Laura Laemmle found that some teachers didn't always understand how to teach her daughter, who has a nonverbal learning disability. Some were very empathetic, while others were not. Special education wasn't a good fit for her daughter, but neither was mainstream education. She felt that her daughter ultimately wasn't getting what she needed.
Laemmle wanted to do something to help other children like her daughter. She thought someone must be working to raise awareness, but it seemed like no one was. She decided she had to do it.
But now nonverbal learning disabilities (NVLDs) are unexpectedly getting attention after some on social media took notice of the emotional reaction of Minnesota Governor Tim Walz's teenage son, Gus, when Walz accepted the Democratic vice presidential nomination, raising awareness of what NVLDs are.
The Waltz family previously Gus suffers from attention deficit hyperactivity disorder, anxiety disorders and a non-verbal learning disability.
Laemmle, founder of the NVLD Project, a nonprofit that aims to raise awareness of the illness and get it recognized as an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, the standard used by U.S. mental health professionals to classify mental disorders, said the Waltzes' outspokenness has shone a light on NVLD.
“It's an issue for this population that hasn't received much attention,” she said. “Having it in the DSM, to me, is just the beginning, because a lot more work needs to be done.”
If not recognized in the DSM, NVLD is not covered by the Individuals with Disabilities Education Act, and students cannot receive assistance unless they have another diagnosable disability.
When it comes to learning disabilities, there's a lack of research on disabilities other than dyslexia, said Monica McHale Small, education director for the Learning Disabilities Association of America.
“We often hear that the most common learning disability is dyslexia, but we don't have good data to show that's the case. Dyslexia is the one we have the most information about and the most research,” McHale Small said. “We need more research on learning disabilities and how they manifest in the classroom and in life.”
There is a need for further awareness, research, and eventual inclusion in the DSM. Here are some frequently asked questions and answers.
What is a Nonverbal Learning Disorder?
NVLD refers to a group of children and adults who experience problems with vision, spatial awareness and problem-solving that impair their ability to function in everyday life, said Amy Margolis, a professor of pediatric neuropsychiatry at Columbia University, whose research is funded by the NVLD Project.
Because it's called a nonverbal learning disability, a common misconception is that people with NVLD have language or speech problems or that they have an autism spectrum disorder. Researchers have studied the similarities and differences between these disorders. Margolis says that while it's possible to be both, they're different.
In a study several years ago, Margolis asked parents of children with NVLD and children with autism spectrum disorder to assess their children's social functioning. When researchers looked at the children's brain function, they found that the problems with social functioning stemmed from “different problems in the circuitry that underlies social functioning,” Margolis said. The technical term is different pathophysiology, but essentially the brain substrate is different, she said.
What are some common signs of NVLD that educators may see in the classroom?
A classic example is difficulty with math, Margolis said: either understanding the concepts behind numbers and math, or learning the mechanics of learning the steps to align things on the page, like when you're writing an addition problem and the columns don't line up.
As they grow, students with NVLD may struggle with certain types of math that require visual or spatial problem solving, such as geometry, or with science subjects that require reading or drawing graphs.
Students who learned to read easily in first and second grade may now find it harder to read for schoolwork and may struggle to grasp themes and big picture of what they read, Margolis said.
In gym class, a child with NVLD might run in the wrong direction during a soccer game. They might have trouble packing a backpack, building a structure with Lego, or determining whether it is safe to cross the street.
Margolis said these students often have stronger verbal skills than visual-spatial abilities. Giving students diagrams and helping them label them, rather than drawing them, is one way teachers can create an inclusive space.
“For a lot of kids, tracing a square in a circle isn't that hard, but for this kid it was,” she says. “I want to take that difficulty away and get him to focus on learning what the shape represents.”
The NVLD project also devised a toolkit to help educators understand NVLD and how it manifests in the classroom.
These students may also struggle with higher-level comprehension, said McHale Small, who has been an educator for nearly 30 years. Rephrasing instructions or explaining concepts in different ways can help.
McHale Small added that social skills are also essential for success in and out of school, and it's important for educators to help develop friendships and model how to navigate social conflicts.
Do you have a diagnosis of NVLD?
Because NVLD isn't included in the diagnosis, it's hard for students to get a diagnosis, Margolis said. Clinicians are forced to categorize students based on “downstream issues,” like whether they also meet the criteria for ADHD, anxiety, or a specific learning disability in math. That means students often don't get help specific to NVLD under IDEA.
A study published in 2020Margolis and his colleagues found that as many as 3 percent of North American children may meet criteria for the disorder, and while many of the children in their sample had other diagnoses, about 10 percent did not.
“We estimate that there are 300,000 children who are not receiving care because they don't meet other diagnostic criteria,” she said.
Currently, people must undergo a neuropsychological evaluation to receive a diagnosis, she said, and there are efforts underway to include NVLD as a diagnosis in the DSM and to redefine it as developmental visuospatial disorder (DVSD).
“We hope that having it in the book will really increase people's access,” she said, “and we encourage this diagnosis to be interview-based, just like ADHD is diagnosed based on an interview rather than requiring testing.”
Now, Margolis and his colleagues are working to prove that the new definition can be used reliably. If it's included in the DSM, Margolis says, it could not only improve access to health care but also spur interest in research.
“If it's not in the DSM and it's not recognized, people aren't going to study it because it's very hard to get research funding to study it. Why would anyone want to develop a cure for a disease that no one can diagnose?” she said.