Mathematics learning disabilities in girls with fragile X or Turner syndrome during late elementary school

Turner syndrome and neuropsychological abnormalities: a review and case series

OBJECTIVE

The objective of this study was to establish the genotype-phenotype correlation between karyotype results and the neurological and psychiatric alterations presented in patients with Turner syndrome (TS).

METHODS

A retrospective study was conducted on the medical records of 10/140 patients with TS and neurophysiological abnormalities seen at a university hospital in southern Brazil. In addition, a literature review spanning the period from January 1, 2012 to January 1, 2023 was carried out using the PubMed and Virtual Health Library databases.

RESULTS

Our study showed a potential correlation between neurological and psychiatric alterations in patients with TS. These findings are in accordance with those described in literature such as a high prevalence of learning or intellectual disabilities. However, our sample found more seizure episodes than those reported in other studies.

CONCLUSIONS

The correlation established could be due to X chromosome dose-effect, as the review suggests that sex chromosome number and hormonal development can be associated with verbal, social, and cognitive skills or impairments.

Neurobiology of numerical learning

Numerical abilities are complex cognitive skills essential for dealing with requirements of the modern world. Although the brain structures and functions underlying numerical cognition in different species have long been appreciated, genetic and molecular techniques have more recently expanded the knowledge about the mechanisms underlying numerical learning. In this review, we discuss the status of the research related to the neurobiological bases of numerical abilities. We consider how genetic factors have been associated with mathematical capacities and how these link to the current knowledge of brain regions underlying these capacities in human and non-human animals. We further discuss the extent to which significant variations in the levels of specific neurotransmitters may be used as potential markers of individual performance and learning difficulties and take into consideration the therapeutic potential of brain stimulation methods to modulate learning and improve interventional outcomes. The implications of this research for formulating a more comprehensive view of the neural basis of mathematical learning are discussed.

Working memory and arithmetic impairments in children with FMR1 premutation and gray zone alleles

Expansive mutations in familial mental retardation 1 (FMR1) gene have been associated with different phenotypes. Full mutations are associated with intellectual disability and autism spectrum disorder; premutations are associated with math learning difficulties and working memory impairments. In gray zone, neuropsychological development has not yet been described.

Objectives

This study aimed to describe the frequency of FMR1 premutation and gray zone alleles in a school population sample representing a broad spectrum of variation in math achievement and detail school achievement and cognitive performance in the children identified with FMR1 premutation or gray zone alleles.

Methods

We described a two-phase study. In the first phase, 2,195 school-age children were screened for math achievement. In the second phase, 378 children with normal intelligence were neuropsychologically assessed and genotyped for FMR1. Of these, 121 children (61 girls) performed below percentile 25 in mathematics (MD group) and 257 children (146 girls) performed above percentile 25 (control group).

Results

Four pupils presented expanded alleles, one premutation and three gray zone alleles. The girl with the premutation and one boy with a gray zone allele presented impairments in working memory and arithmetic performance below percentile 6, compatible with the diagnosis of developmental dyscalculia. These children's difficulties were not associated with inaccuracy of nonsymbolic number representations or literacy impairments. Dyscalculia in these children seems to be associated mainly with working memory impairments.

Conclusions

FMR1 expansions in the gray zone may contribute to dyscalculia in otherwise healthy and normally intelligent children.

Arithmetic in developmental cognitive disabilities

This paper reviews and discusses research on arithmetical strengths and weaknesses in children with specific developmental cognitive disabilities. It focusses on children with dyslexia, developmental language disorder, attention deficit hyperactivity disorder and autism. In general, studies show that arithmetical weaknesses are commoner in children with any of these disorders than in controls. Autism is sometimes associated with specific strengths in arithmetic; but even in autism, it is commoner for arithmetic to be a relative weakness than a relative strength. There may be some genetic reasons why there is an overlap between mathematical difficulties and other developmental learning difficulties; but much of the reason seems to be that specific aspects of arithmetic are often influenced by other factors, including language comprehension, phonological awareness, verbal and spatial working memory and long-term memory, and executive functions. The findings discussed here will be discussed in relation to Pennington's (2006) Multiple Deficit Model.

