Challenges in Understanding Numerical Learning: Editorial for Brain Sciences Special Issue "Neurocognitive Signatures of Math (Learning) across the Lifespan and Their Interrelation with Other Aspects of Cognition and Emotion".

Living in our information- and technology-driven society at the beginning of the 21st century requires the ability to understand and handle numbers not only for a successful career but also for coping with everyday life tasks [...].

Impaired Arithmetic Fact Retrieval in an Adult with Developmental Dyscalculia: Evidence from Behavioral and Functional Brain Imaging Data.

Developmental dyscalculia (DD) is a developmental disorder characterized by arithmetic difficulties. Recently, it has been suggested that the neural networks supporting procedure-based calculation (e.g., in subtraction) and left-hemispheric verbal arithmetic fact retrieval (e.g., in multiplication) are partially distinct. Here we compared the neurofunctional correlates of subtraction and multiplication in a 19-year-old student (RM) with DD to 18 age-matched controls. Behaviorally, RM performed significantly worse than controls in multiplication, while subtraction was unaffected. Neurofunctional differences were most pronounced regarding multiplication: RM showed significantly stronger activation than controls not only in left angular gyrus but also in a fronto-parietal network (including left intraparietal sulcus and inferior frontal gyrus) typically activated during procedure-based calculation. Region-of-interest analyses indicated group differences in multiplication only, which, however, did not survive correction for multiple comparisons. Our results are consistent with dissociable and processing-specific, but not operation-specific neurofunctional networks. Procedure-based calculation is not only associated with subtraction but also with (untrained) multiplication facts. Only after rote learning, facts can be retrieved quasi automatically from memory. We suggest that this learning process and the associated shift in activation patterns has not fully occurred in RM, as reflected in her need to resort to procedure-based strategies to solve multiplication facts.

Self-efficacy matters: Influence of students' perceived self-efficacy on statistics anxiety.

Statistical knowledge is a key competency for psychologists in order to correctly interpret assessment outcomes. Importantly, when learning statistics (and its mathematical foundations), self-efficacy (defined as an individual's belief to successfully accomplish specific performance attainments) is a central predictor of students' motivation to learn, learning engagement, and actual achievement. Therefore, it is crucial to gain a better understanding of students' self-efficacy for statistics and its interrelations with statistics anxiety and students' belief in the relevance of statistics. Here, we present results showing development and validation of a self-assessment questionnaire for examining self-efficacy for statistics in psychology students (Self-Efficacy for Learning Statistics for Psychologists, SES-Psy). Upon using different methodological approaches, we demonstrate that the SES-Psy questionnaire has (1) sound psychometric properties, and within our sample of university students, (2) a robust latent structure disclosing three clearly distinctive profiles that are characterized by a complex and nonlinear interplay between perceived self-efficacy (for basic and advanced statistics), statistics anxiety, and students' belief in the relevance of statistics. Implications for educational settings and future research are discussed.

Pain and Associated Neuropsychiatric Symptoms in Patients Suffering from Dementia: Challenges at Different Levels and Proposal of a Conceptual Framework.

Old age is critically associated with multi-morbidity, chronic pain, and high risk for dementia. Recognizing and treating pain is very much dependent on language comprehension and production. Both may be impaired in dementia. Moreover, neuropsychiatric symptoms may interact with pain perception. The main aims of the present article were 1) to identify key areas for future research to elucidate the relation between pain and associated neuropsychiatric symptoms in dementia, and 2) to provide a conceptual framework for ameliorating the clinical process of recognizing, assessing, and managing pain in non-communicating patients with advanced dementia.

Loneliness and Burden Perceived by Family Caregivers of Patients With Alzheimer Disease.

BACKGROUND: The present study aimed at investigating loneliness and burden experienced by family members caring for relatives diagnosed with Alzheimer disease. METHODS: Participants were 40 caregivers of inpatients with Alzheimer disease. Correlation and multiple regression analyses were conducted to investigate whether caregivers' loneliness (uni- and multidimensional) and burden are associated with and predicted by (1) specific caregiver characteristics and/or (2) patients' dementia severity and neuropsychiatric symptoms. RESULTS: Loneliness was significantly correlated with caregivers' sex, age, and living circumstances, while burden was significantly correlated with caregivers' education solely. Regression analyses revealed that caregivers' sex and living circumstances contributed significantly to variance explanation of loneliness (but not burden), while the additional consideration of patient variables did not improve model fit. CONCLUSIONS: Loneliness reported by caregivers of relatives diagnosed with dementia is significantly modulated by caregiver (but not patient) characteristics. Notably, both uni- and multidimensional loneliness scales seem to be sensitive diagnostic tools.

