Contributions from specific and general factors to unique deficits: two cases of mathematics learning difficulties

Profiles of mathematical deficits in children with dyslexia

Despite a high rate of concurrent mathematical difficulties among children with dyslexia, we still have limited information regarding the prevalence and severity of mathematical deficits in this population. To address this gap, we developed a comprehensive battery of cognitive tests, known as the UCSF Mathematical Cognition Battery (MCB), with the aim of identifying deficits in four distinct mathematical domains: number processing, arithmetical procedures, arithmetic facts retrieval, and geometrical abilities. The mathematical abilities of a cohort of 75 children referred to the UCSF Dyslexia Center with a diagnosis of dyslexia, along with 18 typically developing controls aged 7 to 16, were initially evaluated using a behavioral neurology approach. A team of professional clinicians classified the 75 children with dyslexia into five groups, based on parents' and teachers' reported symptoms and clinical history. These groups included children with no mathematical deficits and children with mathematical deficits in number processing, arithmetical procedures, arithmetic facts retrieval, or geometrical abilities. Subsequently, the children underwent evaluation using the MCB to determine concordance with the clinicians' impressions. Additionally, neuropsychological and cognitive standardized tests were administered. Our study reveals that within a cohort of children with dyslexia, 66% exhibit mathematical deficits, and among those with mathematical deficits, there is heterogeneity in the nature of these deficits. If these findings are confirmed in larger samples, they can potentially pave the way for new diagnostic approaches, consistent subtype classification, and, ultimately personalized interventions.

Numerical Processing Impairment in 22q11.2 (LCR22-4 to LCR22-5) Microdeletion: A Cognitive-Neuropsychological Case Study

Although progress has been made, the cognitive, biological and, particularly, the genetic underpinnings of math learning difficulties (MD) remain largely unknown. This difficulty stems from the heterogeneity of MD and from the large contribution of environmental factors to its etiology. Understanding endophenotypes, e.g., the role of the Approximate Number System (ANS), may help understanding the nature of MD. MD associated with ANS impairments has been described in some genetic conditions, e.g., 22q11.2 deletion syndrome (22q11.2DS or Velocardiofacial syndrome, VCFS). Recently, a girl with MD was identified in a school population screening. She has a new syndrome resulting from a microdeletion in 22q11.2 (LCR22-4 to LCR22-5), a region adjacent to but not overlapping with region 22q11.2 (LCR22-2 to LCR22-4), typically deleted in VCFS. Here, we describe her cognitive-neuropsychological and numerical-cognitive profiles. The girl was assessed twice, at 8 and 11 years. Her numerical-cognitive performance at both times was compared to demographically similar girls with normal intelligence in a single-case, quasi-experimental study. Neuropsychological assessment was normal, except for relatively minor impairments in executive functions. She presented severe and persistent difficulties in the simplest single-digit calculations. Difficulties in commutative operations improved from the first to the second assessment. Difficulties in subtraction persisted and were severe. No difficulties were observed in Arabic number writing. Difficulties in single-digit calculation co-occurred with basic numerical processing impairments in symbolic and non-symbolic (single-digit comparison, dot sets size comparison and estimation) tasks. Her difficulties suggest ANS impairment. No difficulties were detected in visuospatial/visuoconstructional and in phonological processing tasks. The main contributions of the present study are: (a) this is the first characterization of the neuropsychological phenotype in 22q11.2DS (LCR22-4 to LCR22.5) with normal intelligence; (b) mild forms of specific genetic conditions contribute to persistent MD in otherwise typical persons; (c) heterogeneity of neurogenetic underpinnings of MD is suggested by poor performance in non-symbolic numerical processing, dissociated from visuospatial/visuoconstructional and phonological impairments; (d) similar to what happens in 22q11.2DS (LCR22-2 to LCR22-4), ANS impairments may also characterize 22q11.2DS (LCR22-4 to LCR22-5).

