### DSM-IV-TR criteria

- A. Considered a disorder in 1937. Formerly known as developmental arithmetic disorder, developmental acalculia, or dyscalculia. This is a learning disorder in which a person’s mathematical ability is substantially lower than the expected base for age, intelligence levels, life experiences, educational background, and physical impairments.
- B. Mathematical ability, as measured by individually administered standardized tests, is substantially below that expected given the person’s chronological age, measured intelligence, and age appropriate education.
- C. The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living that require mathematical ability.
- D. If a sensory deficit is present, the difficulties in mathematical ability are in excess of those usually associated with it.

**Coding Note:** If a general medical (e.g., neurological) condition or sensory deficit is present, code the condition on Axis III.

### Associated Features

- The person’s mathematical ability must be substantially below the levels of peers with symptoms usually occurring simultaneously. Early difficulties with arithmetic are very noticeable through low scores in math. There are four types of symptom categories that people with Mathematics Disorder can be observed having: 1.) Language Symptoms:misunderstanding of greater than or less than or misunderstanding of word problems 2.) Recognition or Perceptual Symptoms: difficulty reading numbers, difficulty understanding plus or minus signs, or properly aligning numbers to perform calculations 3). Mathematical Symptoms: difficiencies in the ability to count, memorize basic arithmetic data as multiplication tables, or follow sequential steps in problem solving 4.) Attention Symptoms: inability to copy numbers or ignoring operational signs
- Other learning disabilities are common in comorbidity with mathematics disorders. Usually reading problems can be highly associated with mathematical disorders. For example, a child can experience difficulty when attempting to solve a math word problem if he/she cannot even understand the words he/she is reading

### Child vs. Adult Presentation

This is primarily seen in children in elementary school more than in adults because of the amount of mathematical requirements that schools tend to impose on children to progress with their peers. It can also be seen in children as young as 6, but it is usually diagnosed when the child is 8 or in the third grade due to a foundation of basic math at that age. If proper diagnosis and treatment is not received early, studies show that there is higher risk of school drop out rates in children suffering from the disorder.

### Gender and Cultural Differences in Presentation

Some studies have shown no significant gender difference, but it may occur with greater frequency in girls. Social constructs and state level administered tests tend to suggest that boys are better at math and girls are better at reading and writing. This way of thinking has been unconsciouly passed on to children and they test higher and perform academically superior in their gender specific areas. This has negatively impacted research as researchers must first eliminate that way of thinking before even beginning their research on gender differences in mathematics disorders. For the purpose of identifying cultural differences, a random sample of the population is tested, as well as the individualized testing that is performed to diagnose the disorder. Equally vital, is the inclusion of a similar socioeconomic and educational status for the participants that are being researched.

### Epidemiology

- According to the Diagnostic and Statistical Manual of Mental disorders, which is the basic manual consulted by mental health professional to asses the presence of mental disorders, approximately 1% of school age children have a mathematical disorder. It is difficult to determine the actual prevalence rate for mathematics disorders because so many studies focus on the prevalence of learning disabilites as a whole rather than separating into the specific reading, mathematic, or written expression disorders.
- Mathematical disorders appear to be less prevalent than reading disorders. Approximately one in every five cases of learning disorders has a specific mathematics disorder.
- This disorder appears to run in families, similar to other learning disabilities. This suggests that there is a genetic component to this disorder.

### Etiology

- The genetic components, which are thought to be a possible culprit for the disorder, are ones such as: Fragile X and Turner Syndrome. Fragile X is a genetic syndrome which results in a spectrum of characteristics: physical, intellectual retardation, emotional and behavioral features which range from severe to mild manifestation. It is the most common inherited cause of mental retardation and is associated with autism. It is a genetic disorder caused by a mutation of the FMR1 gene on the X chromosome. Mutation on that site is found in 1 out of every 4,000 males and in 1 out of every 6000 females. Turner Syndrome is a genetic disorder in which only an X chromosome is present, instead of an X and a Y chromosome. This disorder affects females and is associated with short stature, lack of sexual development, cardiac problems, kidney abnormalities, and possible mental retardation.
- It is also more commonly seen in familial instances, in which one or more parents show more difficulty with mathematical subjects. Also, it is commonly thought to be multifactorial. Children seem to show signs of other learning disorders in reading and language skills, but can experience it independently if their reading and language skills are average or above average.
- Injury to specific portions of the brain are also known to cause the inability to perform critical calculations thus leading to Mathematics disorder.

### Twin Studies

Monozygotic twins have the same genotype, as opposed to dizygotic twins. In other words, monozygotic twins share the same environment and, therefore, share heritability. The results for a group of twins researched were shared genetic influences in mathematics disorders and language disorders.

### Empirically Supported Treatments

- Children diagnosed with this disorder are eligible for an individual education plan that focuses on giving them specific details that include learning accommodations for the child and a unique plan to treat their disorder. Studies show that those children need to be introduced to more problem-solving skills and tactics to eliminate distraction and add to their understanding.
- Placement in special math classes with expert math teachers may be the most helpful to a child once he or she is diagnosed. Remedial education is shown to be effective for children because they need the specific help from teachers trained in learning disorders.
- Tutoring can help when the child’s learning disorder is diagnosed very early to help them develop more tactics to perform at the average level. Because of the wide variety of problems found under the diagnosis of mathematics disorder, plans vary considerably. Concrete, hands-on instruction is more successful than abstract or theoretical instruction.
- Individualized Education Programs (IEPs) also address other language or reading disabilities that affect a child’s ability to learn mathematics and assist children in overcoming them and coping with them.
- Parents and teachers can look for the following signs to asses a potential mathematical disorder: problems counting, problems memorizing multiplication tables, inability to grasp the difference between addition and subtraction, poor computational skills, slowness in performing calculations, difficulty arranging numbers in order, inability to understand place values, difficulity understanding word problems, inability to understand mathmatical symbols, and inability to align two or three digit numbers to perform calculations. In most cases, the symptoms are present simultaneously with each other.