UK study finds children with maths difficulties (SLDM/dyscalculia) far less likely to receive an official diagnosis than their peers with dyslexia

GettyImages-637223078.jpgBy Christian Jarrett

Given how important maths skills are in everyday life, it is vital that we develop ways to reliably identify those children with particular learning difficulties related to maths (known as “specific learning disorder in mathematics”/SLDM or dyscalculia) so that they can be provided with appropriate support. Unfortunately, maths-related learning problems are far less understood and recognised compared with similar problems related to reading and language.

A recent study in the British Journal of Psychology highlights this issue, being the first to estimate the prevalence of SLDM/dyscalculia in primary school age children using contemporary criteria (as outlined by the American Psychiatric Association in the latest version of its diagnostic manual). The results provide much needed data on this topic, reveal some worrying facts and also useful insights for policy.

The research is based on nearly 2,500 children, aged 7 to 13, from 19 rural and urban schools in Northern Ireland. The data are averages of several years’ standardised test results of the children’s maths, reading and IQ, together with background demographic information and notes on any diagnoses of other developmental problems.

Historically, diagnosis of SLDM/dyscalculia took a child’s IQ into account a child, such that a specific problem with maths was only diagnosed if their maths ability was low relative to their IQ – the so-called “discrepancy criterion”. The newer diagnostic criteria (in DSM 5) abandon this principle. Now a persistent, significant problem with maths counts as SLDM/dyscalculia even if it occurs alongside comparably low IQ or other learning problems (however SLDM is still discounted in the context of extremely low IQ).

Based on the new criteria, Kinga Morsanyi and her colleagues at Queen’s University Belfast, estimated the relevance of SLDM/dyscalculia in primary school children at around 6 per cent. This is substantially higher than previous estimates of 1.1 per cent prevalence based on the earlier diagnostic criteria. Morsanyi’s team said this could have “huge consequences for children’s outcomes” because it means more children ought to be able to access maths-based educational support.

Somewhat worryingly, however, the data showed that only one child in the sample had actually received a formal diagnosis of SLDM/dyscalculia, in contrast with 108 children who had received a diagnosis of dyslexia. Given that prevalence rates of SLDM/dyscalculia and dyslexia are usually similar, the researchers explained that this means “we can say that a child with dyslexia was more than a hundred times more likely to receive an official diagnosis of that disorder (which is necessary to obtain specialist educational support) than a child with dyscalculia.”

In theory, the revamped diagnostic criteria ought to lead to the identification of more children with SLDM/dyscalculia, thus opening up the chance for them to receive specialist support, but in practice this does not seem to be happening. At least, not yet. Moreover, from speaking to educational psychologists, Morsanyi and her team said the situation is compounded by the fact the educational psychologists said there are “no generally accepted intervention methods that could be recommended” for SLDM (a further complication is that the new diagnostic criteria state that maths problems should be persistent in spite of interventions, which promotes the unhelpful idea that extra support for children with SLDM/dyscalculia is futile – the researchers challenge this view and point to their finding of reduced prevalence of SLDM/dyscalculia with age as evidence that persistent maths problems can be addressed effectively).

“An important first step,” to addressing these issues, they said, “would be to raise awareness of SLDM/dyscalculia among both teachers and educational psychologists as part of their work training.”

In terms of demographic background and other concurrent diagnoses, the new data suggest that children with persistent maths problems also often have problems with English and low IQ; tend to come from relatively deprived backgrounds; usually have other special educational needs; and are more likely to have “newcomer status” (meaning that English wasn’t their first language). The researchers said that additional support for maths should be given to children with SLDM/dyscalculia regardless of the source of their maths problems (be they environmental or cognitive or a mix of the two). They also noted that there were some children with SLDM/dyscalculia who also had a diagnosis of autism, but none with a concurrent diagnosis of ADHD.

A final finding to note concerns gender differences – overall, there was no evidence that girls or boys were more likely to have dyscalculia/SLDM (or be exceptional in maths), which contrasts with the situation for dyslexia, which is about twice as common among boys. However, when the researchers matched girls and boys for IQ and English scores (which were generally higher in girls overall) and special educational needs status, there was evidence of more maths problems among girls than similar status boys – what the researchers described as “… a hidden gender difference in maths performance even among primary school children. That is, although girls do not underperform in terms of their actual scores, they underperform relative to their cognitive/learning potential”. Considering reports that many girls lose interest in maths and science at around age 11, the researchers said another policy implication of their results was that intervention programmes aimed at encouraging girls into science and maths subjects should start even earlier.

In a prepared media statement, Morsanyi wrote that “From these figures, we can estimate that about 10,000 children in Northern Ireland have sustained, serious difficulties with mathematics. Given that virtually no children in our sample received an official diagnosis of mathematics disorder, we can expect that most of these children do not receive educational support with mathematics. This can have very important adverse consequences.” She added that “…these figures in the UK in general would be much higher.”

The prevalence of specific learning disorder in mathematics and comorbidity with other developmental disorders in primary school-age children

Christian Jarrett (@Psych_Writer) is Editor of BPS Research Digest

10 thoughts on “UK study finds children with maths difficulties (SLDM/dyscalculia) far less likely to receive an official diagnosis than their peers with dyslexia”

  1. Regarding Mr. Jarrett’s article on how UK children with dyscalculia “are 100 times less likely” to get an official diagnosis, I’d like to point out the glaring and funny-if-it-weren’t-so-ironic error. To say “100 times less likely” is an example of mathematical innumeracy. Times ALWAYS results in a larger number, unless you are multiplying by a number less than one. It would be correct to say “children with dyslexia are 100 times more likely” to get the diagnosis than those with dyscalculia. Or “one percent” of those with dyscalculia get diagnosed. Or 1/100th. The headline is just incorrect. You do not earn “5 times less than your regional manager,” you earn 20%, or one fifth. If your boss makes $100,000 and you make $20,000, you do NOT make “five times less” than she does. There is no such thing as “100 times less.” One hundred times is a LARGER NUMBER. Thank you for the shining example of innumeracy.

    Robert Berend, J.D., Ph.D. USA

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    1. This is a very valuable and interesting report. I would be interested to know whether there are any plans to replicate or extend it beyond Northern Ireland to England and Wales or Scotland?

      Identification of a generic problem (similar to dyslexia) is complex as we know. Secondly, in the light of the long standing difficulties that many Primary teachers face in their own understanding of maths, and difficulties in the teaching of maths to children even by maths graduates, there may be ‘noise’ and/or confounding variables involved.

      Reports from Cockcroft and Kings to the Hub highlight both teachers’ re/training needs and the mathematical misconceptions among children after school transition at ages 11-12 (place value, decimals and fraction, speed and automaticity, mastery etc.). I’d be interested to know whether the study includes data on the nature of the participants’ mathematical difficulties (including misconceptions) or whether there might be such an analysis or follow up. Many thanks!

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      1. A reply published on behalf of lead author Kinga Morsanyi:

        Regarding the first part of the question, we are not planning to extend this study to other parts of the UK, but we expect that the results would be similar. In terms of the origins of mathematics difficulties, we have identified several environmental risk factors, including low socio-economic status, and when children do not speak English as their first language. I very much agree that teaching styles could also be responsible for some children’s difficluties, but in our study we focussed on children who had extremely low maths scores over several school years. This is unlikely to be the result of just poor teaching alone.
        Regarding the specific difficulties of the children, we do not have data about this. However, given the extremely low scores, it can be expected that difficulties are present across a range of tasks in the case of each child. I agree that it would be very interesting to look at difficulties with specific concepts, such as fractions, place values, etc. We were not focussing on specific concepts, because we were interested in maths difficulties across several school years. However, the expectation would be that children with dyscalculia would already struggle with more simple concepts, including subtraction, multiplication and division, especially if these involve multi-digit numbers.

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      2. Thanks so much for replying. I’m a researcher but also someone who researches and teaches maths to children ages 3 to 9+. After many years I find that many of the children who have low maths scores caused by poor teaching but not rectified over several years almost never catch up. This usually includes those who struggle with language and cognition generally.

        Once these students don’t understand place value (as one key example) by age 6-7 they can then never grasp addition, multiplication etc. as these operations depend almost entirely on a clear conceptualisation of place value.

        Hence low scores continue into KS2 as teaching pace speeds up, there is little time to diagnose the root cause and little specialist help, and they fall even further behind in KS3.

        A targetted intervention study identifying and addressing the missing concept/s would be great follow up. Do carry on the good work!

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      3. A reply posted on behalf of Kinga Morsanyi: Thank you for this interesting comment! Although not in this paper, but in another study which was part of the same project, we investigated the cognitive deficits that underlie dyscalculia (see here: https://www.tandfonline.com/doi/abs/10.1080/87565641.2018.1502294 ) One of the most important factors that we identified as contributing to mathematics difficulties was the ability to remember and judge the ordinal position of items within a set. Your comment about place values is particularly interesting, because it obviously requires taking into account the relative position of numerals. At an earlier stage, the understanding of multi-digit numbers, subtracting numbers, and even learning the count list also require taking into account ordinal information. Indeed, ordinality processing also relates to mathematics learning in young children at the start of formal education: https://onlinelibrary.wiley.com/doi/full/10.1111/desc.12645 So this is definitely a line of work that we want to pursue.

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  2. Without looking for the definition in DSM of this apparently too rare diagnosis, it is hard to get any wiser. Is switching the numbers around, reading 15 where it says 51 dyslexia or dyscalculia?

    Having brought children up in the US where most of the elementary math materials are to be turned in on blank copy paper, I think giving the children tools such as grit paper or paper with columns might make it much easier for many to understand math.

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