Magnitude processing in populations with spina-bifida: The role of visuospatial and working memory processes

People with Spina Bifida usually experience difficulties with mathematics. In a series of other developmental disorders, a magnitude processing deficit was considered to be the main source of subsequent difficulties in mathematics. The processing of magnitude could be numerical (which is the larger number) or non-numerical such as spatial (e.g., which is the longer?) or temporal (which one last longer?) for instance. However, no study yet has examined directly magnitude processes in a population with Spina Bifida. On the other hand, recent studies in people with genetic syndromes have suggested that visuospatial and working memory processes play an important role in magnitude processing, including number magnitude. Therefore, in this study we explored for the first time magnitude representation using several tasks with different visuospatial and working memory processing requirements, cognitive skills frequently impaired in Spina Bifida. Results showed children with SB presented a global magnitude processing deficit for non-numerical and numerical comparison tasks, but not in symbolic number magnitude tasks compared to controls. Importantly, visuospatial skills and working memory abilities could partially explain the differences between groups in comparison and estimation tasks. This study proposes that magnitude processing difficulties in children with SB could be due to higher cognitive factors such as visuospatial and working memory processes.

Cognitive Functioning in Turner Syndrome: Addressing Deficits Through Academic Accommodation

Background: The cognitive profile of Turner syndrome, a genetic disorder resulting from partial or complete X-chromosome deletion, presents characteristic deficits. Despite this, studies have yet to evaluate how deficits translate into and are compensated for in academic settings. This study seeks to explore cognitive functioning, as well as the accessibility and development of academic accommodations in females with Turner syndrome from adolescence to adulthood. Materials and Methods: This cross-sectional study took place at the National Institutes of Health. Females with Turner syndrome (age range: 10-68; n = 142) were evaluated on need for and procurement of academic accommodations. Cognitive functioning was evaluated in participants aged 20 years and older (n = 101), as per the age validation of the Repeatable Battery for the Assessment of Neuropsychological Status. Data were analyzed using descriptive statistics, one-sample comparisons, and analyses of variance. Results: Females with Turner syndrome scored significantly lower than the normative population on visuospatial (p < 0.001), delayed memory (p < 0.001), and overall (p < 0.001) functioning. About 25.9% of participants reported that accommodations were not needed, despite displaying one or more cognitive deficits. Approximately 12.7% reported needing but not receiving accommodations, however, this is only reported by females 30 years and older; no females aged 10-29 years indicated this discrepancy. Conclusions: Findings suggest that procurement of academic accommodations has increased within recent decades. Still, there is a discrepancy between those displaying cognitive deficits and those receiving academic accommodations. We highlight frequently received accommodations so that students and professionals can target deficits with appropriate accommodations.

Genetic factors underlie the association between anxiety, attitudes and performance in mathematics

Students struggling with mathematics anxiety (MA) tend to show lower levels of mathematics self-efficacy and interest as well as lower performance. The current study addresses: (1) how MA relates to different aspects of mathematics attitudes (self-efficacy and interest), ability (understanding numbers, problem-solving ability, and approximate number sense) and achievement (exam scores); (2) to what extent these observed relations are explained by overlapping genetic and environmental factors; and (3) the role of general anxiety in accounting for these associations. The sample comprised 3410 twin pairs aged 16-21 years, from the Twins Early Development Study. Negative associations of comparable strength emerged between MA and the two measures of mathematics attitudes, phenotypically (~ -0.45) and genetically (~ -0.70). Moderate negative phenotypic (~ -0.35) and strong genetic (~ -0.70) associations were observed between MA and measures of mathematics performance. The only exception was approximate number sense whose phenotypic (-0.10) and genetic (-0.31) relation with MA was weaker. Multivariate quantitative genetic analyses indicated that all mathematics-related measures combined accounted for ~75% of the genetic variance in MA and ~20% of its environmental variance. Genetic effects were largely shared across all measures of mathematics anxiety, attitudes, abilities and achievement, with the exception of approximate number sense. This genetic overlap was not accounted for by general anxiety. These results have important implications for future genetic research concerned with identifying the genetic underpinnings of individual variation in mathematics-related traits, as well as for developmental research into how children select and modify their mathematics-related experiences partly based on their genetic predispositions.

