Dyscalculia

Clemens Gödel is a freelancer for the medical team.

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Dyscalculia is the technical term for arithmetic weaknesses. Those affected have great difficulty understanding and applying the simplest mathematics. This is usually noticeable in elementary school or even in kindergarten. A series of tests must be performed to confirm the suspicion. The treatment is based on individual support for dyscalculia in order to avoid disadvantages caused by poor numeracy. Read more about dyscalculia here!

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. F81

Dyscalculia: description

The answer to the question “What is dyscalculia?” Is, in a nutshell: a profound difficulty in dealing with mathematics. As a result, dyscalculia is also known as arithmetic weakness. It is one of the so-called learning disorders. This group of school development disorders can affect various skills such as reading, writing or arithmetic - these do not develop “normally”. The background is a defined failure of brain functions.

Dyscalculia must be differentiated from acquired acalculia (arithmetic inability) that occurs later. Alkaline disease occurs, for example, as a result of a stroke.

In almost all cases, a weakness in numeracy is discovered in childhood. The definition of dyscalculia also includes that the numerical weakness cannot be explained by poor schooling, reduced intelligence or sensory disorders such as deafness. Dyscalculia is thus characterized by a disproportion between expected and actual performance. Affected people have big problems with numbers and quantities. This makes it difficult or impossible for them to enter even simple invoices. Problems that only become clear with higher mathematical requirements, on the other hand, are usually not compatible with dyscalculia.

As a result of the arithmetic weakness, not only the performance in mathematics, but also in physics or chemistry classes are poor. Affected children often have problems in everyday situations such as reading the clock.

Combination with other disorders

In addition to dyscalculia, many sufferers have other disorders, especially combined reading and spelling disorders or attention deficit disorder (ADHD). Studies in the US show that over 50 percent of children with reading disabilities also have poor math skills. Conversely, more than 40 percent of children with dyscalculia also showed signs of reading difficulties.

Dyscalculia: frequency
In Germany, between three and seven percent of children and adolescents have dyscalculia. Girls are more often affected than boys.

Interestingly, arithmetic weaknesses are more common in American children than in Germany. Differences in the school system may be partly responsible for this.

Dyscalculia: symptoms

With dyscalculia, those affected have no or wrong ideas about calculation steps. Dealing with the decimal system also causes significant difficulties for the children. Numbers are not understood as a quantity, but as a symbol. Therefore, number rotations often creep in. However, there is no clear combination of symptoms that define dyscalculia.

Most of the time, the dyscalculia is noticeable because the affected children can no longer follow the lessons and their performance deteriorates. Although there may be indications of dyscalculia as early as kindergarten age, a weakness in numeracy can initially go unnoticed even at school age.

If, on the other hand, there are problems with numbers for a school starter, it does not necessarily have to be due to dyscalculia: Around a third of children who have difficulties with numbers in the first year of school achieve average performance in the following years and therefore do not have any dyscalculia. However, if a mathematical weakness only becomes apparent later, especially after the fifth grade, it usually does not go away on its own.

Dyscalculia symptoms in kindergarten or preschool

Even in kindergarten there can be indications of an increased risk of dyscalculia. Recognizing a numeracy weakness is not always easy at this age. Possible signs at this age include problems with ratios and counting. Getting started with units (such as weight) and the decimal system is also difficult.

Dyscalculia Symptoms in Elementary School

Dyscalculia is often more noticeable in elementary school. In contrast to classmates, affected children show knowledge gaps when dealing with numbers, for example when it comes to writing or naming numbers. Mathematical calculations are hardly understood. Teachers usually notice this from the fact that these children need significantly more time than their peers. Aids such as finger counting are also used to solve the arithmetic problems. Dealing with quantities is also much more difficult with dyscalculia. In addition, types of calculation are often confused.

Dyscalculia symptoms in everyday life

In addition to poor math performance at school, children with dyscalculia also face a number of difficulties in everyday life. Reading the clock and dealing with money, for example, can be a major challenge for those affected.

Psychological stress

The experiences that those affected have because of dyscalculia often result in problematic behaviors and conspicuous problem avoidance behavior. On the one hand, the children often withdraw and develop (exam) anxiety, depressive symptoms and somatic complaints. Somatic complaints are physical symptoms such as headache or abdominal pain for which no organic cause can be found.

