Evidence-Based Reviews

Does your patient have a psychiatric illness or nonverbal learning disorder?

Current Psychiatry. 2011 May;10(5):17-36

References

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Related Resources

Rourke BP. Syndrome of nonverbal learning disabilities: Neurodevelopmental manifestations. New York, NY: Guilford Press; 1995.
NLD Line. www.nldline.com.
NLD on the Web. www.nldontheweb.org.
Massachusetts General Hospital school psychiatry program and Mood and Anxiety Disorders Institute resource center. www2.massgeneral.org/schoolpsychiatry.

Disclosures

Drs. Delgado and Wassenaar report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

Dr. Strawn has received research support from the American Academy of Child and Adolescent Psychiatry and Eli Lilly and Company.

Acknowledgements

The authors acknowledge Drs. Michele Berg and Carleen Franz for their careful review of this manuscript and for their critiques, which have greatly improved this contribution.

Neurophysiology of nonverbal learning disorder

Rourkea conceptualized nonverbal learning disorder (NLD) as being related to dysfunction in the right cerebral hemisphere with subsequent disruption of the cognitive functions modulated by that region. Difficulties associated with NLD were thought to be related to dysfunction in intermodal integration, a process that inherently depends on white matter connectivity.b

More recent data suggest that although right brain dysfunction may affect cognition, NLD patients likely exhibit dysfunction in multiple brain regions.c-e Nonetheless, right hemisphere lesions in adults often result in similar disturbances as those observed in patients with NLD (eg, visual-spatial integration, attention, nonverbal memory, and expression and integration of emotion).f,g Functional brain imaging studies and functional connectivity studies are needed to better elucidate the neurocircuitry of NLD.

References

a. Drummond CR, Ahmad SA, Rourke BP. Rules for the classification of younger children with nonverbal learning disabilities and basic phonological processing disabilities. Arch Clin Neuropsychol. 2005;(20):171-182.
b. McDonald BC. Recent developments in the application of the nonverbal learning disabilities model. Curr Psychiatry Rep. 2002;4(5):323-330.
c. McCann MV, Pongonis SJ, Golomb MR, et al. Like father, like son: periventricular nodular heterotopia and nonverbal learning disorder. J Child Neurol. 2008;23:950-953.
d. Carey ME, Barakat LP, Foley B, et al. Neuropsychological functioning and social functioning of survivors of pediatric brain tumors: evidence of nonverbal learning disability. Child Neuropsychol. 2001;7(4):265-272.
e. Denckla MB. Academic and extracurricular aspects of nonverbal learning disabilities. Psychiatric Annals. 1991;21: 717-724.
f. Gross-Tsur V, Shalev RS, Manor O, et al. Developmental right-hemisphere syndrome: clinical spectrum of the nonverbal learning disability. J Learn Disabil. 1995;28(2):80-86.
g. Mesulam M. Principles of behavioral and cognitive neurology. New York, NY: Oxford University Press; 2000.