Understanding Cognitive-Academic Bidirectionality in Math Learning Disabilities

/ABSTRACT Despite important advances in the treatment of learning disabilities (LDs), the dominant approach to intervention—direct skills instruction—fails to meet the needs of 25-45% of LD students. This indicates the need to expand the framework for LD intervention science with innovative approaches. This clinical trial (CT) assesses the effects and mechanistic processes of an innovative approach to intervention guided by cognitive-academic mutualism theory, in which cognitive resources support development of academic competencies while academic tasks in turn exercise & strengthen cognitive abilities. The CT’s innovative intervention provides coordinated cognitive training & direct skills instruction with supports for transfer across domains. The academic focus is math: word-problem solving & arithmetic, both critical foundational skills. The cognitive focus is working memory (WM) because WM plays a central role in early math development. Participants are 6–8 years old, a critical age when WM malleability & beneficial effects between emerging skills are rich in opportunity and when school instruction on the targeted math competencies intensifies. Also, delays that remain at the end of 1st grade forecast math LDs. First-grade children selected for math delays and low WM are randomly assigned to: (1) standard-of-care direct skills math treatment + coordinated computerized WM training (the innovation; CO-Tx); (2) the same standard-of- care direct skills math treatment + the same amount of computer game-like instructional activities not involving WM or math (the contrast standard-of-care condition); & (3) control group (the conventional school program & maturation; CON). Treatment occurs 3 times per week for 15 weeks. The primary outcomes are word-problem solving, arithmetic, & WM. Innovative intervention’s added value over standard-of-care direct skills math treatment (without WM training) is tested at posttest & delayed posttest, with 1-year follow-up effects explored. Mechanistic processes are assessed by testing whether bidirectional relations between WM & math are involved in the mediation pathway linking CO-Tx’s effects on delayed posttest math & WM and whether CO-Tx’s bidirectional relations are stronger in CO-Tx than in other conditions. Exploratory subgroup analyses are conducted to provide insight into the robustness of effects. This CT impacts science by deepening understanding about the potential for treatments based on cognitive-academic mutualism theory to enhance learning more than conventional direct skills instruction and deepening understanding about bidirectional relations between WM and early math development. Results may impact clinical practice by providing an innovative approach for treating math difficulties and other forms of LD. This CT is highly relevant & significant because math LDs are associated with long-term debilitating difficulty in school, the workplace, and everyday life and because pressing need exists to expand the framework for treating LDs with innovative approaches. Project Number: 1R01HD115592-01A1 | Fiscal Year: 2025 | NIH Institute/Center: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | Principal Investigator: Marcia Barnes | Institution: VANDERBILT UNIVERSITY, Nashville, TN | Award Amount: $693,293 | Activity Code: R01 | Study Section: Child Psychopathology and Developmental Disabilities Study Section[CPDD] View on NIH RePORTER: https://reporter.nih.gov/project-details/1R01HD11559201A1