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Concept: Nonverbal learning disorder


The current study investigated morphological differences in the corpus callosum in children ages 8 to 18 years old with nonverbal learning disability (NLD; n = 19), high-functioning autism (HFA; n = 23), predominantly inattentive ADHD (ADHD:PI; n = 23), and combined type ADHD (ADHD:C; n = 25), as well as those demonstrating typical development (n = 57). Midsagittal area of the corpus callosum and five midsagittal anterior-to-posterior corpus callosum segments were examined using magnetic resonance imaging. Controlling for midsagittal brain area and age, no group differences were found for total corpus callosum area. This finding indicates that higher functioning children on the autistic spectrum do not have smaller corpus callosi as has been found in previous research with heterogeneous samples. Following segmentation of the corpus callosum, the NLD group was observed to have significantly smaller splenia compared to all other groups. Smaller splenia in the NLD group was associated with lower WASI PIQ scores but not WASI VIQ scores. Children with HFA were observed to have larger midbody areas than children with NLD and neurotypically developing children. Children with HFA and NLD demonstrated behavioral symptoms of inattention and hyperactivity similar to the ADHD groups indicating that corpus callosum differences seen in the NLD and HFA groups are not related to these behaviors.

Concepts: Brain, Magnetic resonance imaging, Autism, Corpus callosum, Attention-deficit hyperactivity disorder, ADHD predominantly inattentive, Asperger syndrome, Nonverbal learning disorder


Based on a review of the literature, the diagnostic criteria used for children with nonverbal learning disabilities (NLD) were identified as follows: (a) low visuospatial intelligence; (b) discrepancy between verbal and visuospatial intelligence; © visuoconstructive and fine-motor coordination skills; (d) visuospatial memory tasks; (e) reading better than mathematical achievement; and (f) socioemotional skills. An analysis of the effect size was used to investigate the strength of criteria for diagnosing NLD considering 35 empirical studies published from January 1980 to February 2011. Overall, our results showed that the most important criteria for distinguishing children with NLD from controls were as follows: a low visuospatial intelligence with a relatively good verbal intelligence, visuoconstructive and fine-motor coordination impairments, good reading decoding together with low math performance. Deficits in visuospatial memory and social skills were also present. A preliminary set of criteria for diagnosing NLD was developed on these grounds. It was concluded, however, that-although some consensus is emerging-further research is needed to definitively establish shared diagnostic criteria for children with NLD.

Concepts: Diagnosis, Educational psychology, Learning, Disability, Reading, Learning disabilities, Nonverbal learning disorder


Research has shown that children with learning disabilities (LD) are less prone to evince associative illusions of memory as a result of impairments in their ability to engage in semantic processing. However, it is unclear whether this observation is true for scripted life events, especially if they include emotional content, or across a broad spectrum of learning disabilities. The present study addressed these issues by assessing recognition memory for script-like information in children with nonverbal learning disability (NLD), children with dyslexia, and typically developing children (N=51). Participants viewed photographs about 8 common events (e.g., family dinner), and embedded in each episode was either a negative or a neutral consequence of an unseen action. Children’s memory was then tested on a yes/no recognition task that included old and new photographs. Results showed that the three groups performed similarly in recognizing target photographs, but exhibited differences in memory errors. Compared to other groups, children with NLD were more likely to falsely recognize photographs that depicted an unseen cause of an emotional seen event and associated more “Remember” responses to these errors. Children with dyslexia were equally likely to falsely recognize both unseen causes of seen photographs and photographs generally consistent with the script, whereas the other participant groups were more likely to falsely recognize unseen causes rather than script-consistent distractors. Results are interpreted in terms of mechanisms underlying false memories' formation in different clinical populations of children with LD.

