Neurodivergent Conditions Critically Limit Societal Participation—The Case of Dyscalculia in Adults

Abstract

Mathematical skills are crucial in our modern knowledge society. Consequently, poor mathematical skills can significantly limit societal participation in terms of academic but also life prospects more generally. However, little is known about specific consequences of mathematical learning difficulties like dyscalculia in adults. In this study, we conducted a thematic analysis of anamnestic interview data from 18 university students with dyscalculia presenting at a university clinic for students with neurodevelopmental conditions. Results indicated three major themes. First, all participants reported significant number-related key deficits with basic mathematical skills and arithmetic operations. Second, considerable daily struggles, in particular regarding money usage and time management were indicated. Third, severe emotional and behavioral consequences, such as shame, mathematics anxiety, and avoidance behavior emerged. Together, our findings underscore the impact of dyscalculia on the academic and personal lives of adult university students. Considerable everyday strain resulted in lasting emotional and behavioral consequences. Despite these experienced limitations, dyscalculia in adults remains largely neglected in academic and societal discourse on neurodivergence. By examining this frequently overlooked form of neurodivergence, our study contributes to a critical perspective on neurodiversity, calling for a more inclusive understanding of neurodevelopmental differences.

Lay Abstract

Mathematical skills are essential in our modern world and difficulties with math can significantly impact a person's life, from their education to their daily activities. Yet, little is known about the specific challenges that adults with a mathematical learning difficulty like dyscalculia face. This study looked at the experiences of university students with dyscalculia who sought help at a university clinic that supports students with neurodevelopmental conditions like ADHD, autism, and learning disorders. We spoke with 18 university students to learn about their struggles. Our conversations revealed three key areas of difficulty. First, all participants reported fundamental problems with numbers and basic calculations. These issues were not just limited to academics; they also caused significant daily struggles with common tasks like managing money and understanding time. These challenges, in turn, had a profound emotional impact. The students described feeling shame and anxiety about math, and often went to great lengths to avoid situations involving numbers. Our findings show that dyscalculia can significantly impact an adult's life, affecting their studies, personal life and emotional well-being. By shedding light on the experiences of these students, we hope to start a broader conversation about dyscalculia and create a more inclusive understanding of neurodevelopmental differences. By exploring the experiences of adults with dyscalculia, our work highlights the need for greater understanding, recognition, and support for this often-overlooked group.

Introduction

Developmental dyscalculia, also referred to as mathematical learning disabilities, mathematical disability or mathematical learning difficulties, is a specific learning disorder that affects an estimated 3% to 7% of children and adolescents (Haberstroh & Schulte-Körne, 2019). According to ICD-11 (WHO, 2022) and DSM-V (APA, 2013), this neurodevelopmental condition is characterized by challenges in acquiring and applying basic numerical skills (e.g., magnitude understanding) and arithmetic operations (Karagiannakis et al., 2014). These difficulties arise despite typical general cognitive abilities and adequate learning opportunities (Haberstroh & Schulte-Körne, 2019). Importantly, dyscalculia does not spontaneously remit over time but persists into adulthood (De Visscher et al., 2018).

Children with dyscalculia typically experience problems with magnitude understanding. For instance, Decarli et al. (2022) observed that children with dyscalculia were slower and less accurate in processing symbolic numbers in tasks involving magnitude comparison, number order judgments, and number line estimation. Furthermore, children with dyscalculia typically do poorly on basic arithmetic operations and/or fact retrieval. For instance, Meier et al. (2021) observed that subtraction and division were specifically challenging for them. Moreover, the study demonstrated that children with dyscalculia often relied on inefficient problem-solving strategies like counting strategies even in later grades of primary and early secondary school.

Importantly, previous studies have shown that, in addition to these domain-specific difficulties with basic numerical and arithmetical skills, children with dyscalculia also exhibit impairments in domain-general abilities, such as working memory or executive functions (Attout & Majerus, 2014; Mishra & Khan, 2023; Rotzer et al., 2009). For instance, as reported by Szucs et al. (2013) children with dyscalculia showed significantly impaired visuospatial working memory, presenting as difficulties remembering stimuli positions in a matrix and suppressing distracting stimuli.

When persisting into adulthood, difficulties are very similar to those observed in children, including problems with basic numerical skills such as magnitude understanding and basic arithmetic operations. Consistent with observations in affected children, adults with dyscalculia often rely on compensatory strategies, including (finger) counting, to solve even basic arithmetic problems. These strategies are often time-consuming and prone to error (Kaufmann et al., 2011). As such, adult students with dyscalculia still face considerable challenges in performing up to their full potential in tertiary education (Kaufmann et al., 2022).

