People who think, learn, and do things differently from the majority of the population (neurotypicals, or NTs) because of neurological differences are known as neurodivergent (ND). Those with NVLD are therefore categorized as ND. Since their appearance doesn’t indicate the discrepancy between their exceptional verbal and poor nonverbal communication (body language, facial expressions, gestures, tone of voice) and performance difficulties, people assume they are neurotypical. NVLD may be the most overlooked, misunderstood, misdiagnosed, and misnamed learning disability. According to “Estimated Prevalence of Nonverbal Learning Disability among North American Children and Adolescents,” published in the April 2020 issue of the Journal of the American Medical Association (JAMA), between 2.2 and 2.9 million children under the age of eighteen in the United States and Canada may have NVLD.
Moreover, as many as 50 percent of them have received no diagnosis. Overlapping symptoms and co-occurring disorders may cause those with NVLD to be misdiagnosed as having ADHD or autism level 1 (a variant of autism formerly known as Asperger’s syndrome) and, therefore, NVLD to be underdiagnosed. Marcia Rubinstein, an education specialist in West Hartford, Connecticut, once said that almost every child she saw with NVLD had first been diagnosed with ADHD. Despite the overlapping symptoms in all of these disorders, the causes stem from differences in brain pathology that distinguish one disorder from another.
A nonverbal learning disability is believed to be caused by damage, disorder, or destruction of neuronal white matter in the brain’s right hemisphere. In an article published in the March 1, 1994, Journal of Learning Disabilities, Michael C. S. Harnadek and Bryan P. Rourke wrote that brain scans have identified that children with NVLD have smaller splenia than those with high-functioning autism and ADHD. The splenium is a part of the corpus callosum that connects the left and right hemispheres of the brain and is vital for visual-spatial functioning. NVLD typically shows up as a right-hemisphere weakness. Adding to the confusion is disagreement among professionals within the psychological and educational communities. Since NVLD is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), it isn’t recognized as an official disorder. The DSM is the bible of mental disorders, used by professionals as a reference for descriptions, symptoms, and criteria to make an official diagnosis required for insurance reimbursement and approval of special education services. But not all children and adults fit into the same pattern. In other words, NVLD is not a cookie-cutter diagnosis. The saying “When you’ve met one person with autism, you’ve met one person” also applies to those with NVLD. NVLD is distinguished by both visual-spatial and nonverbal communication skills deficits, according to experts at the National Center for Learning Disabilities. A defining criterion for the condition is the presence of a discrepancy between perceptual reasoning (formerly performance IQ) and verbal comprehension (formerly verbal IQ), as measured in diagnostic testing and evaluations.
Let alone NVLD; the majority of learning disabilities are invisible, causing these individuals to “mask” as neurotypical for acceptance in our society. When we see someone in a wheelchair, we don’t hold that person accountable for things they struggle with or cannot do. Most of us understand they may need assistance and alter our expectations accordingly. But, there is no such sign or visible evidence, like a wheelchair, to account for those with invisible difficulties and socially awkward behaviors.
The good news is our society is becoming rapidly aware of the neurodiverse population, the importance of inclusion, and realizing that being different is not better or worse, just different. You can learn more about how those with NVLD and other invisible learning disabilities can thrive and live their best lives in my new book Misnamed, Misdiagnosed, Misunderstood.
Linda Karanzalis, Board-Certified Cognitive Specialist is the author of Misnamed, Misdiagnosed, Misunderstood, a new book on Nonverbal Learning Disorder and other brain-based challenges.
Dr. Ned Hallowell, a psychiatrist, world-renowned expert on ADHD, and the New York Times best-selling author of Driven to Distraction says, “Linda’s book is vivid, compelling, full of heart and fresh understanding. Karanzalis replaces suffering with clarity and triumph for the millions of people with NVLD.”
Linda, who has NVLD and ADHD, has worked for more than 25 years with individuals of all ages with NVLD, ADHD, learning disabilities, and those on the autistic spectrum. As an author, podcaster, presenter, learning specialist, and ambassador for the NVLD Project, she provides validation, awareness, solutions, strategies, and, most importantly, compassion to the millions who live with neurodiversity. Find out more about her story and book at www.lindakaranzalis.com.