Language processing skills linked to FMR1 variation: A study of gaze-language coordination during rapid automatized naming among women with the FMR1 premutation

The FMR1 premutation (PM) is relatively common in the general population. Evidence suggests that PM carriers may exhibit subtle differences in specific cognitive and language abilities. This study examined potential mechanisms underlying such differences through the study of gaze and language coordination during a language processing task (rapid automatized naming; RAN) among female carriers of the FMR1 PM. RAN taps a complex set of underlying neuropsychological mechanisms, with breakdowns implicating processing disruptions in fundamental skills that support higher order language and executive functions, making RAN (and analysis of gaze/language coordination during RAN) a potentially powerful paradigm for revealing the phenotypic expression of the FMR1 PM. Forty-eight PM carriers and 56 controls completed RAN on an eye tracker, where they serially named arrays of numbers, letters, colors, and objects. Findings revealed a pattern of inefficient language processing in the PM group, including a greater number of eye fixations (namely, visual regressions) and reduced eye-voice span (i.e., the eyes' lead over the voice) relative to controls. Differences were driven by performance in the latter half of the RAN arrays, when working memory and processing load are the greatest, implicating executive skills. RAN deficits were associated with broader social-communicative difficulties among PM carriers, and with FMR1-related molecular genetic variation (higher CGG repeat length, lower activation ratio, and increased levels of the fragile X mental retardation protein; FMRP). Findings contribute to an understanding of the neurocognitive profile of PM carriers and indicate specific gene-behavior associations that implicate the role of the FMR1 gene in language-related processes.

The nature of the association between number line and mathematical performance: An international twin study

BACKGROUND

The number line task assesses the ability to estimate numerical magnitudes. People vary greatly in this ability, and this variability has been previously associated with mathematical skills. However, the sources of individual differences in number line estimation and its association with mathematics are not fully understood.

AIMS

This large-scale genetically sensitive study uses a twin design to estimate the magnitude of the effects of genes and environments on: (1) individual variation in number line estimation and (2) the covariation of number line estimation with mathematics.

SAMPLES

We used over 3,000 8- to 16-year-old twins from the United States, Canada, the United Kingdom, and Russia, and a sample of 1,456 8- to 18-year-old singleton Russian students.

METHODS

Twins were assessed on: (1) estimation of numerical magnitudes using a number line task and (2) two mathematics components: fluency and problem-solving.

RESULTS

Results suggest that environments largely drive individual differences in number line estimation. Both genes and environments contribute to different extents to the number line estimation and mathematics correlation, depending on the sample and mathematics component.

CONCLUSIONS

Taken together, the results suggest that in more heterogeneous school settings, environments may be more important in driving variation in number line estimation and its association with mathematics, whereas in more homogeneous school settings, genetic effects drive the covariation between number line estimation and mathematics. These results are discussed in the light of development and educational settings.

Intelligence and specific cognitive functions in intellectual disability: implications for assessment and classification

PURPOSE OF REVIEW

Current diagnostic criteria for intellectual disability categorize ability as measured by IQ tests. However, this does not suit the new conceptualization of intellectual disability, which refers to a range of neuropsychiatric syndromes that have in common early onset, cognitive impairments, and consequent deficits in learning and adaptive functioning. A literature review was undertaken on the concept of intelligence and whether it encompasses a range of specific cognitive functions to solve problems, which might be better reported as a profile, instead of an IQ, with implications for diagnosis and classification of intellectual disability.

RECENT FINDINGS

Data support a model of intelligence consisting of distinct but related processes. Persons with intellectual disability with the same IQ level have different cognitive profiles, based on varying factors involved in aetiopathogenesis. Limitations of functioning and many biopsychological factors associated with intellectual disability are more highly correlated with impairments of specific cognitive functions than with overall IQ.

SUMMARY

The current model of intelligence, based on IQ, is of limited utility for intellectual disability, given the wide range and variability of cognitive functions and adaptive capacities. Assessing level of individual impairment in executive and specific cognitive functions may be a more useful alternative. This has considerable implications for the revision of the International Classification of Diseases and for the cultural attitude towards intellectual disability in general.

Number sense and mathematics: Which, when and how?

