Dyscalculia

The neural connections that process numbers are difficult to access for those diagnosed with dyscalculia. Though symptoms of dyscalculia are similar to dyslexia, but present in various categories. 

Types of dyscalculia:

• Operational dyscalculia—Challenges with completing written or spoken math calculations, and problems with numbers and symbols
• Verbal dyscalculia—Trouble naming or understanding math concepts when discussed verbally. Able to read and write numbers, but difficult to recognize when heard
• Ideognostical dyscalculia—Challenges with remembering math concepts, and with non-numerical math problems
• Practognostic dyscalculia—Trouble translating math concepts, including comparing, listing and manipulating equations
• Graphical dyscalculia—Able to understand math concepts, but can’t read, write, or select the correct symbols
• Lexical dyscalculia—Challenges with reading and writing math symbols and numbers, but can still understand the concepts when being discussed

The causes and risk factors for dyscalculia are unknown, although genes and a combination of environmental factors may play a role. In addition to genetics, scientists are studying other possible causes and risk factors, including:

• Brain injury
• Exposure to environmental risks (e.g., lead) during pregnancy or at a young age
• Alcohol and tobacco use during pregnancy
• Premature delivery
• Low birth weight

Using neuroimaging, experts have been able to learn that those struggling with dyscalculia have a deficit in the neural connections in the parietal lobe of the brain. Other parts of the brain affected include the prefrontal cortex, back of the temporal lobe, the cingulate cortex and subcortical regions. 

These neurobiological brain disorders are sometimes caused by drug and alcohol use in utero. 

Most developmental disabilities, including dyscalculia, are thought to be caused by a complex mix of factors. These factors include genetics, parental health and behaviors (such as smoking and drinking) during pregnancy, complications during birth, infections the mother might have during pregnancy or the baby might have very early in life, and exposure of the mother or child to high levels of environmental toxins, such as lead. For some developmental disabilities, such as fetal alcohol syndrome, which is caused by drinking alcohol during pregnancy, we know the cause. But for most, we don’t.

Healthcare providers can play an important part in collaborating with schools to help a child with learning disorders or other disabilities get the special services they need. The American Academy of Pediatrics (AAP) has created a report that describes the roles that healthcare providers can have in helping children with disabilities, including learning disorders:

• Identifying children in need of early intervention or special education services
• Sharing relevant information with early intervention or school personnel
• Meeting with early intervention or school personnel and parents or guardians
• Using early intervention or school information in medical diagnostic or treatment plans
• Working within an early intervention, school or school-based health clinic
• Working at an administrative level to improve school functioning around children with special needs

Testing general math-related skills is the primary method of detecting signs of dyscalculia. Children should also have their vision, mental health, brain functions and hearing tested to rule out more serious or co-occurring conditions. 

Children with dyscalculia display an inability to perform basic numerical functions, including difficulty counting backwards and slow performance with calculations. Basic math facts are hard to remember, making concepts like fractions, division, multiplication and borrowing challenging, with an auto-default to addition as the main processing operation. 

Children with learning disorders may feel frustrated that they cannot master a subject despite trying hard, and they may act out, act helpless or withdraw. Learning disorders can also be present with emotional or behavioral disorders, such as attention-deficit/hyperactivity disorder (ADHD), or anxiety. The combination of problems can make it particularly hard for a child to succeed in school. Properly diagnosing each disorder is crucial so that the child can get the right kind of help for each.

Many children may struggle in school with some topics or skills from time to time. When children try hard and still struggle with a specific set of skills over time, it could be a sign of a learning disorder. Having a learning disorder means that a child has difficulty in one or more areas of learning, even when overall intelligence or motivation is not affected.

Children with a displayed lack of achievement may be diagnosed just as commonly as those of average or above-average intelligence. Discrepancies may exist from one type of diagnosis to another, with variations depending on the individual. Learning disabilities and deficiencies in information processing can make learning and communication challenging or impossible. 

A range of interventions can be helpful in treating children diagnosed with dyscalculia. Allowing students to find and focus on their learning strengths, with instruction based on a growth mindset, is helpful, as are using multi-sensory instruction and assistive technology. Teaching modalities that make math visual have been shown to be supportive in learning. 

Children with learning disorders often need extra help and instruction that are specialized for them. Having a learning disorder can qualify a child for special education services in school. Schools usually do their own testing for learning disorders to see if a child needs intervention. An evaluation by a healthcare professional is needed if there are other concerns about the child’s behavior or emotions. Parents, healthcare providers and the school can work together to find the right referrals and treatment.

The most common treatment for learning disabilities is special education. Specially trained teachers may perform a formal assessment to understand the child’s academic and intellectual potential. They will also look at the level of academic performance. Once the evaluation is complete, the basic approach is to teach learning skills by building on the child’s abilities and strengths while correcting disabilities and weaknesses. Other professionals such as speech and language therapists also may help. Some medications may help the child learn by enhancing attention and concentration. Psychological therapies may also be used.

Children with specific learning disabilities are eligible for special education services or accommodations at school under the Individuals with Disabilities in Education Act (IDEA).

The U.S. Department of Education issued a “Dear Colleague” letter providing clarification to both parents and practitioners about ensuring a high-quality education for children with specific learning disabilities, including children with dyslexia, dyscalculia and dysgraphia.

To develop a better understanding of your diagnosis, consider participating in a clinical trial so clinicians and scientists can learn more about learning disabilities and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research, visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for participants at Clinicaltrials.gov.