The CERAD Neuropsychological Assessment Battery Is Sensitive to Alcohol-Related Cognitive Deficiencies in Elderly Patients: A Retrospective Matched Case-Control Study.

OBJECTIVES: Adverse effects of heavy drinking on cognition have frequently been reported. In the present study, we systematically examined for the first time whether clinical neuropsychological assessments may be sensitive to alcohol abuse in elderly patients with suspected minor neurocognitive disorder. METHODS: A total of 144 elderly with and without alcohol abuse (each group n=72; mean age 66.7 years) were selected from a patient pool of n=738 by applying propensity score matching (a statistical method allowing to match participants in experimental and control group by balancing various covariates to reduce selection bias). Accordingly, study groups were almost perfectly matched regarding age, education, gender, and Mini Mental State Examination score. Neuropsychological performance was measured using the CERAD (Consortium to Establish a Registry for Alzheimer's Disease). Classification analyses (i.e., decision tree and boosted trees models) were conducted to examine whether CERAD variables or total score contributed to group classification. RESULTS: Decision tree models disclosed that groups could be reliably classified based on the CERAD variables "Word List Discriminability" (tapping verbal recognition memory, 64% classification accuracy) and "Trail Making Test A" (measuring visuo-motor speed, 59% classification accuracy). Boosted tree analyses further indicated the sensitivity of "Word List Recall" (measuring free verbal recall) for discriminating elderly with versus without a history of alcohol abuse. CONCLUSIONS: This indicates that specific CERAD variables seem to be sensitive to alcohol-related cognitive dysfunctions in elderly patients with suspected minor neurocognitive disorder. (JINS, 2018, 24, 360-371).

Gestational age modulates neural correlates of intentional, but not automatic number magnitude processing in children born preterm.

Premature birth is a significant risk factor for learning disabilities in general and mathematics learning difficulties in particular. However, the exact reasons for this relation are still unknown. While typical numerical development is associated with a frontal-to-parietal shift of brain activation with increasing age, influences of gestational age have hardly been considered so far. Therefore, we investigated the influence of gestational age on the neural correlates of number processing in 6- and 7-year-old children born prematurely (n=16). Only the numerical distance effect - as a measure of intentional number magnitude processing - elicited the fronto-parietal activation pattern typically observed for numerical cognition. On the other hand, the size congruity effect - as a measure of automatic number magnitude processing - was associated with activation of brain areas typically attributed to cognitive control. Most importantly, however, we observed that gestational age reliably predicted the frontal-to-parietal shift of activation observed for the numerical distance effect. Our findings seem to indicate that human numerical development may start even before birth and prematurity might hamper neural facilitation of the brain circuitry subserving numerical cognition. In turn, this might contribute to the high risk of premature children to develop mathematical learning difficulties.

Cognitive Mechanisms Underlying Directional and Non-directional Spatial-Numerical Associations across the Lifespan.

There is accumulating evidence suggesting an association of numbers with physical space. However, the origin of such spatial-numerical associations (SNAs) is still debated. In the present study we investigated the development of two SNAs in a cross-sectional study involving children, young and middle-aged adults as well as the elderly: (1) the SNARC (spatial-numerical association of response codes) effect, reflecting a directional SNA; and (2) the numerical bisection bias in a line bisection task with numerical flankers. Results revealed a consistent SNARC effect in all age groups that continuously increased with age. In contrast, a numerical bisection bias was only observed for children and elderly participants, implying an U-shaped distribution of this bias across age groups. Additionally, individual SNARC effects and numerical bisection biases did not correlate significantly. We argue that the SNARC effect seems to be influenced by longer-lasting experiences of cultural constraints such as reading and writing direction and may thus reflect embodied representations. Contrarily, the numerical bisection bias may originate from insufficient inhibition of the semantic influence of irrelevant numerical flankers, which should be more pronounced in children and elderly people due to development and decline of cognitive control, respectively. As there is an ongoing debate on the origins of SNAs in general and the SNARC effect in particular, the present results are discussed in light of these differing accounts in an integrative approach. However, taken together, the present pattern of results suggests that different cognitive mechanisms underlie the SNARC effect and the numerical bisection bias.

Age-related differences in inhibitory control and memory updating in boys with Asperger syndrome.

Deficits in specific executive domains are highly prevalent in autism spectrum disorder; however, age-related improvements in executive functions (reflecting prefrontal maturational changes) have been reported even in individuals diagnosed with autism. The current study examined two components of cognitive flexibility (inhibition of prepotent responses and memory monitoring/updating) by using a random-motor-generation task (MPT) in a group of 23 boys with Asperger syndrome (AS) and 23 matched healthy controls. We found poorer inhibition and more repetitive responses in younger AS children solely, but comparable memory monitoring/updating skills across groups. Overall, our findings correspond well with previous studies and reveal that even in AS specific EFs may improve with age and, thus, call for a more differentiated view of executive (dys) function profiles in children diagnosed with AS. Tests such as the random-motor-generation task may help to disentangle more specific processes of executive deficits in autism spectrum disorder as compared to the more classical tests.