Individual differences in number sense correlate with mathematical ability and performance, although the presence and strength of this relationship differs across studies. Inconsistencies in the literature may stem from heterogeneity of number sense and mathematical ability constructs. Sample characteristics may also play a role as changes in the relationship between number sense and mathematics may differ across development and cultural contexts. In this study, 4,984 16-year-old students were assessed on estimation ability, one aspect of number sense. Estimation was measured using 2 different tasks: number line and dot-comparison. Using cognitive and achievement data previously collected from these students at ages 7, 9, 10, 12, and 14, the study explored for which of the measures and when in development these links are observed, and how strong these links are and how much these links are moderated by other cognitive abilities. The 2 number sense measures correlated modestly with each other (r = .22), but moderately with mathematics at age 16. Both measures were also associated with earlier mathematics; but this association was uneven across development and was moderated by other cognitive abilities.

Early numeracy skills in preschool-aged children: a review of neurocognitive findings and implications for assessment and intervention

OBJECTIVES

The goals are to (1) provide a review of the typical and atypical development of early numeracy; (2) present what is known about the neurocognitive underpinnings of early numeracy; and (3) discuss the implications for early assessment and intervention.

METHOD

Studies on the development of typical and atypical early numeracy are reviewed with a particular focus on longitudinal findings including those from our work on spina bifida myelomeningocele. Implications of this research for assessment are presented. The paper ends with a discussion of early math interventions.

RESULTS

Learning to count, identify numbers, and compare and manipulate quantities are key early numeracy skills. These are powerful predictors of school-age mathematical learning and performance. General neurocognitive abilities such as working memory and language, are also important for the development of early numeracy. It is recommended that early assessment for risk of mathematical learning difficulties include tests of both early number knowledge and key neurocognitive abilities. Math-specific interventions are most effective for improving early numeracy. There is currently little evidence that training of general cognitive functions transfers to mathematical learning.

CONCLUSION

Understanding the development of early numeracy skills and their neurocognitive predictors offer important insights into early assessment and intervention for children at risk for or with mathematical learning difficulties.

From classroom environment to mathematics achievement: The mediating role of self-perceived ability and subject interest

Drawing on Bandura's triadic reciprocal causation model, perceived classroom environment and three intrapersonal factors (mathematics self-efficacy, maths interest and academic self-concept) were considered as predictors of test performance in two correlated mathematics assessments: a public examination (GCSE) and an on-line test, both taken by UK pupils at age 16 (n = 6689). Intrapersonal factors were significantly associated with both test scores, even when the alternative score was taken into account. Classroom environment did not correlate with mathematics achievement once intrapersonal factors and alternative test performance were included in the model, but was associated with subject interest and academic self-concept. Perceptions of classroom environment may exercise an indirect influence on achievement by boosting interest and self-concept. In turn, these intrapersonal factors have direct relationships with achievement and were found to mediate the relationship between perceived classroom environment and maths performance. Findings and their implications for mathematics education are discussed.

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Can learning environment (classroom) and intrapersonal factors (self-perceived ability and interest) predict maths at age 16?

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Intrapersonal factors are associated with maths performance at 16.

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Learning environments are associated with intrapersonal factors at this age.

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In particular, perceived maths classroom environment predicts interest in maths.

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Intrapersonal factors mediate the relationship between perceived classroom environment and maths performance.

Multidimensionality in the Measurement of Math-Specific Anxiety and its Relationship with Mathematical Performance

Traditionally, mathematical anxiety has been utilized as a unidimensional construct. However, math-specific anxiety may have distinguishable factors, and taking these factors into account may better illuminate the relationship between anxiety and mathematics performance. Drawing from the Western Reserve Reading and Math Project (N = 244 children, mean age = 12.28 years), the present study examined math-specific anxiety and mathematics problem evaluation, utilizing a structural equation modeling approach with an item-level measurement model structure. Results suggested math-specific anxiety tapped into three factors: anxiety about performing mathematical calculations, anxiety about math in classroom situations, and anxiety about math tests. Among the three math anxiety factors, only calculation anxiety was significantly and negatively related to math performance while holding other anxiety factors constant. Implications for the measurement of math-specific anxiety are discussed.