Heterogeneity of math difficulties and its implications for interventions in multiplication skills

Math learning disability (MLD) is a heterogeneous condition characterized by severe and persistent difficulties in learning math, including difficulties in learning multiplication facts.

Arithmetic Abilities in Children With Developmental Dyslexia: Performance on French ZAREKI-R Test

A high comorbidity between reading and arithmetic disabilities has already been reported. The present study aims at identifying more precisely patterns of arithmetic performance in children with developmental dyslexia, defined with severe and specific criteria. By means of a standardized test of achievement in mathematics ( Calculation and Number Processing Assessment Battery for Children; von Aster & Dellatolas, 2006), we analyzed the arithmetic abilities of 47 French children with dyslexia attending 3rd, 4th, and 5th grade. Of them, 40% displayed arithmetic deficits, mostly with regard to number transcoding and mental calculation. Their individual profiles of performance accounted for varying strengths and weaknesses in arithmetic abilities. Our findings showed the pathway for the development of arithmetic abilities in children with dyslexia is not unique. Our study contrasts with the hypotheses suggesting the mutual exclusiveness of the phonological representation deficit and the core number module deficit.

Examining pitch and numerical magnitude processing in congenital amusia: A quasi-experimental pilot study

INTRODUCTION

Congenital amusia is a developmental disorder associated with deficits in pitch height discrimination or in integrating pitch sequences into melodies. This quasi-experimental pilot study investigated whether there is an association between pitch and numerical processing deficits in congenital amusia. Since pitch height discrimination is considered a form of magnitude processing, we investigated whether individuals with amusia present an impairment in numerical magnitude processing, which would reflect damage to a generalized magnitude system. Alternatively, we investigated whether the numerical processing deficit would reflect a disconnection between nonsymbolic and symbolic number representations.

METHOD

This study was conducted with 11 adult individuals with congenital amusia and a control comparison group of 6 typically developing individuals. Participants performed nonsymbolic and symbolic magnitude comparisons and number line tasks. Results were available from previous testing using the Montreal Battery of Evaluation of Amusia (MBEA) and a pitch change detection task (PCD).

RESULTS

Compared to the controls, individuals with amusia exhibited no significant differences in their performance on both the number line and the nonsymbolic magnitude tasks. Nevertheless, they showed significantly worse performance on the symbolic magnitude task. Moreover, individuals with congenital amusia, who presented worse performance in the Meter subtest, also presented less precise nonsymbolic numerical representation.

CONCLUSIONS

The relationship between meter and nonsymbolic numerical discrimination could indicate a general ratio processing deficit. The finding of preserved nonsymbolic numerical magnitude discrimination and mental number line representations, with impaired symbolic number processing, in individuals with congenital amusia indicates that (a) pitch height and numerical magnitude processing may not share common neural representations, and (b) in addition to pitch processing, individuals with amusia may present a deficit in accessing nonsymbolic numerical representations from symbolic representations. The symbolic access deficit could reflect a widespread impairment in the establishment of cortico-cortical connections between association areas.

What Is Specific and What Is Shared Between Numbers and Words?

Reading and spelling performance have a significant correlation with number transcoding, which is the ability to establish a relationship between the verbal and Arabic representations of numbers, when a conversion of numerical symbols from one notation to the other is necessary. The aim of the present study is to reveal shared and non-shared mechanisms involved in reading and writing of words and Arabic numerals in Brazilian school-aged children. One hundred and seventy-two children from second to fourth grades were evaluated. All of them had normal intelligence. We conducted a series of hierarchical regression models using scores on word spelling and reading single words and Arabic numerals, as dependent variables. As predictor variables we investigated intelligence, the phonological and visuospatial components of working memory (WM) and phonemic awareness. All of the writing and reading tasks (single word spelling and reading as well as number reading and number writing) were significantly correlated to each other. In the regression models, phonological WM was specifically associated to word reading. Phonemic awareness was the only cognitive variable that systematically predicted all of the school skills investigated, both numerical and word tasks. This suggests that phonemic awareness is a modular cognitive ability shared by several school tasks and might be an important factor associated to the comorbidity between dyslexia and dyscalculia.

