The importance of raising awareness for people who struggle with Nonverbal Learning Disability.
“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” Maya Angelou (1928–2014)
This is a beautiful quote, although the last part might be somewhat confrontational for those who have a Nonverbal Learning Disability (NVLD or NLD). People who encounter a person with NVLD risk feeling negatively about the interaction afterward and these negative feelings are often attributed to the person’s character.
World-famous comedian, Chris Rock, a person who openly discusses his own NVLD diagnosis, described the impact of the disability this way:
“I’d always just chalked it up to being famous. Any time someone would respond to me in a negative way, I’d think, ‘Whatever, they’re responding to something that has to do with who they think I am.’ Now, I’m realizing it was me. A lot of it was me.” (1)
For a neurotypical person, someone with NVLD appears to have an unusual communication style and an unfamiliar social understanding. These distinctions in social behavior originate in a neurodevelopmental disability that has, at its core, an impairment of visuospatial processing.
NVLD affects important abilities, such as motor and attention skills, academic learning, and navigation of the social world. Additionally, the disability affects the person’s understanding of pictorial metaphors and generalized language comprehension. (2) Another challenge that people with NVLD are known to struggle with is the detection of nonverbal social cues. This impedes their ability to infer mental states, such as emotions and intentions, from cues and gestures. In other words, these deficiencies hamper their ability to mentalize about others.
When we mentalize, we gather meaningful social information through the verbal and nonverbal signals of others. Based on this social information, we infer their mental states, such as emotions, beliefs, and intentions. Arriving at an accurate understanding of what other people think is critical to building up connections and having smooth interactions.
NVLD people struggle, especially with the most elementary level of mentalizing, basic mentalizing. On this level, we infer the basic emotions and straightforward elemental needs and intentions of others. This level of mentalizing is also critical to building rapport and creating a positive ambiance so that others do not feel constrained in their interactions with others. This inability to infer emotions, feelings, and moods impedes affective mentalizing as well because it is on this level that we advance to empathic and compassionate behavior when our interactions with others become emotionally fraught.
Finally, NVLD impacts our highest, and most cognitive, level of mentalizing (strategic mentalizing) since nonverbal information normally adds meaning to verbal communication. Picking up on the paralinguistic aspects of communication is critical to well-informed understanding, for instance, the willingness of others to affiliate and cooperate with, or their intention to compete or to socially distance themselves from, others. (3)
People with NVLD are, to a certain extent, socially blind and have to navigate many unseen aspects of social interactions. When others are not aware of their disability, an NVLD person’s behavior is often misinterpreted and perceived in a negative way.
I wonder whether Chris Rock, owing to his own NVLD, failed to pick up on the nonverbal cues of Will Smith, as the latter strode across the stage and delivered a slap of epic viral YouTube proportions.
Or maybe, Chris didn’t pick up on the facial expressions of Jada Pinkett Smith, or her interactions with Will Smith, after Rock’s joke about her physical appearance (her hairstyle) at the 2022 Academy Awards Ceremony.
He certainly misjudged the impact that his joke had on the celebrity husband of Ms. Smith (a reference to Chris Rock’s 2022 Academy Award altercation with Will Smith).
Regrettably, social conventions, along with the wish to avoid exposure, hold NVLD people back from broaching the subject of their disability when they meet someone for the first time. Moreover, strangers are not inclined to immediately assume that someone they just met has a disability. Then again, if a stranger did suspect something, he or she would probably feel uncomfortable with asking straight away, whether the other might have a disability.
People initially tend to judge a person with NVLD as being rude, not interested in a conversation, or otherwise dysfunctional. Why do some people find it difficult to deal with an NVLD person? Due to their visuospatial impairments, people with NVLD can come across as clumsy and uncoordinated. Someone suffering from NVLD might not follow up on the instructions they are given. This can result in social disconnects in interpersonal settings. Moreover, those with NVLD tend to come across as socially awkward or aloof.
NLVD people often don’t display the nonverbal behavior you might expect, resulting in confusion and social disruption. Additionally, others often feel misunderstood, as those suffering from NVLD don’t infer their own mental states accurately given that they are unable to pick up on available social cues.
Despite their difficulties in grasping the social meaning of spoken language, NVLD people often excel verbally. This proficiency in verbal communication can, however, lead to awkward encounters in social settings, as the affected person often has a hard time “reading the room.” It leads them to make inappropriate remarks and commit social faux pas. They also tend to take things literally and are generally impaired in the detection of sarcasm and humor in verbal communication, leaving others feeling disconnected.
As you can imagine, social environments tend to present a source of stress for people with NVLD. There are occasions when neurotypical people get a little taste of what it means to have NVLD. For instance, if you have ever had the chance to travel or work in a cultural environment that is totally different from your own, you have probably experienced a sense of social uncertainty.
Difficulties in detecting nonverbal behavior in cross-cultural settings are especially challenging and can lead to misinterpretations on both sides. Let me share an illustrative anecdote from a time when I was traveling in Africa.