The processing of number scales beyond whole numbers in development: Dissociations in arithmetic in Turner's syndrome

The arithmetical skills in two children with Turner's syndrome (TS), each the focus of a case study, were analysed in whole numbers and other number scales that have not been systematically explored previously, fractions, decimals, percentages, and negative numbers. The intention was to identify the fractionation of arithmetical skills. The two girls with TS showed dissociations of arithmetical skill in the calculation system of whole numbers that support its modular organization. Fractionation of skills was observed in some components of the other number scales, suggesting an analogous organization within these scales. The operational specificity of impairment within number scales but not others argued against a unitary arithmetical system but rather for autonomous operational scales within distinct number scales. A general model of arithmetic is proposed.

A meta-analysis of math performance in Turner syndrome

AIM

Studies investigating the relationship between Turner syndrome and math learning disability have used a wide variation of tasks designed to test various aspects of mathematical competencies. Although these studies have revealed much about the math deficits common to Turner syndrome, their diversity makes comparisons between individual studies difficult. As a result, the consistency of outcomes among these diverse measures remains unknown. The overarching aim of this review is to provide a systematic meta-analysis of the differences in math and number performance between females with Turner syndrome and age-matched neurotypical peers.

METHOD

We provide a meta-analysis of behavioral performance in Turner syndrome relative to age-matched neurotypical populations on assessments of math and number aptitude. In total, 112 comparisons collected across 17 studies were included.

RESULTS

Although 54% of all statistical comparisons in our analyses failed to reject the null hypothesis, our results indicate that meaningful group differences exist on all comparisons except those that do not require explicit calculation.

INTERPRETATION

Taken together, these results help elucidate our current understanding of math and number weaknesses in Turner syndrome, while highlighting specific topics that require further investigation.

Examining the neural correlates of emergent equivalence relations in fragile X syndrome

The neural mechanisms underlying the formation of stimulus equivalence relations are poorly understood, particularly in individuals with specific learning impairments. As part of a larger study, we used functional magnetic resonance imaging (fMRI) while participants with fragile X syndrome (FXS), and age- and IQ-matched controls with intellectual disability, were required to form new equivalence relations in the scanner. Following intensive training on matching fractions to pie charts (A=B relations) and pie charts to decimals (B=C relations) outside the scanner over a 2-day period, participants were tested on the trained (A=B, B=C) relations, as well as emergent symmetry (i.e., B=A and C=B) and transitivity/equivalence (i.e., A=C and C=A) relations inside the scanner. Eight participants with FXS (6 female, 2 male) and 10 controls, aged 10-23 years, were able to obtain at least 66.7% correct on the trained relations in the scanner and were included in the fMRI analyses. Across both groups, results showed that the emergence of symmetry relations was correlated with increased brain activation in the left inferior parietal lobule, left postcentral gyrus, and left insula, broadly supporting previous investigations of stimulus equivalence research in neurotypical populations. On the test of emergent transitivity/equivalence relations, activation was significantly greater in individuals with FXS compared with controls in the right middle temporal gyrus, left superior frontal gyrus and left precuneus. These data indicate that neural execution was significantly different in individuals with FXS than in age- and IQ-matched controls during stimulus equivalence formation. Further research concerning how gene-brain-behavior interactions may influence the emergence of stimulus equivalence in individuals with intellectual disabilities is needed.

Visual-spatial abilities relate to mathematics achievement in children with heavy prenatal alcohol exposure

OBJECTIVE

The current study examined the relationship between mathematics and attention, working memory, and visual memory in children with heavy prenatal alcohol exposure and controls.

METHOD

Subjects were 56 children (29 AE, 27 CON) who were administered measures of global mathematics achievement (WRAT-3 Arithmetic & WISC-III Written Arithmetic), attention, (WISC-III Digit Span forward and Spatial Span forward), working memory (WISC-III Digit Span backward and Spatial Span backward), and visual memory (CANTAB Spatial Recognition Memory and Pattern Recognition Memory). The contribution of cognitive domains to mathematics achievement was analyzed using linear regression techniques. Attention, working memory, and visual memory data were entered together on Step 1 followed by group on Step 2, and the interaction terms on Step 3.

RESULTS

Model 1 accounted for a significant amount of variance in both mathematics achievement measures; however, model fit improved with the addition of group on Step 2. Significant predictors of mathematics achievement were Spatial Span forward and backward and Spatial Recognition Memory.

