Math & Cognitive Skill Interventions for Dyscalculia

Overseen By Vinod Menon, Ph.D.

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Must not be taking: Psychiatric medications

Disqualifiers: Neurological, Psychiatric, Head injury, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 weeks

180 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to understand how certain teaching methods can improve math skills in children, especially those with math learning disabilities. Researchers will test two types of interventions: one focuses on connecting numbers with their quantities, and the other enhances memory skills. The trial seeks elementary school children who struggle with math and have no serious vision or hearing issues. Participants will engage in activities designed to boost their numerical skills over six weeks. As an unphased trial, this study offers a unique opportunity for children to enhance their math skills through innovative teaching methods.

Will I have to stop taking my current medications?

The trial excludes participants who are on consistent psychiatric medications, so you may need to stop taking them to participate.

What prior data suggests that these interventions in mathematics and cognitive skills are safe for children?

In a previous study, researchers tested a method to improve math skills using non-symbolic arithmetic training, such as working with large groups of items. The study found that children who participated demonstrated better math abilities, with no safety concerns or negative effects reported. This suggests that Integrative Symbolic Non-Symbolic (iSNS) training is generally safe and well-tolerated for kids.

For the active control intervention, which aims to improve working memory (the ability to temporarily hold and use information), researchers reported no specific safety concerns. Schools commonly use working memory training, and it is considered safe for children.

Both treatments in this trial are designed to help kids improve their math skills safely. Similar studies have noted no major safety issues, which reassures those considering joining the trial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these interventions for dyscalculia because they offer a novel approach by focusing on cognitive training rather than traditional methods like tutoring or medication. The Integrative Symbolic Non-Symbolic (iSNS) Training is unique because it specifically targets the connection between symbolic and non-symbolic numerical skills, potentially enhancing numerical fluency more effectively than current options. Meanwhile, the Active Control Intervention emphasizes boosting working memory, which is crucial for mathematical processing. Together, these methods could provide a comprehensive improvement in math skills for individuals with dyscalculia.

What evidence suggests that this trial's treatments could be effective for dyscalculia?

Research shows that teaching methods focusing on both symbolic (like numbers) and non-symbolic (like quantities) ways of understanding can help children with math learning disabilities, such as dyscalculia. In this trial, participants in the Integrative Symbolic Non-Symbolic (iSNS) Training arm will engage in activities designed to strengthen the mapping of symbolic numerical representations to non-symbolic numerical quantities and enhance fluency in symbolic numerical skills. One study found that tutoring aimed at improving number sense helped reduce the differences in how children understand these types of numbers. This training improved their ability to work with numbers in a symbolic way, which is often difficult for these children. Other research supports that focusing on basic number skills and understanding can lead to better math abilities. Overall, teaching that improves both symbolic and non-symbolic number skills seems promising in helping children with dyscalculia get better at math. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for elementary school children aged 6-12 with an IQ over 70. It's aimed at those struggling with math, scoring below the 25-35th percentile in certain tests, and typically developing kids who score above that range. Participants must have normal vision and hearing, be right-handed for MRI scans, and not have psychiatric disorders or head injuries.

Inclusion Criteria

Only people who are right-handed can participate in the MRI scan.

My vision is normal or corrected to normal, and I don't have hearing problems.

If you score lower than most people on a math test and have trouble with math in general, you may not be able to join the study.

Exclusion Criteria

I have had a head injury due to an accident or trauma.

I have a history of mental health issues like schizophrenia or ADHD.

My psychiatric medications have been stable.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo Integrative Symbolic Non-Symbolic (iSNS) training or Active Control Intervention over a period of 6 weeks to enhance numerical skills

6 weeks

Follow-up

Participants are monitored for changes in cognitive and neural measures post-intervention

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Interventions in Mathematics and Cognitive Skills

Trial Overview

The study is testing educational interventions to improve mathematical skills in children with learning disabilities compared to typical development. It examines how these interventions affect brain function and decision-making related to numbers.

How Is the Trial Designed?

Group I: Integrative Symbolic Non-Symbolic (iSNS) Training Experimental Treatment 1 Intervention

Integrative symbolic non-symbolic (iSNS) training: Over a period of 6 weeks, participants will complete activities that progressively strengthen the mapping of symbolic numerical representations to non-symbolic numerical quantities and enhance fluency in symbolic numerical skills.