Concepts: Psychology, Causality, Educational psychology, Disability, Dyslexia, Learning disability, Learning disabilities, Nonverbal learning disorder


Clinicians acknowledge the presence of developmental cognitive phenotypes mainly characterized by a specific visuospatial impairment in presence of intact verbal functioning (usually referred as Nonverbal Learning Disability: NLD) since many decades, without providing sufficient empirical evidence supporting their nosological validity and inclusion in current diagnostic manuals. This contribution suggests that the goal of including NLD in future diagnostic manuals could be achieved only be the demonstration of the validity of this hypothesized clinical category. Considering the blind spot of empirical literature represented by the differential diagnosis of NLD, this issue should the primary focus of empirical research supported by a renewed interest on NLD. Both neurophysiological and clinical evidence suggest that the differential diagnosis and the related empirical comparison should be primarily settled with Developmental Coordination Disorder, looking for the possible identification of children presenting a visuospatial impairment in absence of severe motor coordination impairment. In conclusion, further studies are needed to support the validity of NLD as valid diagnostic category to be included in future revisions of diagnostic manuals.

Concepts: Medical terms, Research, Motor control, Empiricism, Empirical, Disability, Empirical research, Nonverbal learning disorder


Visuo-constructive and perceptual abilities have been poorly investigated in children with learning disabilities. The present study focused on local or global visuospatial processing in children with nonverbal learning disability (NLD) and dyslexia compared with typically-developing (TD) controls. Participants were presented with a modified block design task (BDT), in both a typical visuo-constructive version that involves reconstructing figures from blocks, and a perceptual version in which respondents must rapidly match unfragmented figures with a corresponding fragmented target figure. The figures used in the tasks were devised by manipulating two variables: the perceptual cohesiveness and the task uncertainty, stimulating global or local processes. Our results confirmed that children with NLD had more problems with the visuo-constructive version of the task, whereas those with dyslexia showed only a slight difficulty with the visuo-constructive version, but were in greater difficulty with the perceptual version, especially in terms of response times. These findings are interpreted in relation to the slower visual processing speed of children with dyslexia, and to the visuo-constructive problems and difficulty in using flexibly-experienced global vs local processes of children with NLD. The clinical and educational implications of these findings are discussed.

Concepts: Educational psychology, Disability, Dyslexia, Reading, Learning disability, Special education, Learning disabilities, Nonverbal learning disorder


The nonverbal learning disability (NLD) is a neurological dysfunction that affects cognitive functions predominantly related to the right hemisphere such as spatial and abstract reasoning. Previous evidence in healthy adults suggests that acoustic pitch (i.e., the relative difference in frequency between sounds) is, under certain conditions, encoded in specific areas of the right hemisphere that also encode the spatial elevation of external objects (e.g., high vs. low position). Taking this evidence into account, we explored the perception of pitch in preadolescents and adolescents with NLD and in a group of healthy participants matched by age, gender, musical knowledge and handedness. Participants performed four speeded tests: a stimulus detection test and three perceptual categorization tests based on colour, spatial position and pitch. Results revealed that both groups were equally fast at detecting visual targets and categorizing visual stimuli according to their colour. In contrast, the NLD group showed slower responses than the control group when categorizing space (direction of a visual object) and pitch (direction of a change in sound frequency). This pattern of results suggests the presence of a subtle deficit at judging pitch in NLD along with the traditionally-described difficulties in spatial processing.

Concepts: Psychology, Cognition, Acoustics, Frequency, Concept, Sound, Psychoacoustics, Nonverbal learning disorder


Nonverbal learning disability is a childhood disorder with basic neuropsychological deficits in visuospatial processing and psychomotor coordination, and secondary impairments in academic and social-emotional functioning. This study examines emotion recognition, understanding, and regulation in a clinic-referred group of young children with nonverbal learning disabilities (NLD). These processes have been shown to be related to social competence and psychological adjustment in typically developing (TD) children. Psychosocial adjustment and social skills are also examined for this young group, and for a clinic-referred group of older children with NLD. The young children with NLD scored lower than the TD comparison group on tasks assessing recognition of happy and sad facial expressions and tasks assessing understanding of how emotions work. Children with NLD were also rated as having less adaptive regulation of their emotions. For both young and older children with NLD, internalizing and externalizing problem scales were rated higher than for the TD comparison groups, and the means of the internalizing, attention, and social problem scales were found to fall within clinically concerning ranges. Measures of attention and nonverbal intelligence did not account for the relationship between NLD and Social Problems. Social skills and NLD membership share mostly overlapping variance in accounting for internalizing problems across the sample. The results are discussed within a framework wherein social cognitive deficits, including emotion processes, have a negative impact on social competence, leading to clinically concerning levels of depression and withdrawal in this population.

