Dyscalculia Awareness in the Medical Community
Some months ago, I heard from a friend who is a social worker in a local hospital. She was working with a mother who was at risk of losing custody of her baby because of the infant’s severe malnutrition.
My social worker friend noticed that the new mom was having trouble with measurements surrounding feeding. The mother was unable to tell the doctors how many ounces of formula she had mixed or how much the baby had taken, and she couldn’t tell what time, even an estimation, of when the baby had fed.
Normally in a situation like this, someone may assume that the mother is irresponsible, uncaring, or unfit to care for her infant. However, my friend made a connection that would not normally be made; she suspected that the young mom may be dyscalculic. The symptoms all matched. She also knew that dyscalculia was not something that only impacts school age children, but it persists through adulthood.
Because my friend recognized the unique symptoms of dyscalculia, she was able to ask more questions and find a way to help this patient. She was able to understand the breakdown in communication between what the doctors were requesting and what the patient could understand, and she was able to make adjustments and accommodations for the baby’s care plan so that the mom could provide adequate nourishment for her baby.
I thought back to my own experience of being in the hospital when my girls were infants. Looking through the lens of how it would be for someone who had dyscalculia but was unaware of it, I could see all sorts of complicated situations in the hospital setting.
These are a few realities of dyscalculia and examples where a patient’s dyscalculia would impact their ability to provide doctors with the information requested or be able to carry out basic medical instructions:
1. Lack of number-sense or lacking a feel for numbers and what they represent. There is confusion and difficulty understanding quantities of weight or volume and what they represent. One wouldn’t know if an ounce or milliliter is as big as a milk jug or as small as a spoonful. The same is for weight, they may not understand how something that is 8 pounds would compare to something that was 5 pounds.
2. Difficulty with ordinary numeric operations. One would be unable to do seemingly simple calculations mentally, such as: If the bottle was filled to 4 ounces, and there is 2 ounces left in bottle, how many did the baby drink? There would also be difficulty in mixing correct ratios of water to formula powder.
3. Estimating is very difficult, if not impossible. There would be an inability to give even a semi-accurate guess as to how much time was spent feeding a child, about how long it was between feedings, or about how much milk a baby was given.
4. Memory weaknesses, often an inability to remember facts involving numbers with accuracy. One may struggle with giving ID information such as patient number, social security number, date of birth, phone numbers, address. In fact, much of the ID information asked in medical settings involves numbers, which often cannot be reliable recalled by a dyscalculic.
5. More confusion than usual with directions such as left and right. There could be confusion over whether baby nursed at left or right breast, whether pain is in right or left arm, or confusion over directions to turn to the left or right.
6. Not easily recognize number patterns and trouble with number sequencing. Reading charts or graphs showing patterns or trajectories will be bewildering if not impossible.
7. Difficulty telling time and understanding time calculations. One will not have any sense of time in terms of hour or minutes. They will struggle to accurately tell time on a clock or apply meaning to the numbers. And it will be almost impossible for them to estimate or calculate how long something lasted or figure out how long they have until the next point in time.
8. Confusion by all aspects of money. Patients will need extra help and understanding when it comes to understanding insurance or paying bills. For the reasons above, you can see how money would be completely baffling. Throw in the added complexity of how hospital bills are sometimes erroneous, and this is a nightmare.
9. Lack of understanding amounts, doses, and time frequencies. Instructions for prescriptions are extremely stressful for dyscalculics because they do not understand times per day, when that is, and they can easily switch up numbers. For example, they may switch the number of pills, the times per day, or hour of the day without realizing their mistake. Many are anxious to take medications for fear they will mess up the amounts. To help, instructions can be written with numbers spelled out. And instead of X times per day, be specific such as “Take one pill at breakfast and one pill at dinner, every day. Start Sunday May 18th. Your last day will be Sunday May 25th.” Or help patients make a check box for them to check off breakfast and dinner pills for each day with the day listed.
My friend’s story of caring for this patient in the hospital, conveys the urgency that is required for our society, and in this case the medical community, in recognizing and growing an awareness of the symptoms and impact of dyscalculia. Would you help spread awareness to the medical community by sharing this post with any medical professionals you know?
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