Beyond Nonverbal Learning Disability: The Case for and Against Developmental Visual-Spatial Disorder as a Distinct Diagnosis-Authors' Reply.

Researchers are proposing a new way to diagnose visual-spatial difficulties called Developmental Visual-Spatial Disorder (DVSD). This would replace the current 'Nonverbal Learning Disability' label. DVSD focuses specifically on problems with understanding visual and spatial information. It can occur alongside autism and other developmental conditions. Unlike current approaches, it doesn't require children to have much better verbal skills or need specific test results for diagnosis.

This authors' reply discusses their proposed diagnostic criteria for Developmental Visual-Spatial Disorder (DVSD) as a reconceptualization of Nonverbal Learning Disability (NVLD). DVSD is defined by persistent deficits in processing or integrating visual and spatial information, captured through 8 behavioral subcriteria. The disorder can co-occur with other neurodevelopmental conditions including autism spectrum disorder and developmental coordination disorder. Key differences from NVLD include: singular focus on visual-spatial deficits, no requirement for discrepancy from verbal skills, no need for neuropsychological testing results, and no requirement for impairment in specific functional areas.

The proposed DVSD criteria may offer a more focused diagnostic framework for visual-spatial difficulties. However, validation studies are needed before clinical implementation. The recognition of comorbidity with autism and other conditions may improve comprehensive assessment approaches.

This is an authors' reply rather than empirical research. No sample data, outcome measures, or validation studies are reported. The diagnostic criteria remain proposed rather than validated through systematic research.

We were pleased by the interest in our reportof the process used to formulate a DSM-style criteria set for developmental visual-spatial disorder (DVSD). A reconceptualization of nonverbal learning disability (NVLD), DVSD is defined by persistent deficits in processing or integrating visual and spatial information, which are captured in 8 behavioral subcriteria and can co-occur with other neurodevelopmental disorders, including, for example, but not limited to, autism spectrum disorder and developmental coordination disorder (DCD). DVSD differs from NLVD in the following important ways: it singularly focuses on visual-spatial deficits; it does not require a discrepancy from verbal skills; it does not require neuropsychological or education test results; and, although it requires impairment, it does not require impairment in a specified area of functioning (eg, social, motor, attention, etc).