However, difficulties related to dyscalculia can also have significant consequences beyond academic achievement, affecting daily life activities, employment, and financial well-being (Kaufmann et al., 2020). For example, Vigna et al. (2022) reported that dyscalculia in adults also impacted their everyday life activities due to difficulties dealing with time and measurement units. This means that adults with dyscalculia struggled to estimate time in everyday situations such as evaluating how long an appointment has taken, which can have a negative impact on their time management and punctuality. Additionally, they exhibited difficulties in estimating the amount of pasta in an average dish, indicating significant challenges in understanding and applying units of measurement to real-world contexts (Vigna et al., 2022). Finally, Parsons and Bynner (2005) found that mathematical difficulties pose a substantial barrier to effective labor market integration and to broader socioeconomic participation. For instance, by the age of 30 years, individuals with poor mathematical skills were more than twice as likely to be unemployed (see also Ritchie & Bates, 2013).

Together, these findings indicate that dyscalculia has far-reaching implications extending beyond learning difficulties as they affect societal participation. Accordingly, understanding dyscalculia requires more than a medical perspective. While diagnostic frameworks such as ICD-11 and DSM-V are essential for clinical identification and access to support, they focus primarily on individual symptoms. From a social-model (Oliver, 2013) perspective, however, disability arises not only from neurodevelopmental differences but also from barriers posed by educational systems, institutional structures, and societal expectations. Our study therefore pursues an integrative approach combining medical and social perspectives, evaluating dyscalculia as a condition whose negative consequences emerge from both neurodevelopmental variations, but also contextual factors.

While previous work has underlined the crucial role of mathematical skill for adults’ academic life prospects and social participation (Parsons & Bynner, 2005; Ritchie & Bates, 2013), the majority of scientific research so far has focused on studying dyscalculia in (primary) school children, leaving its academic, but also behavioral and emotional impact on adults underresearched. This is surprising as it is known that when unidentified or/and unsupported, dyscalculia may affect not only academic and job prospect, but also mental well-being including feelings of shame, but also mathematics anxiety (Devine et al., 2018). However, research on dyscalculia and its impact on adults in general and university students in particular, is lacking. Importantly, this also means a dearth of appropriate assessment instruments and intervention approaches for adults with dyscalculia (Haberstroh & Schulte-Körne, 2019; Kaufmann et al., 2020).

As a consequence—and despite the severe limitations experienced—dyscalculia in adults remains a largely neglected topic in both academic as well as societal discourse on neurodivergence. By addressing this underresearched form of neurodivergence, this study contributes to a more inclusive understanding of neurodevelopmental differences.

Taken together, the above clearly underscores the necessity of further research on identifying emotional and behavioral consequences of dyscalculia in adults, particularly given the severe impact of dyscalculia on individuals’ academic, but also more general life prospects. Accordingly, our study aimed at identifying consequences of dyscalculia in adult university students by conducting a thematic analysis of anamnestic interview data. In particular, we pursued the following research question: How do university students with dyscalculia experience the consequences of their condition in academic and nonacademic contexts?

Method

Participants

Eighteen university students (16 females, two males, mean age of 24.83 years ± 4.57) participated in the study. Participants were recruited between 2022 and 2025 from a university clinic supporting neurodivergent university students (with ADHD, ASD, or specific learning disorders). Participants came from different academic disciplines, including education, psychology, history, biology, law, computer science, and biomechanics. Recruitment followed a consecutive-case sampling approach: all students who presented to the clinic seeking assessment for suspected dyscalculia were offered participation in the study. All first underwent full diagnostic evaluation by a licensed clinical psychologist, including an anamnestic interview and psychometric testing. Only those who received a confirmed clinical diagnosis of dyscalculia, based on DSM-V and ICD-11 criteria (i.e., persisting mathematical difficulties despite adequate general cognitive ability and sufficient educational opportunities), were included in the final sample.

Participation in the study was voluntary and informed consent was obtained from all students prior to participation. The study was conducted in accordance with the Declaration of Helsinki and approved by the local ethics committee.

Study Design and Measures

Our study followed a mixed-methods design integrating psychometric assessments and qualitative interviews in three steps: (a) a structured anamnestic interview, (b) the Eggenberger Calculation Test for adolescents and adults (ERT-JE; Holzer et al., 2017), and (c) the Math4Speed Test (Loenneker et al., 2025). Each step provided complementary insights into participants’ mathematical skills and lived experiences. Interviews captured developmental history, everyday difficulties and compensatory strategies often missed by standardized testing, while psychometric assessments provided norm-referenced data for diagnostic classification. Combining perspectives from the medical and social-model allowed more comprehensive understanding of dyscalculia in adults linking objective performance with subjective experiences.

