Maybe unrelated but this memory pops up: I once worked with a mechanical engineer who could not visualize anything in his mind and had quite some trouble with word finding and explaining his ideas. He just couldn't say what needed to be built, he could only evaluate after it was built (often "argh, no not that").

It's as if his training had centered so much on 3d modeling and tangible tweaking as you go, that he hadn't learned to simulate anything with his thoughts before starting. He had to start building it to figure out what he meant. Incredibly creative person, out of the box thinker and big picture visionary, but with difficulty translating his ideas to verbal concrete steps. But nobody realized this, which resulted in a lot of frustration both ways:

"Why didn't you build what I said?" "I did. This is exactly what you said." "No it's not! I said x y z" "Yes you said x y z, this IS x y z" Silence. "Then that's not what I meant"