Nonverbal learning disorder vs. AS?

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Does anyone know what the difference is? I've been researching it all day, and I have yet to come across a core difference. The only defining factor that I've read is that people with NVLD aren't as severely affected as those with AS, especially in the social department. Wouldn't that still be considered just a mild form of AS?

Usually people with NVLD have visual spatial issues. They may have trouble remembering what a place looks like, even if they see it every day. And the social problems may be less pronounced. I think that there is a difference between nvld and as, though they are extremely similar.

As far as I understand it, the social problems are less severe, and stimming is less of a problem. On the other hand, perceptual and motor impairments tend to be worse, especially when it comes to visual-spatial processing and memory. Here's an article about a girl with NLD that you may find illuminating:

http://www.geocities.com/HotSprings/Spa ... inbow.html

Another thing is that AS cannot be diagnosed really just with neuropsychological testing, while NLD can. When I was tested, I was given portions of the WAIS-III, the Tactual Performance Test (from the Halstead-Reitan battery), the Rey-Osterrieth Complex Figure Test, the California Verbal Learning Test, along with many others (there were like 15). If you're curious, I can post some excerpts from my evaluation report which you might find helpful.

In addition, with NLD there is generally a significant discrepancy between the verbal and performance IQ scores. In my case, my verbal IQ is 27 points above my performance IQ, and my verbal-comprehension index is actually *39* points above my perceptual-organizational index, which is like 2.5 standard deviations. In other words, if I had a normal verbal index, say 100, my perceptual index would be only 69, which is really low, obviously. A difference greater than about 15 points is generally considered to be significant, although some people argue it should be more like 20 points. My best nonverbal skills are still about 2 standard deviations (~30 points) below my usual verbal ability, while my most severely affected skills are more like 5-6 standard deviations lower (~75- 90 points).

There is a lot of cross-over with AS and NLD though. For both, organizational and executive skills are frequently impaired. Rote memory is excellent, and as the neuropsych commented in my report, people with NLD may "rely on verbal or rote skills during social interactions, neglecting more intuitive visual-perceptual and visual-motor skills, which can leave them socially anxious and isolated," which sounds like AS. She also noted that my "range of emotional expression appeared slightly constricted," which I guess is something you would see with AS as well. AS was considered in my case, and the reasons she gave in the report for eliminating AS were: "Although --- described impairment in the use of non-verbal behaviors to regulate social interactions and the subsequent failure to develop appropriate peer relationships, all of which is consistent with Asperger's Disorder, she noted no repetitive motor mannerisms, rigid adherence to routines, or restrictive, all-absorbing interests. --- also noted no unusual social, language, or communication patterns of early onset. --- describes problems with social and motor functioning, but the onset, nature, and magnitude of these problems are inconsistent with a diagnosis of Asperger's Disorder." It was the neuropsych person who brought up AS by the way, not me- I'd already decided that I didn't fit AS as well as NLD.

One additional difference, which is pretty interesting, is that NLD, unlike AS, is almost entirely associated with problems in the right-hemisphere (it's a "white-matter disorder"). This means that problems are frequently worse on the left side of the body. For instance, you might have left-side weakness (my left grip is only in the 10th percentile, which is impaired- right grip is in 65th percentile), motor problems might be worse on the left side, or in some cases, people might even have neglect on their left side. My visual-motor coordination is actually worse on my right side, which might be evidence of bilateral representation of function (especially because of the history of lefthandedness in my family), which is cool. In addition, I definitely favor my right visual field to an unusual degree, even to the point of missing two items in my left visual field during a cancellation task- which is really unusual for someone who hasn't had a stroke or traumatic brain injury (or similar damage). Anyway, as you can probably tell, neuropsychology is an interest of mine. I even considered going into it, but chose speech pathology instead (the reasons are complicated). However, I might be doing an independent study in the spring with someone who works in brain-imaging, which is pretty cool.

Yes, this is very true. I also have trouble recognizing streets I drive on everyday.