I was walking down a road and I passed a police officer who signaled me to continue walking, or at least that was how I interpreted the officer’s arm movements. She was, however, signaling me to turn around and come back toward her. She would wave her arms and I would walk on, she started to wave faster and I started walking a little faster, and then she waved even faster and I almost started running until she finally had to run after and stop me. She asked in a frustrated tone why I was being so rude. She told me that she was trying to signal me to turn around, as I wasn’t allowed to go in that direction. Her arm movements in my culture meant to keep going, while in the officer’s culture they meant to come back. I felt embarrassed by my misinterpretation of her instructions and the frustration I had aroused in the officer.
Another of my cross-cultural SNAFUs occurred while I was living in India. It took me a while to get used to the local custom of answering questions with the ubiquitous Indian head bob. Eventually, I learned that my Indian colleagues might be saying yes or no, depending on the context. While I loved the elegance and high-context nonverbal behavior, oftentimes it left me thoroughly confused and having to ask my colleagues to be more explicit.
In the previous two examples, I was the foreigner, and it was easy for the locals to infer why I didn’t understand their nonverbal behavior. The situation was entirely different in my home country, the Netherlands, where I often found myself dealing with new clients, depending on my assigned project. Particularly in large companies, where it was difficult to keep track of who was an internal employee and who was an external contractor, people were sometimes impatient with me if I failed to pick up on unwritten nonverbal behavioral rules that were part of their organizational culture. They would, for instance, exchange long-standing office jokes with just a look or other nonverbal behavior, such as posture, a deep sigh, or a specific tone of voice that I didn’t interpret correctly.
Tight-knit teams were especially prone to such behavior, and it made me feel a little awkward, as it was sometimes used to make it clear that I was an outsider.
Luckily, I don’t suffer from NVLD, so I learned their nonverbal social culture quickly. The experience did, however, give me a glimpse of how someone with NVLD can feel when they struggle to read the room and don’t pick up on other people’s sarcasm or jokes.
In sum, NVLD impacts the lives of afflicted people at home, at school, and work. Early diagnosis, appropriate therapeutic intervention, and a supportive environment can mitigate the challenges significantly. Regrettably, NVLD often remains undiagnosed, with other people simply assuming that the person with NVLD is neurotypical, but clumsy and/or socially inept. Additionally, their strong verbal skills tend to mask their difficulties.
For decades, society has focused strongly on academic performance over social or emotional development, which has contributed to the high probability that people with NVLD were not identified by the “disability detection” skills of those in their environment (parents, teachers, mental health practitioners, etc.). This problem is also attributable to the fact that most people have never heard about NVLD. Advocacy and research have received little attention, and public awareness campaigns have been scant.
Another reason for the underdiagnosis of NVLD is its overlap with other disabilities such as ADHD (problems with attention), high functioning Autism (problems with reading social signals), and Dyslexia (problems with generalized language comprehension).
Within the research field that focuses on NVLD, there is general recognition that a well-defined and standardized set of criteria needs to be developed to assist mental health practitioners in diagnosing NVLD. This criteria set needs to be based on solid scientific research, and described in an understandable and actionable way so that the disability can be included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD). It is critically important that the criteria that are finally set don’t substantially overlap with existing diagnoses.
In the meantime, however, we don’t want to wait until the clinical field has established a clearly described set of criteria, as people need to be made aware of NVLD and the accompanying behavior that might reveal whether we are dealing with someone who has NVLD. Signs to look for include:
Visuospatial difficulties such as an inability to read maps, navigate environments, assemble objects, interpret charts, or draw an object, for instance, of a 3D shape.
Problems with motor coordination such as displays of awkward/clumsy behavior in connection with activities that require coordination and balance (such as riding a bicycle), or difficulties with fine motor skills (such as tying shoes).
Issues with executive functioning such as breaking tasks into smaller pieces, difficulties in dealing with disruption of routines, or misjudging how long an activity will take.
Academic challenges, such as difficulties in understanding abstract concepts and spatial reasoning, struggles in completing homework in a timely and efficient manner, or difficulty with tasks that require visual learning.
Social and communication problems that create confusion, displays of social awkwardness, difficulties in the initiation and/or maintenance of relationships, or struggles with conversational rules, such as turn-taking and picking up on jokes or sarcasm.
Emotional issues due to the aforementioned challenges that can bring about feelings of frustration and anxiety in social and academic settings, often leading to social withdrawal.
High verbal IQ, even though speech appears to be less rich and is characterized by struggles with information integration. (2) & (3)
All of these symptoms are telltale signs that a person may have NVLD. This understanding can help people mentalize more accurately about people who unintentionally, and often unwittingly, make others feel uncomfortable.
So, if you know someone who has NVLD, you can help them mentalize about you by being more explicit and patient when they have a hard time understanding your nonverbal and verbal behavior, or when you see them struggle with daily tasks or academic pursuits.
Thank you for reading this article. I hope it supports others who are working so incredibly hard to raise awareness of NVLD.