CONCLUSIONS

These findings suggest that deficits in spatial processing may be related to math impairments seen in FASD. In addition, prenatal alcohol exposure was associated with deficits in mathematics achievement, above and beyond the contribution of general cognitive abilities.

Are 22q11.2 distal deletions associated with math difficulties?

Approximately 6% of school-aged children have math difficulties (MD). A neurogenetic etiology has been suggested due to the presence of MD in some genetic syndromes such as 22q11.2DS. However, the contribution of 22q11.2DS to the MD phenotype has not yet been investigated. This is the first population-based study measuring the frequency of 22q11.2DS among school children with MD. Children (1,564) were identified in the schools through a screening test for language and math. Of these children, 152 (82 with MD and 70 controls) were selected for intelligence, general neuropsychological, and math cognitive assessments and for 22q11.2 microdeletion screening using MLPA. One child in the MD group had a 22q11.2 deletion spanning the LCR22-4 to LCR22-5 interval. This child was an 11-year-old girl with subtle anomalies, normal intelligence, MD attributable to number sense deficit, and difficulties in social interactions. Only 19 patients have been reported with this deletion. Upon reviewing these reports, we were able to characterize a new syndrome, 22q11.2 DS (LCR22-4 to LCR22-5), characterized by prematurity; pre- and postnatal growth restriction; apparent hypotelorism, short/upslanting palpebral fissures; hypoplastic nasal alae; pointed chin and nose; posteriorly rotated ears; congenital heart defects; skeletal abnormalities; developmental delay, particularly compromising the speech; learning disability (including MD, in one child); intellectual disability; and behavioral problems. These results suggest that 22q11.2 DS (LCR22-4 to LCR22-5) may be one of the genetic causes of MD.

Knowing right from wrong in mental arithmetic judgments: calibration of confidence predicts the development of accuracy

Does knowing when mental arithmetic judgments are right--and when they are wrong--lead to more accurate judgments over time? We hypothesize that the successful detection of errors (and avoidance of false alarms) may contribute to the development of mental arithmetic performance. Insight into error detection abilities can be gained by examining the "calibration" of mental arithmetic judgments-that is, the alignment between confidence in judgments and the accuracy of those judgments. Calibration may be viewed as a measure of metacognitive monitoring ability. We conducted a developmental longitudinal investigation of the relationship between the calibration of children's mental arithmetic judgments and their performance on a mental arithmetic task. Annually between Grades 5 and 8, children completed a problem verification task in which they rapidly judged the accuracy of arithmetic expressions (e.g., 25 + 50 = 75) and rated their confidence in each judgment. Results showed that calibration was strongly related to concurrent mental arithmetic performance, that calibration continued to develop even as mental arithmetic accuracy approached ceiling, that poor calibration distinguished children with mathematics learning disability from both low and typically achieving children, and that better calibration in Grade 5 predicted larger gains in mental arithmetic accuracy between Grades 5 and 8. We propose that good calibration supports the implementation of cognitive control, leading to long-term improvement in mental arithmetic accuracy. Because mental arithmetic "fluency" is critical for higher-level mathematics competence, calibration of confidence in mental arithmetic judgments may represent a novel and important developmental predictor of future mathematics performance.

Neurocognitive profiles of learning disabled children with neurofibromatosis type 1

Neurofibromatosis 1 (NF1) is a genetic condition generally associated with intellectual deficiency and learning disabilities. Although there have been groundbreaking advances in the understanding of the molecular, cellular, and neural systems underlying learning deficits associated to NF1 in animal models, much remains to be learned about the spectrum of neurocognitive phenotype associated with the NF1 clinical syndrome. In the present study, 32 children with NF1 ranging from 7 to 14 years were evaluated with neurocognitive tests dedicated to assess basic capacities which are involved in reading and mathematical achievement. Deficits in lexical and phonological strategies and poor number facts retrieval were found underlying reading and arithmetic disorders, respectively. Additionally, efficiencies in lexical/phonological strategies and mental arithmetic were significant predictors of individual differences in reading attainment and math. However, deficits in core numeric capacities were not found in the sample, suggesting that it is not responsible for calculation dysfluency. The estimated prevalence of Developmental Dyscalculia was 18.8%, and the male:female ratio was 5:1. On the other hand, the prevalence of Developmental Dyslexia was almost 3 times as high (50%), and no gender differences were found (male: female ratio = 1:1). This study offers new evidence to the neurocognitive phenotype of NF1 contributing to an in depth understanding of this condition, but also to possible treatments for the cognitive deficits associated with NF1.

