Dyscalculia

What Causes Dyscalculia?

The precise causes of dyscalculia aren’t clear, but they are likely the result of atypical function or development in the part of the brain responsible for processing numbers. We use this part of the brain to understand the concept of numbers and estimate the quantities in a set of objects without counting them. These skills are essential for understanding mathematics, and they seem to be lacking in people with dyscalculia.

Dyscalculia may be either acquired or developmental, depending on its origin.

• Developmental dyscalculia. This type typically affects children and results in problems developing numerical skills.
• Acquired dyscalculia. This relatively rare type of the disorder, also called acalculia, can result from brain damage caused by an injury, stroke, disease, or another brain-related event. A person with acquired dyscalculia experiences the disability only after the triggering event, not throughout their life.

Is Dyscalculia Hereditary?

Children who have a history of dyscalculia and other learning disabilities in their families have a much greater risk than the general population of having the disorder. Environmental factors could play a role in the prevalence of learning disabilities within families. Studies of identical twins–who are genetically identical to one another–suggest that genetic similarities are at least part of the reason for increased risk in some families.

Researchers have not yet determined which genes or gene variants might contribute to the risk of developing dyscalculia. The process of neurological development that results in dyscalculia is complex; there is not a single genetic cause for the disorder. Instead, it’s more likely that an interplay of multiple genes and environmental factors is to blame.

How Is Dyscalculia Detected?

The problems caused by dyscalculia are most often noticed when they begin to interfere with a child’s schoolwork, usually in elementary school. However, some signs may be apparent much earlier. Early detection of the disorder can help the child learn to cope and ensure that they get adequate support at home and school from the very beginning.

Potential early symptoms of dyscalculia include:

• Delays in learning to count
• Difficulty associating numbers with objects (e.g., not knowing that there are three kittens in a picture)
• Struggles putting things in order
• Difficulty recognizing patterns of numbers
• Counting on fingers past the appropriate stage
• Difficulty keeping score in games
• Avoiding games or activities that involve numbers

How Is Dyscalculia Diagnosed?

Dyscalculia doesn’t have an easily identifiable physical cause, so there is no physical exam or laboratory test that can detect the disorder. Instead, a doctor will focus on assessments of a child’s developmental and educational performance to determine whether the child’s symptoms are consistent with dyscalculia. There will also probably be an effort to rule out other possible causes for the symptoms. An actual diagnosis of dyscalculia will typically come from a psychologist.

• Developmental history. Your healthcare provider will ask questions about your child’s development and current mathematical skills. They will also ask about the child’s medical history to rule out other health factors that could contribute to the symptoms.
• Family history. The provider will look for a family history of dyscalculia or other learning disorders.
• Physical and neurological exams. These exams will check the child’s vision, hearing, and neurological functions to rule out physical problems other than dyscalculia that could be causing the symptoms.
• Psychological assessments. The provider may also administer exams or questionnaires meant to rule out psychological conditions such as depression or anxiety that could be responsible for learning difficulties.
• Cognitive and educational assessments. These exams and questionnaires will be aimed at accurately assessing the child’s mathematical skills to pinpoint exactly where the learning difficulties lie.

How Is Dyscalculia Treated?

There is no cure for dyscalculia, and no known treatment will consistently and reliably improve symptoms. Treatment is focused on helping the person with dyscalculia compensate for the mathematical disability to minimize its impact. For the most part, the disorder is managed by developing educational plans that support the person’s skills. Different individuals respond to different approaches, so individualized education plans are essential.

Some common treatment approaches include:

• Allowing more time for the child to complete math assignments and exams
• Allowing the use of calculators and assistive devices
• Allowing the use of supplementary materials to help the child remember formulas and concepts
• Personalized math tutoring
• Using hands-on or technology-based methods to teach math concepts

How Does Dyscalculia Progress?

Some scientists believe dyscalculia is related to dysfunction in the intraparietal sulcus (IPS), a part of the brain involved in, among other things, the conception of numbers and counting. Dysfunction in this area could explain why people with dyscalculia have trouble comparing and working with numbers and sets of objects.

The IPS is an area in the upper rear part of the brain. The IPS is involved in important brain functions including attention, short-term memory, and sensory interpretation. Researchers think that the IPS is part of a brain network responsible for processing incoming sensory (primarily visual) information, as well as organizing and remembering information related to tasks being performed.

Research also suggests that the IPS may be used to create a visual map of the space around a person and to remember the location of objects within that space. This function could be related to the comprehension of numbers, along with the ordering, comparison, and manipulation of mathematical concepts.

How Is Dyscalculia Prevented?

There is no known way to prevent dyscalculia. However, parents can take steps to support their child’s early learning and help minimize the condition’s impact in the future.

• Look for warning signs and seek help early. Early detection and treatment of dyscalculia is the single most significant factor in effectively managing the disorder.
• Support, encourage, and facilitate your child’s learning. Acknowledge your child’s dyscalculia and encourage them to find ways to deal with the learning disability. Don’t criticize them for their struggles, and praise them for their successes.
• Make sure your child is getting support at school. Work with the school to develop an individualized educational plan, and remain involved as the plan is carried out.

Dyscalculia Caregiver Tips

Many people with dyscalculia also suffer from other brain-related issues, a condition called co-morbidity. Here are a few of the disorders sometimes associated with dyscalculia:

• Dyscalculia is often co-morbid with attention-deficit/hyperactivity disorder (ADHD).
• Dyscalculia and autism are sometimes associated.

Dyscalculia Brain Science

Some scientists believe dyscalculia is related to dysfunction in the intraparietal sulcus (IPS), a part of the brain involved in, among other things, the conception of numbers and counting. Dysfunction in this area could explain why people with dyscalculia have trouble comparing and working with numbers and sets of objects.

The IPS is an area in the upper rear part of the brain. The IPS is involved in important brain functions including attention, short-term memory, and sensory interpretation. Researchers think that the IPS is part of a brain network responsible for processing incoming sensory (primarily visual) information, as well as organizing and remembering information related to tasks being performed.

Research also suggests that the IPS may be used to create a visual map of the space around a person and to remember the location of objects within that space. This function could be related to the comprehension of numbers, along with the ordering, comparison, and manipulation of mathematical concepts.

Dyscalculia Research

Title: Improving the Academic Performance of First-Grade Students With Reading and Math Difficulty

Stage: Enrolling by Invitation

Principal Investigator: Douglas Fuchs, PhD

Vanderbilt University 

Nashville, TN

This clinical trial aims to explore the short-term effects of coordinated intervention versus the business-as-usual school program on the primary endpoints of post-intervention word-reading fluency and arithmetic fluency. The study population is students who begin 1st grade with delays in word reading and calculations. Students who meet entry criteria are randomly assigned to coordinated intervention across reading and math, reading intervention, math intervention, and a business-as-usual control group (schools’ typical program). The 3 researcher-delivered interventions last 15 weeks (3 sessions per week; 30 minutes per session). Students in all 4 conditions are tested before the researcher-delivered intervention begins and after it ends.

First-grade students who meet study entry criteria are identified near the start of the school year using a 3-stage screening process—students who enter the study complete the pre-test battery.

Then, students are randomly assigned at the individual level to coordinated intervention, reading intervention, math intervention, or a business-as-usual control group (the schools’ typical classroom instruction with supplemental intervention schools choose to provide). Research staff deliver the intervention in the coordinated intervention condition, in the reading intervention condition, and in the math intervention condition 1:1 for 15 weeks (three 30-min sessions per week, scheduled in line with teacher input to avoid students missing important content). Adherence to the researcher-delivered interventions is monitored via audio recordings and live observations.

The content of each researcher-delivered intervention is aligned with the school district’s 1st-grade foundational reading & math learning standards; relies on explicit instruction, and incorporates fluency-building activities, word reading, and/or arithmetic problems; incorporates procedures designed to build engagement and perseverance. Reading intervention is designed to build skills in letter-sound associations, decoding, sight words, and contextualized reading. Math intervention is designed to build number knowledge, counting strategies, and arithmetic skills. The coordinated intervention addresses the same instructional objectives as reading intervention & math intervention.

When the researcher-delivered intervention ends, students in all four conditions complete the post-test assessment battery. Testers are blind to students’ study conditions. Adherence to testing protocols is monitored via audio recordings. The primary endpoints are post-test word-reading fluency and arithmetic fluency.

Title: Attention and Achievement: A Mind Wandering Investigation

Stage: Recruiting

Principal Investigator: Paul T. Cirino, PhD

University of Houston 

Houston, TX

This study assesses the impact of mind-wandering on reading and math. Specifically, 120 middle school student participants will receive descriptive measures (of achievement, attention, and related factors, including mind-wandering), and will receive a brief (~30 min) lesson in reading and math (order counterbalanced). Participants will receive a brief pre-test, the lesson, and then a post-test on the reading and math outcomes. 75% of the participants will receive a brief manipulation that sets up the influence of mind-wandering, as well as redirects when probe-caught mind-wandering occurs. The remaining participants will receive only redirects, and only randomly. Among participants to receive the mind-wandering manipulation, an equal number will receive this only for reading, only for math, and for both reading and math.

Title: Transcranial Magnetic Stimulation for BECTS (TMS4BECTS)

Stage: Recruiting

Principal Investigator: Fiona M. Baumer, MD

Stanford University 

Palo Alto, CA

Benign epilepsy with centrotemporal spikes (BECTS) is the most common pediatric epilepsy syndrome. Affected children typically have a mild seizure disorder, yet have moderate difficulties with language, learning, and attention that impact quality of life more than the seizures. Separate from the seizures, these children have very frequent abnormal activity in their brain known as interictal epileptiform discharges (IEDs, or spikes), which physicians currently do not treat. These IEDs arise near the motor cortex, a region in the brain that controls movement.

In this study, the investigators will use a form of non-invasive brain stimulation called transcranial magnetic stimulation (TMS) to determine the impact of IEDs on brain regions important for language to investigate: (1) if treatment of IEDs could improve language; and (2) if brain stimulation may be a treatment option for children with epilepsy.

Participating children will wear electroencephalogram (EEG) caps to measure brain activity. The investigators will use TMS to stimulate the brain region where the IEDs originate to measure how this region is connected to other brain regions. Children will then receive a special form of TMS called repetitive TMS (rTMS) that briefly reduces brain excitability. The study will measure if IEDs decrease and if brain connectivity changes after rTMS is applied.

The investigators hypothesize that the IEDs cause language problems by increasing connectivity between the motor cortex and language regions. The investigators further hypothesize that rTMS will reduce the frequency of IEDs and also reduce connectivity between the motor and language regions.