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Nonverbal Learning Disability



  • A nonverbal learning disability causes problems understanding body language, facial expressions, and tone of voice. A child with NLD also has trouble with balance, coordination, and doing physical things.
  • Treatment may include sensory integration therapy, social skills training, physical and occupational therapy, and help from your child’s school.
  • Work with your child, as well as the school and your child’s therapists, to support and encourage your child.


What is a nonverbal learning disability?

A nonverbal learning disability (NLD) causes problems understanding body language, facial expressions, and tone of voice. A child with NLD also has trouble with balance, coordination, and doing physical things.

What is the cause?

NLD is caused mostly by problems in the right side of the brain. Problems during pregnancy or birth that may increase the risk that your child will have NLD include:

  • A mother who smoked, drank alcohol, or was ill while pregnant
  • Very long labor at birth
  • Having the umbilical cord wrapped around the child’s neck
  • Premature birth or low birth weight

Serious infections as a young infant also may increase the risk. NLD affects boys and girls equally.

Children with NLD may also have autistic spectrum disorder or other learning disorders that sometimes run in families.

What are the symptoms?

Your child may talk early and know more words than other children of the same age. However, your child may have trouble with:

  • Learning how to make the shapes of the letters
  • Copying and drawing shapes
  • Writing on lines and inside of margins, jumbling words together instead of putting spaces between them, and keeping columns of numbers straight
  • Spelling words that cannot be sounded out such as the word "enough"
  • Not recognizing words that your child has previously sounded out over and over, which can make your child a slow reader
  • Doing math, especially word problems

Your child may also:

  • Be clumsy and have many small accidents such as spilling things
  • Have trouble learning to kick or catch a ball, ride a bicycle, or tie shoes
  • Be slower than other children to learn to tell left from right
  • Miss or not understand facial gestures and body language cues
  • Seem out of touch with others in conversations
  • Take things too literally and not understand jokes or sarcasm
  • Have trouble making and keeping friends
  • Have a hard time with changes, such as stopping an activity to go someplace

How is it diagnosed?

Your healthcare provider will ask about your child's symptoms and medical history and examine your child. Sometimes scans of the brain will be done to screen for any physical problems.

Your child may need to see a specialist for more testing. Your school district may also provide testing services for your child.

How is it treated?

Several kinds of therapy can help treat NLD:

  • Sensory integration therapy, which is a kind of therapy that uses games to improve your child's sense of touch, sense of movement, and sense of body position
  • Social skills training to help your child learn how to respond to people
  • Help from your child’s school with math, reading, spelling, and physical education classes
  • Physical therapy or occupational therapy, which helps improve your child’s strength, balance, and coordination

Medicines are generally not helpful for NLD, but may help with some symptoms.

How can I help my child?

  • Find out what services are offered through your school district to help children with learning disabilities.
  • Learn ways to work with your child at home. Spend regular time at home working with your child on writing, spelling, and math skills. It will help if you talk through the steps. Encourage your child to say the steps of a process aloud.
  • Help your child follow a structured daily routine. Give clear instructions and explanations.
  • Teach your child not to be embarrassed about having NLD. It does not mean that your child is not intelligent.
  • Be patient with your child. Praise your child for all efforts and for any improvement, however small.
  • Look for your child’s strengths. No one knows what your child may be able to do in time, so don’t set your expectations too low.
  • Talk with your child's teachers to see if your child can use a computer, calculator, or other tools to help with schoolwork.
  • Help your child identify emotions and the meanings that go with facial expressions and body cues and think about how to respond.
  • If your child is anxious or depressed, seeing a mental health therapist may be helpful. Your child’s healthcare provider may refer you to a therapist who can also help parents.

For more information, contact:

Developed by Change Healthcare.
Pediatric Advisor 2022.1 published by Change Healthcare.
Last modified: 2020-09-30
Last reviewed: 2018-09-13
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2022 Change Healthcare LLC and/or one of its subsidiaries
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