Concepts: Psychology, Sociology, Educational psychology, Skill, Attention-deficit hyperactivity disorder, Emotion, Paul Ekman, Nonverbal learning disorder


Social perception is an important underlying foundation for emotional development and overall adaptation. The majority of studies with children with High Functioning Autism (HFA) or nonverbal learning disabilities (NLD) evaluating social functioning have used measures of parent and/or teacher ratings. The present study utilized parent and teacher ratings of behavior as well as executive functioning in addition to direct measures of social perception. Three groups participated in this study (control [n = 38] HFA [n = 36], NLD [n = 31]). Results indicated that the HFA group experienced the most difficulty understanding emotional cues on the direct measure while both the HFA and NLD groups experienced difficulty with nonverbal cues. Significant difficulties were reported on the parent rating scale for sadness and social withdrawal for both clinical groups. Executive functioning was found to be particularly problematic for the clinical groups. The direct social perception measure was highly correlated with the measures of executive functioning and reflects the contribution that executive functions have on social functioning. These findings suggest that the clinical presentation on behavior rating scales may be very similar for children with HFA and NLD. Moreover, it appears that measures of executive functioning are sensitive to the clinical difficulties these groups experience. The findings also suggest there is a commonality in these disorders that warrants further investigation.

Concepts: Psychology, Autism, Attention-deficit hyperactivity disorder, Asperger syndrome, Working memory, Executive functions, Neuropsychological assessment, Nonverbal learning disorder


A specific overlap between Asperger syndrome (AS) and nonverbal learning difficulties (NLD) has been proposed, based on the observation that, as a group, people with AS tend to have significantly higher verbal IQ (VIQ) than performance IQ (PIQ), one of the core features of NLD. The primary aim was to assess the longer term outcome of NLD-broken down into persistent and transient forms. The present study of 68 individuals was performed in the context of a larger prospective longitudinal study to late adolescence/early adult life of 100 boys with AS. Using self- and parent-report measures, we studied the longer term outcome of the NLD (defined as VIQ > PIQ by 15 points) as regards social communication, repetitive behaviour, attention, and executive function (EF) was studied. Three subgroups were identified: (1) Persistent NLD (P-NLD), (2) Childhood “only” NLD (CO-NLD) and (3) Never NLD (NO-NLD). The P-NLD group had the worst outcome overall. The CO-NLD group had better reported EF scores than the two other AS subgroups. There were no differences between the subgroups regarding social communication, repetitive behaviour, or attentional skills. Low PIQ increased the risk of ADHD symptoms. In the context of AS in males, P-NLD carries a relatively poor outcome, particularly with regard to self-reported EF. However, CO-NLD appears to entail a significantly better outcome. The results underscore the importance of analysing the cognitive profile both at diagnosis and after several years, so as to be able to formulate a realistic prognosis.

Concepts: Sociology, Asperger syndrome, Intelligence quotient, Wechsler Adult Intelligence Scale, Wechsler Intelligence Scale for Children, David Wechsler, Block design test, Nonverbal learning disorder


Chromosome 22qll.2 deletion syndrome (22qllDS) is the most common microdeletion in humans. Nonverbal learning disability (NLD) has been used to describe the strengths and deficits of children with 22q11DS, but the applicability of the label for this population has seldom been systematically evaluated. The goal of the current study was to address how well the NLD diagnosis characterizes children and adolescents with 22q11DS. A total of 74 children and adolescents with 22q11DS were given neurocognitive, socioemotional, and academic assessments to measure aspects of NLD. Of the cohort, 20% met at least 7 of 9 assessed criteria for NLD; 25% showed verbal skills exceeding their nonverbal skills as assessed by an IQ test; and 24% showed the good rote verbal capacity commonly associated with NLD. Hypothesizing that if the entire cohort did not show consistent NLD characteristics, the descriptor might be more accurate for a distinct subgroup, the authors used latent class analysis to divide participants into three subgroups. However, the lines along which the groups broke out were more related to general functioning level than to NLD criteria. All three groups showed a heightened risk for psychiatric illness, highlighting the importance of careful mental health monitoring for all children with 22qllDS.

Concepts: Psychology, Chromosome, Mental disorder, Asperger syndrome, Genetic disorders, Disability, Psychiatry, Nonverbal learning disorder