On the other hand, attention deficits, delinquent and aggressive behavior can develop. Statistically speaking, children with dyscalculia are more likely to have psychological symptoms than unaffected children. Overall, the dyscalculia leads to a very high level of psychological stress for the children.

In addition, there are the symptoms of any accompanying illnesses such as ADHD, depression, anxiety disorders or disorders of social behavior.

Dyscalculia: causes and risk factors

Dealing with numbers and mathematical calculations places high demands on the child's brain, which is developing and constructing increasingly complex nerve networks. Researchers assume that a basic understanding of mathematics is innate. Even in the first week of life, small amounts can usually be distinguished.

Mathematical skills are independent of language skills or intelligence. They are an independent part of thinking. However, it is clear that the processing of mathematical tasks is not completely separated from language.So it is necessary to recognize and understand the mathematical jargon. Reading and spelling disorders complicate this process and are therefore often associated with dyscalculia.

There are a number of models that attempt to clarify the causes of dyscalculia. They take into account the individual steps that are required to record mathematical processes. The basis is an understanding of a mathematical problem and suitable problem-solving strategies. This includes the processing of logical processes with an understanding of details, but also the ability to learn and to have a sufficient working memory for this. In order to be able to visualize geometric tasks in particular, there must also be a good visual-spatial imagination.

Causes of dyscalculia so far unclear

To this day it is quite unclear how and why exactly a calculation disorder develops. Studies have shown that the brain regions responsible for arithmetic are underactive in those affected. This also explains why those affected take up numbers like “empty words” to which they cannot assign any further meaning. In order to calculate, several areas of the brain have to be used. Scientists suspect that a developmental and activity disorder in these regions is responsible for the "math weakness".

Studies with families and twins also suggest that some degree of dyscalculia is hereditary. Around 45 percent of those affected have relatives with learning disabilities. However, a specific gene that could be responsible for the disorder has not been identified. Dyscalculia can also occur in the context of genetic diseases such as Turner syndrome or phenylketonuria.

Brain disorders and epilepsy caused by early childhood can also trigger arithmetic weaknesses. In addition, psychosocial and didactic factors play an important role.

Dyscalculia: examinations and diagnosis

Dyscalculia should be diagnosed as early as possible so that the child concerned can be given appropriate support in addition to school lessons. This is the only way to quickly close gaps in knowledge and ensure that the child does not lose touch with the class.

But even before school age, i.e. in kindergarten, there may be possible indications of a risk for dyscalculia. This includes abnormalities when dealing with basic mathematical tasks. Often, however, these initial difficulties also subside.

School-age teachers should definitely be included in the diagnosis. With their experience they can help identify and analyze weaknesses in the child. In addition to technical restrictions, the teachers often notice disruptions in social behavior.

Diagnostic interview

Specialists for learning disabilities are child and adolescent psychiatrists or appropriate psychotherapists. In order to initiate the diagnostic interview, it is important that both the parents and the affected child are asked about the weaknesses in numeracy. Misunderstandings often have to be cleared up at this point.

The child should describe how they perceive the dyscalculia and what difficulties they see. The examiner can then estimate which stresses result from the weakness in calculation.

Then the child’s dyscalculia symptoms are discussed in detail with the parents. Possible language and motor development disorders should also be discussed. There may also be emotional stresses that reduce the child's drive. Finally, the family situation should also be carefully analyzed in order to identify possible family burdens. Finally, the question of whether measures against the dyscalculia have already been initiated or carried out must also be clarified.

School report

The basis for the investigation is the survey of learning status and school development. This includes the school's report. This report should cover all school-related areas including the child's motivation, as weak language skills, for example, can be associated with dyscalculia. Frequent class and school changes are also a risk factor for school difficulties.

Testing

Experts only speak of dyscalculia if the arithmetic weakness persists despite sufficient school attendance and “normal” intelligence. Various tests are carried out to clarify this. Read more about this in the article Dyscalculia Tests!

Physical examination

A thorough physical examination is important to identify any neurological or sensory deficits such as attention deficits, language problems, memory disorders and visuospatial weaknesses. Particular attention should be paid to visual and hearing difficulties.

Requirements for the diagnosis of "dyscalculia"
The final diagnosis of dyscalculia can be made if the following criteria are met:

• Academic performance is poor or insufficient.
• A result below the worst ten percent is achieved in standardized calculation tests.
• The intelligence quotient is greater than 70.
• The difference between the results of the math tests and the IQ are clear.
• The dyscalculia appeared before the sixth grade.