Very preterm adolescents show impaired performance with increasing demands in executive function tasks.

BACKGROUND: Very preterm birth is often associated with executive function deficits later in life. The transition to adolescence increases personal autonomy, independence and, in parallel, the demands placed on executive functions at home and in school. AIM: To assess the impact of increasing demands on executive function performance in very preterm children and adolescents with normal intellectual and motor functions. METHODS: Forty-one very preterm children and adolescents with normal intellectual and motor functions and 43 healthy term-born peers were assessed at a mean age of 13.0 years (SD: 1.9; range: 10.0-16.9). A comprehensive battery of performance-based executive function measures with different demand levels as well as a parent-rating questionnaire evaluating executive functions relevant for everyday life was applied. Standardized mean differences between groups of d ≥ .41 were regarded as clinically relevant. RESULTS: No group differences were found at the lowest demand levels of working memory (d=.09), planning (d=-.01), cognitive flexibility (d=-.21) and verbal fluency (d=-.14) tasks, but very preterm participants scored significantly below their term-born peers in the most demanding levels (d=-.50, -.59, -.43 and -.55, respectively). These differences were clinically relevant. Executive functions relevant for everyday life were strongly impaired in very preterm participants, e.g., global executive composite (d=-.66). CONCLUSION: Very preterm children and adolescents with normal intellectual and motor functions are at high risk for executive function deficits that may only become apparent with increasing demands, potentially leading to academic and other deficits.

Persistence of visuo-constructional and executive deficits in adolescents after open-heart surgery.

AIM: This study assesses whether previously reported performance deficiencies in visuo-constructional and executive functions, using the Rey-Osterrieth Complex Figure Test (ROCFT) in pediatric patients with congenital heart disease (CHD), persist into adolescence. METHODS: 53 adolescent CHD patients (mean age 13.7) and 39 healthy controls (mean age 14.1) participated. ROCFT performance was measured by three different scoring methods, focusing either on quantitative (Meyers & Meyers, 1995), qualitative (Wallon & Mesmin, 2009), or both performance aspects (Bernstein & Waber, 1996). Potential confounders (i.e., intelligence and visuomotor integration) and surgery-related risk factors were included in the data analysis. RESULTS: Adolescents with CHD demonstrated immature copy and recall approaches on the ROCFT using the qualitative system by Wallon and Mesmin (p<.001). Memory performance was also predicted by Bernstein and Waber scores (p<.03), whereas group differences were not significant according to the other scoring methods. Intelligence and visuomotor skills, but not surgery-related risk factors, were positively correlated with ROCFT performance (each p<.02). Interpretation: Visuoconstructional and executive deficiencies could be found in adolescent patients with CHD. However, not all ROCFT scoring methods were equally apt to detect group differences: especially the qualitative scoring method developed by Wallon and Mesmin seems sufficiently sensitive to detect long-lasting visuo-constructional and executive deficiencies in CHD patients.

Processing of intentional and automatic number magnitudes in children born prematurely: evidence from fMRI.

This study examined the neural correlates of intentional and automatic number processing (indexed by number comparison and physical Stroop task, respectively) in 6- and 7-year-old children born prematurely. Behavioral results revealed significant numerical distance and size congruity effects. Imaging results disclosed (1) largely overlapping fronto-parietal activation for intentional and automatic number processing, (2) a frontal to parietal shift of activation upon considering the risk factors gestational age and birth weight, and (3) a task-specific link between math proficiency and functional magnetic resonance imaging (fMRI) signal within distinct regions of the parietal lobes-indicating commonalities but also specificities of intentional and automatic number processing.

Language affects symbolic arithmetic in children: the case of number word inversion.

Specific language influences have been observed in basic numerical tasks such as magnitude comparison, transcoding, and the number line estimation task. However, so far language influences in more complex calculations have not been reported in children. In this translingual study, 7- to 9-year-old German- and Italian-speaking children were tested on a symbolic addition task. Whereas the order of tens and units in Italian number words follows the order of the Arabic notation, the order is inverted in German number words. For both language groups, addition problems were more difficult when a carry operation was needed, that is, when a manipulation within the place-value structure of the Arabic number system was particularly important. Most important, this carry effect was more pronounced in response latencies for children speaking German, a language with inverted verbal mapping of the place-value structure. In addition, independent of language group, the size of the carry effect was significantly related to verbal working memory. The current study indicates that symbolic arithmetic and the carry effect in particular are modulated by language-specific characteristics. Our results underline the fact that the structure of the language of instruction is an important factor in children's mathematical education and needs to be taken into account even for seemingly nonverbal symbolic Arabic tasks.