Group II: Active Comparator: Active Control Intervention (Working Memory Training) Active Control 1 Intervention

Active control intervention: Over a period of 6 weeks, participants will complete activities that enhance short-term storage and maintenance of visuospatial or verbal information.

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Published Research Related to This Trial

The adaptive game software 'The Number Race' effectively trains children with dyscalculia by personalizing numerical tasks based on their individual performance levels, utilizing a sophisticated algorithm that considers various difficulty dimensions.

After five weeks of use with nine children experiencing mathematical learning difficulties, the software showed positive adaptability to different learning speeds and received favorable feedback from users, indicating its potential for broader educational applications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Principles underlying the design of "The Number Race", an adaptive computer game for remediation of dyscalculia. Wilson, AJ., Dehaene, S., Pinel, P., et al.[2018]

A single case study demonstrated that a theory-based cognitive treatment significantly improved numerical and calculation abilities in a 7.4-year-old child with developmental dyscalculia after 12 months of tailored intervention.

Despite the improvements in numerical tasks, the child remained slower than peers, highlighting the need for early diagnosis and intervention to achieve clinically significant changes and prevent further behavioral and emotional issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of neuropsychological rehabilitation on numerical and calculation abilities: A developmental case study. De Nigris, A., Masciarelli, G., Guariglia, C.[2021]

Recent advancements in the diagnosis of dyscalculia have led to improved testing methods that assess basic numerical skills rather than just curriculum-based math performance.

International studies indicate that specialized interventions for children with dyscalculia are effective, highlighting the importance of tailored treatment approaches in clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Symptoms diagnosis and treatment of dyscalulia]. Ise, E., Schulte-Körne, G.[2013]

A longitudinal study identified two groups of Grade 3 students with different math abilities: those with persistent difficulties (PD group) and those who improved (IP group), highlighting the importance of early identification of math disabilities.

A conceptual intervention focusing on explicit teaching of basic arithmetic significantly benefited the PD group, particularly in written calculations and multiplication speed, suggesting that targeted remediation can effectively address core number deficits in older students.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment and conceptual remediation of basic calculation skills in elementary school students. Karakonstantaki, ES., Simos, PG., Michalis, V., et al.[2019]

Specific neurocognitive abilities, such as visual-spatial skills and attention, are crucial for mathematical development, especially in children with neurodevelopmental disorders.

Children with conditions like congenital disorders or those treated for cancer, such as acute lymphoblastic leukemia, may face greater challenges in math learning due to disruptions in these essential neurocognitive systems.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mathematics development and difficulties: the role of visual-spatial perception and other cognitive skills. Barnes, MA., Raghubar, KP.[2019]

The software designed to remediate dyscalculia showed promising results in a small open-trial with nine children aged 7-9, leading to significant improvements in core number sense tasks, particularly in subtraction accuracy which increased by an average of 23%.

While the software effectively enhanced specific skills like speed in numerical comparison, it did not improve performance in addition and base-10 comprehension, indicating that further research is needed to explore its broader efficacy and optimal timing for intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An open trial assessment of "The Number Race", an adaptive computer game for remediation of dyscalculia. Wilson, AJ., Revkin, SK., Cohen, D., et al.[2018]

5% to 8% of school-age children experience memory or cognitive deficits that hinder their learning in mathematics, indicating a significant prevalence of learning challenges in this area.

The review categorizes these deficits into three subtypes of mathematics learning disability and connects research on mathematical cognition with learning disabilities, suggesting a need for targeted interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mathematics and learning disabilities. Geary, DC.[2019]

Children with developmental dyscalculia showed significant improvements in their calculation skills after participating in a numeracy intervention program focused on basic numerical and conceptual knowledge.

The study involved six children who received individualized and small-group training over one school semester, highlighting the effectiveness of targeted teaching in areas often overlooked in traditional math education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of a numeracy intervention program focusing on basic numerical knowledge and conceptual knowledge: a pilot study. Kaufmann, L., Handl, P., Thöny, B.[2022]

The Calcularis computer-based training program significantly improved number representation and arithmetic skills in 32 children with developmental dyscalculia over a 6-12 week period, with daily 20-minute sessions.

Children enjoyed using the program and reported enhanced mathematical abilities, indicating both efficacy and positive user experience in learning mathematics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Design and evaluation of the computer-based training program Calcularis for enhancing numerical cognition. Käser, T., Baschera, GM., Kohn, J., et al.[2021]

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