Basically, it must always be found out whether the dyscalculia has developed only secondarily due to a reading and spelling weakness. If this problem is corrected, the arithmetic weakness could also disappear at the same time.

It must also be ruled out that the "math weakness" is only due to a lack of teaching, neurological diseases or emotional disorders. If this is the case, the diagnosis of dyscalculia can be made considering all criteria.

Dyscalculia: treatment

Dyscalculia therapy is based almost exclusively on individual and targeted support for the child concerned. No medical measures, especially no medication, are used.

An early start of treatment - possibly during kindergarten - prevents too great a performance deficit in relation to classmates. However, this treatment is not exclusively of an educational nature, but should also be accompanied by psychotherapy and behavioral therapy. Individual support for dyscalculia is based on three pillars:

• Arithmetic training
• Behavior therapy
• neuropsychological training

Arithmetic training

The arithmetic training can either be based on the curriculum or be detached from it. You can read more about the exercise methods used in the article Dyscalculia Exercises.

Behavioral and neuropsychological training

Behavioral therapy can teach the child problem-solving strategies. The neuropsychological training aims to improve important brain functions such as memory, attention, language and visual-analytical and spatial-constructive thinking.

Individual goal setting

The aim of therapy for dyscalculia is that the child constructs their own mathematical thinking and thus also develops a feeling for numbers. This should enable the child to grasp basic mathematics skills in order to benefit from the lessons as best as possible.

The individual goal depends on the level of learning, the existing skills, needs, strengths and difficulties. The focus is on the child's very own strengths and weaknesses. This also means that therapy in most cases has to be carried out in individual sessions. When choosing a therapist, one should make sure that they are specialized learning therapists. Although there is no independent job description of the "dyscalculia therapist", there are psychotherapists who have specialized in this area.

Parents' understanding and cooperation

Correctly dealing with dyscalculia is based on a thorough understanding of the disorder. The arithmetic disorder does not mean impairment of intelligence! But it is important that the relatives understand the scope and consequences of dyscalculia. This includes, for example, the knowledge that various psychological factors such as pressure and frustration play a role in dyscalculia.

Parents and therapists should work together on dyscalculia therapy and coordinate the joint approach. The task of parents is to support their child. The whole family should support the child. This includes showing him his strengths and giving him confidence. Parents should also make it clear to the child that mathematics is not everything in life, but it is still very important. You can use real-life examples for this (reading the clock, dealing with money, etc.).

Despite the always recommended praise, high expectations should not be communicated to the child. It is also important for the child to emphasize the treatment perspective: the supportive therapy is designed for the long term and can very well help to significantly improve the situation.

School is included

School should also be included in dyscalculia therapy. Successful learning is based on a good learning environment. It may be possible to make arrangements with the teachers to make it easier for the child to join the class. It can make sense to extend working hours or reduce the number of tasks. Calculators can also be helpful. If possible, affected children should also use tutorials and be encouraged by innovative teaching methods that also illustrate the connection between real life and mathematics.

Duration and costs of dyscalculia therapy

It is difficult to make a statement about the duration of dyscalculia therapy. In most cases, therapy lasts for at least a year. However, the progress made in individual cases is very difficult to predict.

Another problem is the therapy costs, which in many cases have to be borne by the parents themselves. For the statutory health insurance, dyscalculia has no disease value, which is why, in their opinion, there is no need for treatment. However, under certain circumstances, for example in the case of additional illnesses such as attention deficit disorder (ADHD), the costs of the treatment will be covered.

Dyscalculia: disease course and prognosis

With dyscalculia, targeted support can in most cases result in a significant improvement in performance. Without individual support, however, hardly any progress in the learning process can be expected. This makes it clear that the support must be started early in order to reduce the disadvantages caused by the "math weakness" and to enable normal learning progress. The psychological stress resulting from the dyscalculia can also be significantly reduced by the care.

Dyscalculia does not grow out. Children with a numerical dysfunction will have difficulty arithmetic throughout their entire school career. Without therapy, their educational opportunities are therefore significantly reduced. Statistically speaking, those affected leave school earlier and have problems with further vocational training.

Various clubs and associations provide support to those affected and their families, such as the Federal Association for Dyslexia and Dyscalculia. They can be valuable contacts when dealing with dyscalculia.

Tags:  interview stress hospital