Stable measures of number sense accuracy in math learning disability: Is it time to proceed from basic science to clinical application?

Math learning disability (MLD) or developmental dyscalculia is a highly prevalent and persistent difficulty in learning arithmetic that may be explained by different cognitive mechanisms. The accuracy of the number sense has been implicated by some evidence as a core deficit in MLD. However, research on this topic has been mainly conducted in demographically selected samples, using arbitrary cut-off scores to characterize MLD. The clinical relevance of the association between number sense and MLD remains to be investigated. In this study, we aimed at assessing the stability of a number sense accuracy measure (w) across five experimental sessions, in two clinically defined cases of MLD. Stable measures of number sense accuracy estimate are required to clinically characterize subtypes of MLD and to make theoretical inferences regarding the underlying cognitive mechanisms. G. A. was a 10-year-old boy with MLD in the context of dyslexia and phonological processing impairment and his performance remained steadily in the typical scores range. The performance of H. V., a 9-year-old girl with MLD associated with number sense inaccuracy, remained consistently impaired across measurements, with a nonsignificant tendency to worsen. Qualitatively, H. V.'s performance was also characterized by greater variability across sessions. Concomitant clinical observations suggested that H. V.'s difficulties could be aggravated by developing symptoms of mathematics anxiety. Results in these two cases are in line with the hypotheses that at least two reliable patterns of cognitive impairment may underlie math learning difficulties in MLD, one related to number sense inaccuracy and the other to phonological processing impairment. Additionally, it indicates the need for more translational research in order to examine the usefulness and validity of theoretical advances in numerical cognition to the clinical neuropsychological practice with MLD.

Comparisons of numerical magnitudes in children with different levels of mathematical achievement. An ERP study

The ability to map between non-symbolic and symbolic magnitude representations is crucial in the development of mathematics and this map is disturbed in children with math difficulties. In addition, positive parietal ERPs have been found to be sensitive to the number distance effect and skills solving arithmetic problems. Therefore we aimed to contrast the behavioral and ERP responses in children with different levels of mathematical achievement: low (LA), average (AA) and high (HA), while comparing symbolic and non-symbolic magnitudes. The results showed that LA children repeatedly failed when comparing magnitudes, particularly the symbolic ones. In addition, a positive correlation between correct responses while analyzing symbolic quantities and WRAT-4 scores emerged. The amplitude of N200 was significantly larger during non-symbolic comparisons. In addition, P2P amplitude was consistently smaller in LA children while comparing both symbolic and non-symbolic quantities, and correlated positively with the WRAT-4 scores. The latency of P3 seemed to be sensitive to the type of numerical comparison. The results suggest that math difficulties might be related to a more general magnitude representation problem, and that ERP are useful to study its timecourse in children with different mathematical skills.

Phonemic awareness as a pathway to number transcoding

Although verbal and numerical abilities have a well-established interaction, the impact of phonological processing on numeric abilities remains elusive. The aim of this study is to investigate the role of phonemic awareness in number processing and to explore its association with other functions such as working memory and magnitude processing. One hundred seventy-two children in 2nd grade to 4th grade were evaluated in terms of their intelligence, number transcoding, phonemic awareness, verbal and visuospatial working memory and number sense (non-symbolic magnitude comparison) performance. All of the children had normal intelligence. Among these measurements of magnitude processing, working memory and phonemic awareness, only the last was retained in regression and path models predicting transcoding ability. Phonemic awareness mediated the influence of verbal working memory on number transcoding. The evidence suggests that phonemic awareness significantly affects number transcoding. Such an association is robust and should be considered in cognitive models of both dyslexia and dyscalculia.