Non-Verbal Learning Disability (NVLD) Research Program
The Non-Verbal Learning Disability (NVLD) Research Program in the Division of Child & Adolescent Psychiatry at CUMC aims to establish NVLD as a discrete clinical entity, thereby increasing access to appropriate psychological and educational services for those with NVLD.
Research activities include:
- Neuroimaging and behavioral studies to identify neurobiological substrates of core features of NVLD.
- Preparation of a proposal for the Steering Committee of the American Psychiatric Association’s DSM (Diagnostic and Statistical Manual of Mental Disorders) to consider including NVLD in future DSMs.
- Conducting workshops for educators and other mental health professionals to raise awareness of NVLD and provide information on best practices for early identification and treatment.
We are grateful to The NVLD Project for their support of this critical work. Founded by Dr. Laura Lemle, The NVLD Project is dedicated to raising awareness, building support, and creating helpful solutions for children, adolescents, and adults with Non-Verbal Learning Disability. This goal is accomplished through a variety of programs, including educational workshops, research, and community outreach.
Visit the NVLD Project Website
Current Research
The NVLD Project MRI Study of Children & Adolescents
PI: Margolis, Cognitive Development & Neuroimaging Lab
This study aims to determine whether children with non-verbal learning disability (NVLD) show altered patterns of brain structure, function, and connectivity relative to typically developing children. A discrepancy between verbal and spatial abilities is a core feature of NVLD, and we previously found that a greater verbal-spatial discrepancy is associated with increased thinning and decreased function in fronto-parietal and temporal regions in healthy individuals (Margolis et al., 2013; Margolis et al., 2017). We hypothesize that these associations will be magnified in children with NVLD; such findings would help validate NVLD as a distinct diagnosis.
Next Steps: One next step is to compare our brain and behavioral measures in children with NVLD to children with high-functioning autism. Such data will allow the identification of brain and behavioral deficits that are common and dissimilar among and between the two disorders.
Infant Behavior Study
Co-PIs: Beebe and Margolis, Communication Sciences Lab
We are studying whether specific patterns of non-verbal communication behavior observed in infants is associated with or indicative of NVLD. Our study aims to address the following research questions:
- Can we identify individual differences in infants' communicative behavior based solely on the infants' behavior?
- Might such differences predict later outcomes that are analogous to or precursors of communication difficulties often observed in children with NVLD?
Next Steps: Our long-term goal is to better specify the nature of friendship difficulties in young adults with NVLD. Toward that goal, we aim to identify the social behaviors that may underlie friendship difficulties in young adults from a community (non–NVLD) sample, and examine whether there are precursors in infancy of these social behaviors. This project uses a longitudinal cohort of mother-infant pairs (assessed in infancy and young adulthood) from a low-risk community (non–NVLD) sample of 132 dyads (Beebe Longitudinal Cohort II, 1992–1996). The infancy data of this sample are well-characterized, videotaped mother-infant interactions coded with second-by-second measures of mother and infant attention, emotion, orientation, and touch. Attachment security was assessed when infants were one year old.
Inclusion of NVLD in Future DSMs
PI: Fisher, Methodology & Measurement Group
Non-verbal learning disability (NVLD) is not included as a disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Although an “NVLD profile” is increasingly recognized by neuropsychologists and in educational settings, there is no standard definition for making this diagnosis. Only if NVLD is established and defined as a discrete clinical entity, with a distinct set of agreed-upon criteria, will those with NVLD be able to access appropriate interventions and accommodations.
Further, because there is no standard definition, research groups vary in the definitions they use for NVLD, making it difficult to compare results between research studies. Consistency in criteria is important in moving the field forward by improving identification and designing and testing interventions.
Thus, a long-term goal of the NVLD Project is to submit a proposal to the Steering Committee of the American Psychiatric Association’s DSM (Diagnostic and Statistical Manual of Mental Disorders) for the inclusion of NVLD in future DSMs.
In preparation for this, we are engaged in the following activities:
- Conducting a systematic literature review of NVLD to identify what criteria are currently being used to consider a diagnosis of NVLD and how these criteria were evaluated. We are examining the quality of the research (e.g., samples used, assessment, etc.), as well as consulting with recognized experts in NVLD.
- Preparing a critical review article which evaluates the current state of knowledge of NVLD and criteria for diagnosis.
- Creating a “working draft” criteria set that can be applied reliably by clinicians.
- Convening a consensus conference in which NVLD researchers and clinicians will meet to further define the disorder and discuss research, data, and strategies for preparing the proposal.
Workshops
We have developed a series of workshops for general and special education faculty in lower-, middle-, and upper-school settings. Workshops provide in-service training on factors underlying behavioral and academic issues attendant to NVLD.
In general-education settings, the workshops focus on how to identify and support students with NVLD, as well as best practices for improving the social experiences of all students. School faculty can provide information on students’ social challenges that can be used to create a school self-assessment to determine the social climate in a school and to enhance the social experience of all students.
In special-education settings, the workshops provide information on how to identify NVLD and methods for differentiating instruction for students, taking account of their neurocognitive profiles, with a particular focus on NVLD and how to support the academic and social challenges faced by students with NVLD.
Collaboration with Mary McDowell Friends School
We currently consult with teachers and faculty at the school to develop strategies for supporting children with NVLD during group work in the classroom.