Report of a Work Group on Nonverbal Learning Disability: Consensus Criteria for Developmental Visual-Spatial Disorder, a Reconceptualization of Nonverbal Learning Disability for DSM Consideration.

Abstract

OBJECTIVE Although extant research points to NonVerbal Learning Disability (NVLD) as a distinct disorder, it is not included in the diagnostic nomenclatures, and there is heterogeneity in how it is defined. We formed a working group to gain consensus on a standard DSM type definition for NVLD, a necessary first step for proposing its inclusion in future DSMs and renamed the disorder to better reflect the core deficit - visual-spatial problems. METHOD An iterative process was used to reach consensus on a DSM style criteria set that reconceptualizes NVLD as Developmental Visual-Spatial Disorder (DVSD). This process, similar to that used during the DSM-5 revision, included working with an advisory group of NVLD experts and obtaining feedback from experts in youth psychiatric diagnosis and child mental health practitioners. Data on stakeholder acceptance of the new name were collected from adults who self-identify as having NVLD and parents of youth with NVLD. RESULTS During the iterative process, the criteria set shifted from syndromic, multi-area, and quantitative to singly-focused and more clinically oriented, conceptualizing individuals with the disorder as having persistent deficits in a single area: processing or integrating visual and spatial information. This fills a gap in the DSM system, which includes diagnoses underpinned by problems in other cognitive domains. Data indicate stakeholder acceptance of the name. CONCLUSION A standard definition for NVLD, reconceptualized as DVSD, and included in the DSM will lead to improved identification of individuals with clinically significant visual-spatial deficits and associated functional impairment and improve research in the area.