ICD-10 code: F81.2
Specific Learning Disorder, Impairment in Mathematics is part of a cluster of diagnoses called Specific Learning Disorders. Specific Learning Disorders are a group of psychiatric conditions that include:
These disorders are categorized by a persistent difficulty learning keystone academic sills with an onset during the years of formal schooling. Key academic skills include reading of single words accurately and fluently, reading comprehension, written expression and spelling, arithmetic calculation, and mathematical reasoning. Difficulties learning to map letters with the sound of one's language- to read printed words- is one of the most common manifestations of specific learning disorder.
Learning difficulties are usually readily apparent in the early school years in most individuals. Academic skills that were not mastered during the school-age years remain difficult. They are a persisting problem that evolves throughout the developmental continuum. The academic difficulties an individual might experience as a grade-school student can be very different from what is manifested as an adult with a learning disability. Thus, learning disabilities in adulthood present different themes, challenges, and issues. Social and emotional problems are not uncommon with adults with learning disabilities. An overall feeling of lack of self-worth, low self-esteem, and a poor self-concept can be pervasive. Many adults with learning disabilities have had negative experiences since their school-age years. Consequently, it is not uncommon for them to have carried their self-attributions of feeling incompetent and unintelligent into adulthood. Adults with learning disorders also have considerable strengths that include development of compensatory strategies to bypass academic impairments and resiliency to recover and persist despite challenges.
Adults with Specific Learning Disorders perform well below average for their age, and average achievement is only attained through extraordinarily high levels of effort or support. The low academic skills cause significant interference with vocational or workplace skills. These learning difficulties are considered "specific" for four reasons: (1) they are not attributable to an intellectual disability; (2) they cannot be attributed to external factors such as economic or environmental disadvantage, chronic absenteeism, or lack of education in the individual's community context; (3) they cannot be attributed to a neurological or motor disorder and (4) the difficulties may be restricted to one academic skill or domain (i.e., reading single words, retrieving or calculating number facts).
Note that Dyscalculia is a general term used to describe difficulty in mathematics. If dyscalculia is used to specify this particular pattern of difficulties, it is important to specify what difficulties are present.
Approximately 4% of adults in the general population have a learning disorder. In the 2010 census, 4.6 million adults reported have a learning disorder. Of the children who have a specific learning disability, approximately half have a mathematics impairment.
Mathematics impairments are characterized by one or more of the following domains:
Common characteristics of adults with an impairment in mathematics are:
Impairment in Mathematics is a condition that makes it difficult to make sense of numbers and math concepts. Adults with math impairments have difficulty learning and memorizing basic number facts. They struggle to understand the logic behind math and how to apply their knowledge to solving problems. Impairments in mathematics severity can range from mild to severe. The most common problem seen with adults is with "number sense." This is an intuitive understanding of how numbers work, and how to compare and estimate quantities on a number line.
It is hypothesized that the difficulty in recalling arithmetic facts begins in childhood and persists over the developmental trajectory. Not only are adults slower with math facts, but they also have difficulty with higher order processes such as algebra, fractions/decimals or procedural memory. It is not uncommon for adults to have difficulties learning skills in one or two academic domains, such as math and reading. Adults with impairments with mathematics may also have neurodevelopmental disabilities such as attention-deficit/hyperactivity disorder (ADHD), anxiety and genetic disorders such as fragile X syndrome, Gerstmann's syndrome and Turner's Syndrome.
As with most learning disabilities, the exact cause of math disabilities is unknown. Math impairments are considerably under-researched compared to reading and writing impairments. Research has indicated that it is a brain-based condition. Possible causes of math impairments include genetics and heredity. Researchers have found that an individual with a math impairment often has a parent or sibling with a similar math issue. Studies have also found differences between children with math impairments and matched controls in the surface area, thickness, and volume in parts of the brain that are linked to learning and memory, setting up and monitoring tasks, and remembering math facts. In adults, the research is sparse. In one study, math impairments were linked to lower precision for both perception and estimation in arithmetic skills.
Impairments in mathematics are treatable using a targeted, individualized intervention. The intervention is uniquely tailored to remedy the individual's weaknesses in a targeted area of mathematics (e.g., number sense, memorization of math facts, accurate or fluent calculation, accurate math reasoning). Although interventions should be individualized to take into account an individuals' academic strengths and weaknesses, there are recommendations of what a math intervention should include: Intervention Practices in Adult Literacy Education; Best Practices in Math Interventions
Under the Americans with Disabilities Act (ADA), particularly Title I, employers are required to provide workplace accommodations for individuals with learning disabilities, but only for disabilities that have been disclosed. Individuals have the right to determine whether, when, how, and to whom to disclose their disabilities, and many choose to withhold disability information. The following sources provide recommendations of workplace accommodations for adults with learning disabilities: ProLiteracy.org, LdAmerica.org.
First Line Treatments
Second Line Treatments
When patients do not respond adequately to the first line treatments described above, other strategies might include: