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like other types of learning difficulties, the effectiveness of treatment for math disorders varies from person to person, and not all children will become "successful" after treatment.

written by | huang siyu, ling jun

even if you are not good at math, you can now register at the hospital.

on september 24, the shanghai children’s medical center affiliated with shanghai jiao tong university school of medicine issued a document stating that the “spatial and mathematics learning difficulties clinic” will open on october 8. the clinic was jointly established by the hospital's mental health team and the school of psychology of shanghai jiao tong university. as soon as the news was released, it spread widely among parent groups, and the number was sold out.

screenshot source: public account "shanghai children's medical center patient services"

but unlike anxious parents, many netizens likened it to an "iq tax" and believed it was an "artificially created demand." some colleagues even posted articles questioning, "good or bad math is determined by innate genes. how to treat it?"

in fact, the diagnosis of "mathematical disorder" does exist in clinical practice. it is included in the international classification of diseases (11th edition) and the diagnostic and statistical manual of mental disorders (5th edition) issued by the american psychiatric association. it is a neurodevelopmental disorder that is classified under "learning disabilities (lds)" together with dyslexia and dysgraphia.

wu lingling, deputy director of the department of developmental behavior of the children's hospital of zhejiang university school of medicine, has encountered many children with difficulties in learning mathematics. she told the "medical community" that mathematics difficulties do not necessarily exist alone, and are very likely to be combined with dyslexia and attention deficit. adhd and social, behavioral, and emotional problems require comprehensive analysis and personalized intervention, and the effects vary from person to person.

how to diagnose?

according to an article by the shanghai children's medical center, the outpatient clinic to be opened this time is targeted at "students who have difficulty learning mathematics, physics, chemistry, etc." it is a special needs outpatient clinic, and the registration fee is 316 yuan. the article also emphasizes that not only those under the age of 18, adults also have difficulties with spatial imagination.

this clinic is rare in china, but overseas, many medical institutions have provided diagnosis and treatment services for mathematics learning difficulties. according to the website of the school of psychological sciences at the university of melbourne, the dyscalculia clinic run by the institution can provide assessments for children and adults with mathematical learning difficulties and dyscalculia.

screenshot source: university of melbourne school of psychological sciences website

"among the children with learning difficulties that i have come into contact with, about 1/3 have math learning difficulties." wu lingling told the "medical circle" that clinically, it is usually based on the child's performance and homework at school and at home. , and various neuropsychological assessment results for screening and diagnosis.

wu lingling introduced that mathematics learning involves many important links such as key information extraction, decoding, reasoning, spatial thinking, working memory, visual search, etc., and is related to the function of the fronto-parietal cortex and hippocampus of the brain. once these functions are dysfunctional, mathematics will appear. learning difficulties.

in wu lingling's learning disability clinic, children diagnosed with math disabilities are concentrated in the kindergarten class to the second grade of elementary school. children of this age begin to be exposed to cultural knowledge. if they have difficulty learning mathematics and their academic performance is significantly behind the level of their peers, parents will often be nervous and can’t wait to bring their children to see a doctor.

not long ago, she received a child with math learning difficulties. this child has just entered the first grade of elementary school and cannot complete addition and subtraction within 10 through mental arithmetic. he needs to use his fingers to assist. he even has difficulty counting from 1 to 50, which causes great trouble to his parents.

wu lingling told the "medical community" that children with mathematical disabilities may have weak number sense, difficulty in memorizing numbers or counting, and poor sense of time and direction in kindergarten. after going to school, it may manifest itself as difficulty in calculation, weak abstract concept and reasoning ability, insufficient spatial thinking, difficulty in applying formulas, etc.

children with severe mathematical disabilities may also suffer from anxiety, depression and other emotional problems, and may even be tired of studying. more severe cases of children will also have somatization symptoms. "headache and stomachache as soon as they arrive at school, but they are better as soon as they get home."

it is worth noting that mathematics disorder is a developmental disorder of learning skills, so intellectual disability, visual or hearing impairment, neurological diseases, and other mental and psychological diseases must be excluded when diagnosing.

in addition, the diagnosis must take into account the child's own abilities and environment. wu lingling pointed out that one of the diagnostic criteria for mathematics disorders is: significant interference with academic or occupational performance or activities of daily living. "in other words, a diagnosis can only be made if it causes substantial 'functional damage' to the patient's study, work and life."

for example, although some children have certain mathematics learning difficulties, they do not show symptoms in relatively relaxed learning environments (such as schools in remote areas). if there is no functional impairment, there is no need for diagnosis. however, if the child enters a more rigorous learning environment (such as a private school in a developed city), and the requirements for students are greatly increased, mathematics learning difficulties will appear, causing significant interference to the child's daily learning life, and diagnosis will be required. .

dr. wu lingling (right) in the outpatient clinic/photo provided by zhejiang university children’s hospital

how to treat math disorders?

how are math disabilities treated? wu lingling introduced that if mathematics disorder is combined with attention deficit hyperactivity disorder, tic disorder, mood disorder, etc., drug treatment can be appropriately used. there is currently no specific medicine for pure mathematics disorders, and individualized intervention is required based on the child's age, cognitive level, severity, and comorbid symptoms.

the younger the age, the better the intervention effect. wu lingling said that although mathematics disorders are not diagnosed until before entering school, such children often have traces in their early development. if parents are keen and can detect in time that their children's number sense and spatial sense are weak, and carry out targeted intensive training, math difficulties can be improved to a certain extent.

wu lingling introduced that for children with poor number sense, games can be used, such as allowing children to count common objects in life, read the time on clocks, and arrange more number decorations at home. by establishing the relationship between physical objects and numbers, to strengthen children’s perception of numbers.

"children with poor spatial sense and logical reasoning abilities can be improved by playing jigsaw puzzles, puzzles, building blocks, logical reasoning games, etc." wu lingling said that early intervention of children through games and family scenes can not only enhance the parent-child relationship connection can also achieve better intervention effects.

she also specifically pointed out that in order to observe the effect of intervention, children with various types of learning difficulties should go to the hospital for review every 3-6 months. on the one hand, the intervention effect can be observed, and on the other hand, the intervention method can be adjusted in time.

however, wu lingling also admitted that the effectiveness of clinical intervention for various types of learning difficulties, including mathematics learning difficulties, varies from person to person. although parents can tap their children's potential to the greatest extent, if they want to make their children become "students" through intervention, maybe it won't work out.

there are also some parents who do not pay attention to methods and require their children to cram questions with high intensity. in wu lingling's view, this approach not only has little effect, but may actually aggravate the child's anxiety, depression and oppositional defiance, worsen the child's dislike of learning, and worsen his academic performance.

faced with such anxious parents, wu lingling can only try to reassure them: every child is unique, and although there are some difficulties in learning, there are also many other shining points. instead of focusing on academic performance, it is better to change the perspective, explore other strengths of the child, and engage in positive discipline.

the department of developmental behavior of the children's hospital of zhejiang university has been established for more than ten years. the department has been treating children with learning difficulties and has opened a specialized outpatient clinic for "learning disabilities". wu lingling said that opening a "learning disability" specialist clinic is not to create anxiety, but to allow parents and teachers to better understand and help their children, improve their learning skills and self-confidence, and better adapt to life.

"like autism, attention deficit hyperactivity disorder and other developmental behavioral diseases, the pathogenesis of learning disabilities remains a mystery, and the effectiveness of treatment is also uncertain. we advocate early screening and early diagnosis of children with suspected learning difficulties. we need to intervene early in childhood when the brain has strong plasticity, but we also hope that parents will respect the natural laws and potential limits of their children's intellectual development and avoid the counterproductive effects of excessive intervention," wu lingling said.