Understanding Nonverbal Learning Disorder and Autism Spectrum: A Complete Guide

Many people hear the term “nonverbal learning disorder” and wonder if it is part of autism spectrum disorder. This is especially true once you start looking into the characteristics associated with nonverbal learning disorder, which oftentimes look a lot like those seen in autism. It is true that many characteristics overlap between the two diagnoses, including social challenges, difficulties with executive functioning skills like planning and organization, and interpreting non-verbal cues. In this article, we break down the confusion by describing nonverbal learning disorder, the similarities and differences with autism spectrum disorder, and how families can better navigate supporting their children when given this knowledge.

What is Nonverbal Learning Disorder?

Nonverbal learning disorder is generally defined as a neurodevelopmental condition in which a person has a discrepancy between their verbal and nonverbal abilities, with strengths in verbal skills and significant challenges in non-verbal skills. What this means is that a child may have good verbal memory (i.e., encoding and retrieval of written or spoken information) and vocabulary development accompanied by difficulties with fine motor skills, social interaction, and interpreting visual-spatial information (e.g., understanding where objects are and the relationship between objects in space, including the ability to visually manipulate them in space; mental imagery). Those with nonverbal learning disorder may tend to focus on specific details as opposed to the greater picture. This is referred to as weak central coherence, and is also seen in other developmental conditions (Gambra et al., 2024).

Challenges with visuospatial skills may be the underlying reasons for challenges in other areas. For example, if a child has trouble interpreting objects in space, understanding the relationship between objects in space, and with general mental imagery overall, they may stand too close or too far away from others, seem uncoordinated at team sports, navigating the halls at school, completing math word problems, as well as understanding text that relies on imagining the characters and storyline and making inferences about the characters’ intentions and motivations. 

Although many clinicians and researchers consider nonverbal learning disorder to be a distinct clinical entity, it is not recognized as such in the Diagnostic and Statistical Manual of Mental Illnesses, Fifth Edition (DSM-5). However, because there are distinct clinical markers that separate it from other neurodevelopmental conditions, we believe it is important to highlight those here so that supporting children who present with characteristics of nonverbal learning disorder can be the most effective. 

What is Autism Spectrum Disorder?

Recall from this blog post that autism spectrum disorder is a neurodevelopmental condition that is defined in the DSM-5 as a disorder that results in social communication and social interaction challenges across contexts. Specifically, according to the DSM-5, autism is diagnosed based on two separate, and often related, areas:

1. Differences in social communication and social interaction
   Individuals with autism have challenges using social communication skills to engage in social interactions. Oftentimes this can look like difficulties taking conversational turns, using and understanding body language or tone of voice, and making and maintaining friendships.
2. Restricted and repetitive behaviors and interests (RRBIs)
   Individuals with autism must also have RRBIs. This can include behaviors (such as movements like rocking or handflapping) and/or focused interests (dinosaurs, trains, Minecraft, Bluey, creeks, you name it!). Additionally, individuals with autism tend to prefer routines, and may also experience sights, sounds, and textures more intensely than others.

To receive an autism diagnosis per the DSM-5, an individual must meet both of the criteria outlined above, and these characteristics must be present in early childhood. However, it is also the case that characteristics of autism may not fully come online until the child gets older and experiences social challenges. Moreover, these challenges must impact the person’s ability to function in social or occupational settings, or other areas that are important, and must not be explained by an intellectual disability. Note, however, that a person can have autism and co-occurring intellectual disability.

Differences and Similarities Between Nonverbal Learning Disorder and Autism Spectrum Disorder?

At first glance, nonverbal learning disorder and autism appear quite similar. Both are neurodevelopmental conditions that present with challenges in social interaction skills, interpreting non-verbal cues (such as facial expressions and body language), and executive functioning skills (e.g., planning, organization, initiating). However, there are distinct differences between the two conditions that must be taken into consideration when supporting children with these unique needs. Of note, where nonverbal learning disorder is not recognized as a distinct entity in the DSM-5, autism spectrum disorder is. Additionally, a defining characteristic of autism spectrum disorder is the presence of restricted and repetitive interests and/or behaviors (RRBIs). These RRBIs are not seen in children with nonverbal learning disorders. 

 

Area	Nonverbal Learning Disorder	Autism Spectrum Disorder
Diagnosis	Not formally recognized in the DSM-5; often identified by neuropsychological testing.	Official DSM-5 diagnosis.
Verbal vs. Nonverbal Skills	Strong verbal skills, weaker visual-spatial and motor skills.	Verbal abilities vary widely; social communication differences are central.
Restricted Interests/Repetitive Behaviors	Typically not a defining feature.	Core diagnostic area; may include routines, special interests, or repetitive movements.
Social Understanding	Social struggles often stem from difficulties interpreting nonverbal cues or spatial reasoning.	Differences rooted in social processing and communication style.
Sensory Processing	May be present but less pronounced.	Frequently central; sensitivity to sounds, textures, lights, etc.

How Healthcare Professionals Differentiate Between Nonverbal Learning Disorder and Autism Spectrum Disorder

Because nonverbal learning disorder is not in the DSM-5, there is no standardized checklist that professionals use to diagnose it. Oftentimes, professionals will gather information about a child’s skills by observing them, talking with caregivers and teachers, and give assessments that measure skills like verbal memory, language, social interaction and social communication, visual-spatial abilities, and gross and fine motor skills. With this data, and a comprehensive understanding of nonverbal learning disorder and other neurodevelopmental conditions, professionals can offer an in-depth profile of a child’s skills. From there, a treatment plan can be developed that is appropriate in supporting a child’s areas of need.

Can Someone Have Nonverbal Learning Disorder Without Having Autism Spectrum Disorder

Yes, having nonverbal learning disorder is different from having autism spectrum disorder. Although it is possible that those with autism can also have a co-occurring nonverbal learning disorder, the current evidence suggests that these are distinct conditions with some overlapping characteristics. Of note, it is suggested that the cause of the challenges in nonverbal learning disorder is different from the cause of the same challenges when they are present in autism (Meyer, n.d.).

FAQs

Is nonverbal learning disorder the same as autism?
No, nonverbal learning disorder and autism spectrum disorder are not the same thing. Although both are considered neurodevelopmental conditions, individuals with a diagnosis of autism spectrum disorder primarily have challenges with social communication and social interaction, with restricted and repetitive behaviors and interests. Those with nonverbal learning disorder also present with challenges in social interaction, but do not have restricted and repetitive interests or behaviors. Additionally, those with nonverbal learning disorder have poor visuospatial skills, which is not always present in those with autism.

Can someone have both nonverbal learning disorder and autism?
Yes, a person can have both autism and nonverbal learning disorder.

Is nonverbal learning disorder recognized as a neurodevelopmental condition in the DSM-5?

No, nonverbal learning disorder is not recognized in the DSM-5; however, many researchers and clinicians consider it to be its own clinical entity.

How do I know which diagnosis fits my child best?

A professional can help you understand your child’s current level of skills and functioning and whether they present with characteristics that fit the profile of a person with autism spectrum disorder, someone with nonverbal learning disorder, or a different condition altogether. Speech language pathologists are among the professionals who can help!