Ooh- thought of another difference. Whereas many people on here describe "thinking in pictures," with NLD you definitely tend to think strictly in words, and in fact have difficulty visualizing things. When I visualize things for instance, the images are vague and lacking in details, and tend to slip away very quickly (I can only visualize something for about a split second before it's gone- and it's effortful). Some NLDers can't visualize things at all. People with autism tend to have a strong visual memory and may have problems with auditory processing, while NLDers have a strong auditory memory and problems with visual processing. NLDers also tend to lack an internal map, and often have problems with topographic memory.

I have been re-diagnosed with NVLD and I have that exact same problem! It took me two years to figure out exactly which streets to take to a friends house when walking (and she was only a mile something away in the same neighborhood I had lived in for years)! However, I am excellent at interior directions (such as schools and malls) and I have perfectly fine motor skills.

I can do you one better. In my departmental building, two rooms which I go to frequently (as often as several times a week) are the grad room and the AAC lab. They are in the same hallway, about four or five doors apart. It took me until April (I started in August) to realize that these rooms were in the same hallway. Really. I had a semi-reliable route to get to the grad room, but I could never remember how to get to the AAC lab, so I would just wander around the second floor until I found it (the building was not large by the way). Pathetic? Definitely. But yes, I also had many problems navigating in my hometown growing up. It's only 1.9 square miles, and I lived there my whole life until college, but I couldn't even describe to you how to get from my house to the grocery store (about 6 blocks away). So welcome to the NLD family- you're not alone!

it's really hard to distinguish..... ive posted several threads on it... as i am an odball case can cant decide whether i have AS or a comorbid of NVLD... the great divide seems to be the obsessive nature and stimming associated with AS

but, as a lefthanded female with particular IQ/standardized test scores.... i have a hard time teasing them apart.

NLVDs tend to have more spatial learning issues and more issues with math related topics... like diagram interpretting...

someone posted a really helpful powerpoint presentation on the differences/similarities between the two...

it's thought though that NLVDs may just be a subset of AS... as the symptoms are pretty much umbrellaed under AS... but then again, it's contested whether either is actually a form of autism... it's all so convoluted!


i think we're gonna have to wait until they revamp all that DXing criteria...

but for me... it's mainly my quirky behavior that makes me lean toward AS more

and also... does anyone know whether the eye contact issue associated with autism/as is found in NLVDs too? (ive never gotten a straight answer nor read anything on it)

thanks for adding another thing to my list of confounding variables!! !! !! i am very visual but for the most part prefer to learn auditory............... grrrr!

but also confiming my spatial limitations... i get lost in stores

Last edited by Sedaka on 08 Aug 2007, 1:15 am, edited 1 time in total.

AS has a sex ratio bias (toward males) whereas NVLDs are equal

As I've stated before, I've been re-diagnosed with NVLD and I can safely say I've never had a problem with eye contact.

i didnt think it was associated... but given how confusing this stuff is...... i wasnt aobut to rule it out

thanks though

I have tremendous problems with eye contact (two professors have commented on it actually), but since I also have major social anxiety, it's sometimes hard to tease the symptoms apart. I did read in a book on NLD once, that many NLDers have trouble with eye contact, but again, it may be due to anxiety (which is a very common comorbid with NLD).

The difference between the NLD and AS has been confusing me since I've been investigating it, particularly as it relates to me. In some ways this thread has only added to the confusion.

IQ testing shows a significant discrepancy between my verbal and performance IQ's but
I have a very good visual imagination (at the same time when I was a child I used to remember conversations with my mom and catch her weeks or months later contradicting herself.)

I have an excellent sense of direction (probably based on orientation and sighting landmarks) but
when I'm interested in a subject I become very animated and inflect my words, possibly more than most other people. I can be very charismatic at those times. Public speaking works the same way for me, but when a part of a larger group interacting together I have a hard time.

I focus on very specific interests with little interest in anything else (when I get very involved sometimes I forget to eat) but I don't stimm.

I'm left-handed but I have very poor vision in my left-eye (astigmatism.)

I tend to understand things symbolically and distance myself from literal meaning but
I frequently take the people around me literally in jest.

When I'm not animated my affect tends to be very flat. I've had people I know come up to me quite randomly to ask if I'm okay. I like humor. My deadpan is so effective that I've on multiple occasions unintentionally convinced the people around me of complete nonsense.

