seven before I finally overcame my anxiety and took her. Her mental health had been fragile for quite some time, and something had to give. She would have tantrums that seemed to last all day. She couldn’t listen to reason when she was having paranoia about other kids. She continued to feel completely overwhelmed by school and the kids contained therein.

Nonverbal Learning Disorder is characterized by a deficit in nonverbal skills, but not verbal skills

As the pediatrician outlined the results of my daughter’s testing, I saw little that surprised me. Her verbal IQ was well above average. Her visual-spatial IQ was 40 points lower, in the low average range. She had some global motor issues. She showed signs of anxiety. I nodded my head as he spoke. Mmm-hmm. We know all that.

What I didn’t know until that day, though, was that there was actually a name for this collection of characteristics. My daughter had Nonverbal Learning Disorder (NLD).

Despite having an estimated incidence in children and adolescents of 3–4%, NLD is poorly understood in the education system at large, which is more accustomed to dealing with language-based disabilities like dyslexia.

Many people find the word nonverbal to be misleading; while one might assume nonverbal means the individual doesn’t talk, quite the opposite is true. Once my daughter learned to use her mouth correctly to form intelligible words, she hasn’t stopped talking (one of the hallmarks of NLD). What individuals with NLD struggle with are the things which aren’t verbal.

Math is a struggle for my daughter, along with visual-spatial awareness. Organization is extremely difficult, making tasks such as cleaning her room a huge battle. She becomes overwhelmed by visual stimuli in her environment, because she doesn’t know what to focus on, and because she sometimes can’t distinguish individual components and make sense of them. For this reason, she can require an excessively long time to process a what she’s seeing and respond appropriately. With longer tasks, it sometimes takes so long that she forgets what the question was to begin with.

This is probably the reason she struggled so much with reading when she was younger — letters were really hard to discriminate, especially when they were lined up next to each other to make a word. By the time she got to the end, she forgot what the beginning had sounded like. But once she broke through this barrier, her reading clicked and she took off, shooting up grade levels in just a few months of second grade.

While she’s got her fair share of struggles, my daughter has learned over the years to use her strengths to buttress her weaknesses. Talking through things helps her immensely. She can “do math” when she talks through it aloud, and she can remember every fact she’s ever learned about anything from diplodocus to the atmosphere of Venus. Her verbal ability unlocks skills which might otherwise be hidden away in her mind.

Nonverbal deficits lead to social struggles

Nonverbal struggles, though, have implications that extend beyond the classroom.

While it’s hard to put an exact number on how much communication is nonverbal, estimates usually lie at “over half.” Since my daughter has trouble attending to visual stimuli, she can miss or misinterpret many aspects of nonverbal communication, such as facial expressions, body language, and tone of voice. This leads to her missing more than half the meaning of the conversations that are going on all around her.

She doesn’t always know when kids are being mean to her, or when they’re lying or making fun of her. When she realizes what’s happening, it completely crushes her and it is very difficult to overcome. She would rather change schools than face someone who’s made a fool out of her.

On the flip side, she often misinterprets neutral comments and expressions as negative. When an unfamiliar teacher gives her instructions or reminds her of a routine, she might say the teacher yelled or made fun of her. The poor kid’s self-protection has her assuming everyone is out to embarrass her.

The emotional toll of NLD is much more impactful than the academic one

There is a robust community of individuals with NLD, and I will not speak for any of them. For my daughter, however, the emotional side of NLD affects her far more than the academic side.

There is some interplay, of course. As she’s gotten older, she’s become more aware that she doesn’t understand math like other kids at school (my heart breaks when she says she’s “not as smart” as her friends). And so, in a way, her academic achievement has made her feel inferior.

But, mostly, her feelings of anxiety and depression have stemmed from not being able to understand the other kids, and from them not understanding her. Her feelings of overwhelm have caused her to have emotional breakdowns which embarrass her and push other kids her age away.

I read just after we received my daughter’s diagnosis that children with NLD benefit from having one or two close friends, and after watching my daughter for several years, I can see why that is the case. Navigating multiple relationships when you miss half the cues they’re giving can be confusing and exhausting. We are so lucky her teachers and counselors can keep an eye on her personal relationships and identify for us which ones are healthy, so we can nurture them.

It’s tempting to want to explain my daughter’s idiosyncrasies to potential friends and their parents. Maybe if they understand more about her, they’ll be more accepting and less likely to ghost her like so many friends have already done in her short nine years.

But, really that’s not necessary. Anyone who isn’t understanding enough to accept my daughter for who she is, wouldn’t be a good fit in her life anyway.

Better to continue teaching her to embrace who she is, struggles and all. She’s a perfect little girl who can build on her weaknesses and revel in her strengths. She should never feel she has to explain or excuse herself to anyone.

She’s a force in this world, and the fact that she’s fighting invisible battles most of us couldn’t imagine doesn’t change that.

Invisible illnesses are so difficult to manage, in part because it’s hard for others to understand what they can’t see. It can be even more difficult to understand the debilitating effects of trauma on the developing brain, because “trauma” is not a diagnosis. Yet it still manifests itself for a lifetime, a double-invisible influence, informing the beliefs we hold about ourselves and the world and guiding our behavior, especially in times of struggle. For, me everything started with childhood trauma.

Join me here every second and fourth Monday, where I explore the invisible influence of past trauma on current beliefs and behavior. Find all my past columns and subscribe for updates here.