The Russian School Twin Registry (RSTR): project PROGRESS

The Russian School Twin Registry (RSTR) was established in 2012, supported by a grant from the Government of the Russian Federation. The main aim of the registry is to contribute to Progress in Education through Gene-Environment Studies (PROGRESS). The formation of the registry is ongoing and it is expected that most schools in the Russian Federation (approximately 50,000 schools) will contribute data to the registry. With a total of 13.7 million students in Grades 1-11 (ages 7-18), the potential number of twin pairs exceeds 100,000. Apart from the large sample size and its representative nature, the RSTR has one unique feature: in collaboration with the International Advisory Committee to the Registry, genetically sensitive cross-cultural investigations are planned, aided by the use of the common assessment instruments. Other strengths of the registry include the assessment of a large sample of non-twin school children, including those studying in the same classes as the twins in the registry. It is hoped that the RSTR will provide an important research platform for national and international educationally relevant research.

Extension of the Contingency Naming Test to adult assessment: psychometric analysis in a college student sample

The Contingency Naming Test (CNT; Taylor, Albo, Phebus, Sachs, & Bierl, 1987) was initially designed to assess aspects of executive functioning, such as processing speed and response inhibition, in children. The measure has shown initial utility in identifying differences in executive function among child clinical groups; however, there is an absence of adequate psychometric data for use with adults. The current study expanded psychometric data upward for use with a college student sample and explored the measure's test-retest reliability and factor structure. Performance in the adult sample showed continued improvement above child norms, consistent with theories of executive function development. Exploratory factor analysis showed that the CNT is most closely related to measures of processing speed, as well as elements of response inhibition within the latter trials. Overall, results from the current study provide added support for the utility of the CNT as a measure of executive functioning in young adults. However, more research is needed to determine patterns of performance among adult clinical groups, as well as to better understand how performance patterns may change in a broader age range, including middle and older adulthood.

Changes in frontal-parietal activation and math skills performance following adaptive number sense training: preliminary results from a pilot study

Number sense is believed to be critical for math development. It is putatively an implicitly learned skill and may therefore have limitations in terms of being explicitly trained, particularly in individuals with altered neurodevelopment. A case series study was conducted using an adaptive, computerised programme that focused on number sense and general problem-solving skills. The study was designed to investigate training effects on performance as well as brain function in a group of children with Turner syndrome who are at risk for math difficulties and altered development of math-related brain networks. Standardised measurements of math and math-related cognitive skills as well as functional magnetic resonance imaging (fMRI) were used to assess behavioural and neurobiological outcomes following training. Participants demonstrated significantly increased basic math skills, including number sense, and calculation as well as processing speed, cognitive flexibility and visual-spatial processing skills. With the exception of calculation, increased scores also were clinically significant (i.e., recovered) based on reliable change analysis. Participants additionally demonstrated significantly increased bilateral parietal lobe activation and decreased frontal-striatal and mesial temporal activation following the training programme. These findings show proof of concept for an accessible training approach that may be potentially associated with improved number sense, math and related skills, as well as functional changes in math-related neural systems, even among individuals at risk for altered brain development.

Cognitive profile of Turner syndrome

Turner syndrome (TS) is a relatively common neurogenetic disorder characterized by complete or partial monosomy-X in a phenotypic female. TS is associated with a cognitive profile that typically includes intact intellectual function and verbal abilities with relative weaknesses in visual-spatial, executive, and social cognitive domains. In this report, we review previous and current research related to the cognitive profile of TS. We also discuss how cognitive impairments in this syndrome may reflect integrative rather than modular deficits. For example, the less commonly reported areas of verbal difficulty in TS and certain visual-spatial deficits seem significantly influenced by impairments in executive function and spatially loaded stimuli. We provide a summary of cognitive testing measures used in the assessment of visual-spatial and executive skills, which includes test domain descriptions as well as a comprehensive examination of social cognitive function in TS. This review concludes with a discussion of ecological interpretations regarding the meaning of cognitive deficits in TS at the individual level.