Brain structure, number magnitude processing, and math proficiency in 6- to 7-year-old children born prematurely: a voxel-based morphometry study.

The aim of the present voxel-based morphometry study was to examine the link between brain structure and number skills in a group of 6-7-year-old children born prematurely, which are considered to be an at-risk population for mathematical learning disabilities. Therefore, gray and white matter density values were extracted from brain areas previously reported to be relevant for number processing in developing brain systems and, thereafter, correlated with response time results tapping semantic number knowledge [i.e. numerical distance effect (NDE) derived from a number comparison task] as well as with general math proficiency (as indexed by a standardized calculation test). Behavioral results disclosed a significant NDE, thus indicating well-established number magnitude representations for one-digit numerals in our study group. Significant positive correlations between gray matter and NDE emerged in parietal regions (including the right anterior inferior and the left superior parietal lobe) and in the right superior temporal gyrus. Moreover, white matter and NDE were negatively correlated in the right anterior inferior parietal lobe and the right inferior frontal gyrus. Overall, our results are novel insofar as they show that in 6-7-year-old children born prematurely, individual differences in gray and white matter structures are associated with numerical skills. Importantly, in our study group the observed link between brain structure and behavioral performance emerges only regarding an experimental task tapping semantic number knowledge, whereas general math proficiency does not seem to be related to individual differences in brain structure in our study group.

Brief report: CANTAB performance and brain structure in pediatric patients with Asperger syndrome.

By merging neuropsychological (CANTAB/cambridge neuropsychological test automated battery) and structural brain imaging data (voxel-based-morphometry) the present study sought to identify the neurocognitive correlates of executive functions in individuals with Asperger syndrome (AS) compared to healthy controls. Results disclosed subtle group differences regarding response speed on only one CANTAB subtest that is thought to tap fronto-executive network functions (SWM/spatial working memory). Across all participants, SWM performance was significantly associated with two brain regions (precentral gyrus white matter, precuneus grey matter), thus suggesting a close link between fronto-executive functions (SWM) and circumscribed fronto-parietal brain structures. Finally, symptom severity (ADOS total score) was best predicted by response speed on a set-shifting task (IES) thought to tap fronto-striatal functions (corrected R2 56%).

The diagnosis and management of dyscalculia.

BACKGROUND: Dyscalculia is defined as difficulty acquiring basic arithmetic skills that is not explained by low intelligence or inadequate schooling. About 5% of children in primary schools are affected. Dyscalculia does not improve without treatment. METHODS: In this article, we selectively review publications on dyscalculia from multiple disciplines (medicine, psychology, neuroscience, education/special education). RESULTS: Many children and adolescents with dyscalculia have associated cognitive dysfunction (e.g., impairment of working memory and visuospatial skills), and 20% to 60% of those affected have comorbid disorders such as dyslexia or attention deficit disorder. The few interventional studies that have been published to date document the efficacy of pedagogic-therapeutic interventions directed toward specific problem areas. The treatment is tailored to the individual patient's cognitive functional profile and severity of manifestations. Psychotherapy and/or medication are sometimes necessary as well. CONCLUSION: The early identification and treatment of dyscalculia are very important in view of its frequent association with mental disorders. Sufferers need a thorough, neuropsychologically oriented diagnostic evaluation that takes account of the complexity of dyscalculia and its multiple phenotypes and can thus provide a basis for the planning of effective treatment.

On the development of Arabic three-digit number processing in primary school children.

The development of two-digit number processing in children, and in particular the influence of place-value understanding, has recently received increasing research interest. However, place-value influences leading to decomposed processing have not yet been investigated for multi-digit numbers beyond the two-digit number range in children. Therefore, we evaluated the separate influences of hundreds, tens, and units on three-digit number processing by means of the hundred distance effect, the decade-hundred compatibility effect, and the unit-hundred compatibility effect in a longitudinal design from Grade 2 to Grade 4. In a number magnitude comparison task, a strong hundred distance effect indicated that the magnitudes of the hundreds digits were predominantly processed. We also observed indexes of decomposed parallel processing of hundreds and units digits but not of hundreds and tens digits. Regarding the developmental trajectories, the hundred distance effect and the unit-hundred compatibility effect showed a reliable trend to increase with grade level. However, both the significance and the increase with grade level of decomposed parallel processing were observed to be less consistent than expected. The latter is discussed in terms of different processing strategies as well as specificities differentiating between two- and three-digit numbers. Taken together, these are the first data showing decomposed processing of three-digit numbers in children. Yet, it must be noted that the results also indicate that findings from two-digit number processing cannot simply be generalized to the three-digit number range.