I can be fairly intuitive about other people however I've noticed that I'm not really less intuitive with friends I've made on the internet where there's no body language or facial expression.

I'm hypersensitive. Writing formal papers is very difficult. Applying mathematics is harder for me than understanding the theory behind it.

I have a hard time relating to other people who're struggling with some type of emotional difficulty or less. They'll often get upset because of my habit of laughing (a family trait from my mother's father.) But I'm also a very sensitive person and get upset when I don't have a supportive outlet for expressing my feelings (then again, my three months at a new agey retreat center may very well have had a strong influence on the way I express myself. Not to mention almost two decades of therapy (I'm 23) and a fascination with the psyche and human behavior.)

Sometimes in social situations I'll do something that strikes other people as extremely bizarre that'll seem perfectly natural to me. The weird looks let me know I was acting strangely.

When I sense the people around me aren't being open and honest and direct I get very irritated. If anything I'm more honest and open than I probably should be.

Sorry this went so long. Until I have the opportunity to get thorough testing I'm trying to make whatever sense I can of this for myself. I think I've probably got NLD but this all seems so ambiguous. In addition to being diagnosed as NLD by a social worker (I think he may have been reviewing neuropsych results with me) and autistic spectrum by an MD (food sensitivity tests, may have also been some other testing involved) I've been diagnosed at different times with ODD, Bipolar Disorder (other clinicians have asserted that I absolutely do not have it) and I think a few other things too. Medications were mostly uneffective from 7-about 5 months ago when I stopped taking them (with no negative results.) Maybe I do have some comorbidity

I sometimes have a hard time excluding unimportant information too.

--Malachi

I would agree with this. Of course, if you have either sensory or attention problems, which can be common with NLD as well, you may stim, blurring the difference between AS and NLD (I stim a fair amount actually, although I didn't mention this to the person who tested me- too embarrassed). In addition, intense interests are not only associated with autism, but also giftness, so it can be very complicated to figure out what exactly is going on.

I personally don't think that NLD belongs on the autism spectrum. Even if the difference is hard to define, I definitely see a qualitative distinction. On the other hand, I really don't think it should be grouped with other learning disorders also. It's kind of intermediate between those two groups, in my opinion. It can be so hard to define the different disorders objectively though, that I'm totally making a subjective judgment here. Maybe there should be a more general neurological disorder spectrum, with things like OCD, anxiety, Tourette's, NLD, etc., or even kind of like a Venn Diagram thing, so you can see how different disorders overlap. It could be a "neurological impairment" spectrum or something. Although actually, that would be such a vague label, that it wouldn't really give you any useful information at all, so maybe not. Some people on here have suggested that AS belongs on its own spectrum with NLD- that would be pretty interesting. Well, I guess we'll just have to wait for the DSM-V. I really hope NLD is included.

Just to clarify by the way (it seems like there may be some confusion about this): you can have NLD and be left-handed. The reason that NLD usually shows worse effects on the left side of the body, is that as a white-matter disorder, in people with typical brain organization, it mainly affects the right hemisphere, which has much more white-matter than the left. People who are left-handed, or who have a close family member who is left-handed, along with a family history of lefthandness, are more likely to have atypical organization of their brain, such as bilateral representation of function (things like language that you think of as being centered in one hemisphere are represented in both), or even have right hemisphere dominance for language (although contrary to popular belief, this is rare, even in lefties). Interestingly, some disorders like stuttering or dyslexia are more common in lefties, which may be related to the fact that some cases of left-handness (when someone is strongly left-handed and has no family history of left-handness) are believed to be the result of a small insult to the brain early on in development. However, it's handy having left-handed relatives, because bilateral dominance means that you are more likely to recover language function after a stroke- hooray!

Anyway, if the above wasn't coherent, here's a summary: if you are left-handed, you are more likely to have white matter distributed more evenly in your brain (both hemispheres), or even mainly in your left hemisphere. So it's possible that NLD might affect both sides of your body equally, or even have a larger effect on your right side. Like I said, based on my test results, I might have some bilateral representation of function (and I have a strong family history of lefthandness), as NLD affects both sides of my body.