Effects of treatment with oxandrolone for 4 years on the frequency of severe arithmetic learning disability in girls with Turner syndrome

OBJECTIVES

To study androgen treatment effects on arithmetic performance in girls with Turner syndrome.

STUDY DESIGN

Forty-four girls, ages 10 to 14 years at baseline, completed 4 years of treatment with oxandrolone (Ox) or placebo (Pl). All received growth hormone and estrogen replacement therapy. We assessed the number of girls with severe learning disability (LD, standard score <or=5(th) percentile) on measures of academic arithmetic and reading achievement (WRAT-3, arithmetic and reading), given yearly, and the WIAT numerical operations (NOS) and reading subtests, given at year 4.

RESULTS

On the WRAT-3 arithmetic, the frequency of severe arithmetic LD was similar in the Ox and Pl groups at baseline and at years 1 and 2. At years 3 and 4, fewer girls in the Ox than Pl group had a severe arithmetic LD (year 4: 0/22 vs 5/21, P = .02). On the WIAT NOS (year 4), fewer girls in the Ox than Pl groups had a severe arithmetic LD (3/21 vs 8/20, P = .09). WIAT NOS error analysis suggested that the improved performance in the Ox group was associated with better performance on multiplication and division (P < .01). The frequency of severe LD for the WRAT-3 reading was similar for the Ox and Pl groups (all years) and for the WIAT reading subtest (year 4).

CONCLUSIONS

Androgen treatment for 4 years in girls with Turner syndrome resulted in a small decrease in frequency of severe arithmetic LD, with no effect on reading LD.

A review of mathematical learning disabilities in children with fragile X syndrome

The prevalence rate of mathematical learning disabilities (MLD) among children with fragile X syndrome who do not meet criteria for intellectual and developmental disabilities (approximately 50% of female children) exceeds the rate reported in the general population. The purpose of this article is two-fold: (1) to review the findings on MLD in persons with fragile X syndrome; and (2) to discuss fragile X syndrome as a possible model for understanding pathways to MLD.

Psychiatric phenotypes associated with neurogenetic disorders

Advances in understanding the human genome and clinical application have led to identification of genetically based disorders that have distinctive behavioral phenotypes and risk for serious psychiatric disorders. Some patients have unrecognized genetic disorders presenting as psychiatric symptoms. Practitioners must be knowledgeable about the association between symptoms and underlying genetic bases. Treatment of neurogenetic disorders includes providing information about causes and prognoses. Patients are served best if they remain long term with a multidisciplinary team of providers who recognize the realities of a lifetime course, the high risk for symptom recurrence, and the need for providing information and support to families and coordinating medical and psychiatric care.

Rote numeric skills may mask underlying mathematical disabilities in girls with fragile x syndrome

Mathematical learning disabilities (MLD) have been reported for elementary school age girls with fragile X syndrome who do not have mental retardation. Yet girls with fragile X demonstrate age-appropriate rote math skills, sometimes outperforming other children with MLD. We examined whether MLD and strengths in rote math skills persist during middle school among girls with fragile X. Middle school children were individually administered the Ranking Proportions Task (RPT), which involves fractions and decimals. Such problems, although difficult for many students, yield different performance profiles between children with versus without MLD. We hypothesized that girls with fragile X would outperform children with MLD on rote skills (e.g., naming decimals) despite conceptual difficulties, regardless of effects of FSIQ. To address the influence of fragile X versus MLD or FSIQ, several comparison groups were included. Children from a normative sample outperformed girls with fragile X on conceptual, but not rote, skills. However, their performance resembled that of children with MLD on conceptual skills, such as identifying equal quantities with different symbols (e.g., 0.5 and 1/2). Fragile X syndrome provides a compelling model of the heterogeneity of MLD, as the associated profile resembles that of both children with or without MLD. In terms of applications to serving girls with fragile X, it is important to consider that efficient rote skills may not only fail to enhance math achievement, they may hinder achievement by masking underlying conceptual deficiencies.