Structured Anamnestic Interview

Participants completed a 45-min, one-on-one, in-person interview addressing current and past mathematical difficulties and aspects related to mathematics in academic and daily life. The interview covered: (a) developmental and educational history related to mathematics (early experiences, perceived difficulties in early and later school years, support received); (b) current academic functioning (mathematical demands in university studies, coping with mathematics-related situations); (c) everyday applications of mathematical skills and (d) emotional and behavioral experiences in mathematics-related situations. The interview was based on diagnostic frameworks (ICD-11, DSM-V) and prior research on dyscalculia in adults (Kaufmann et al., 2020).

Standardized Assessment

Standardized tests were administered to assess participants’ basic mathematical skills and arithmetic fluency—using the Eggenberger Rechentest Test (ERT-JE; Holzer et al., 2017) and the Math4Speed Test (Loenneker et al., 2025) as there is currently no standardized dyscalculia test for adults or university students.

The ERT-JE (Holzer et al., 2017) is designed to identify dyscalculia in adolescents. It comprises 16 subtests across four key factors—(a) mathematical ordering structures (comparing and ordering decimals and fractions), (b) arithmetic skills (column addition, subtraction, multiplication and division, calculation with fractions), (c) magnitude relationships (units of length, area, volume and time), and (d) applied mathematics (data collection, single-step and multiple step word problems). The ERT-JE provides norm-referenced scores, which reflect mathematical skills. A percentile rank at or below the 16^th percentile is considered clinically significant. However, please note that available normative data are only available up to the end of 8^th grade.

The Math4Speed Test (Loenneker et al., 2025) is a paper–pencil assessment designed to measure arithmetic fluency in adults. It includes 50 arithmetic problems each for addition, subtraction, multiplication and division, with a 2-min time limit per arithmetic operation. Total scores for each scale are computed by summing up the number of correct answers, providing a quick measure of arithmetic fluency (Loenneker et al., 2025).

Data Analysis

Qualitative data from the anamnestic interviews were analyzed using reflexive thematic analysis (RTA) as suggested by Braun and Clarke (2006, 2019, 2021). This allows for systematic identification, organization, and interpretation of patterns within qualitative data, while acknowledging the active and interpretive role of the researcher. The analysis was conducted primarily inductively, allowing themes to emerge from the data while informed by diagnostic frameworks (ICD-11, DSM-V) on dyscalculia, which guided the interview. Two clinical psychologists carried out the analysis independently and subsequently discussed results to develop shared understanding. The process followed the six recursive phases of RTA:

Familiarization of data: In this initial phase, data of the anamnestic interview was transcribed and re-read to allow comprehensive understanding. During this process, initial notes were taken and challenge defining phrases such as “I have always had difficulties with mental arithmetic” or “I have no intuitive sense for numbers”—were marked, and mathematics-related phrases—such as “deficits with basic arithmetic” or “difficulties with everyday mathematics”—were noted for subsequent analysis.

Generation of codes: The transcribed material was then evaluated line by line and mathematical-related features were coded to capture both explicit and underlying meanings in participants’ accounts. All codes were generated manually; no automated or AI-based tools were used. Codes such as lack of number sense (intuitive understanding of numbers and quantities), use of counting strategies and difficulties with analog clocks were developed and organized using MAXQDA to maintain structure and transparency. Coding was conducted independently by both clinical psychologists, followed by comparison and discussion until consensus was reached.

Combining codes into themes: A comprehensive overview of the findings emerged by collating codes into potential subthemes and gathering relevant pieces of data for each theme.

Reviewing themes: The identified subthemes were reviewed in relation to the coded segments and the dataset to ensure internal consistency and clear distinctions between subthemes. Adjustments were made where needed to improve clarity and coherence.

Refining and naming themes: The identified subthemes were then categorized into overarching themes through a process of iterative development through discussion. This involved resolving conceptual redundancies and clarifying thematic boundaries to ensure each theme captured a distinct and coherent aspect of the data. The resulting themes directly addressed the research question and provided insights into central aspects of the consequences of dyscalculia for university students. A detailed mapping of themes, subthemes, and codes is available in Table A1 in Appendix A.

Report findings: The final step involved analyzing the identified themes and interpreting them in the context of our research question.

Information sufficiency was reached when no new subthemes or relevant concepts emerged during the coding and theme development process. After coding all interviews, both researchers independently confirmed that additional data would likely yield redundancy rather than new conceptual insights, indicating sufficient depth and coverage of the central phenomena under investigation.

Reflexivity and positionality: The analysis was conducted by two clinical psychologists affiliated with the university clinic, responsible for both diagnostic assessment and research. This dual clinician–researcher role was made transparent to participants and informed consent was obtained. Our inclusive approach combined aspects of both medical and social-models of disability allowing diagnostic classification and identification of structural and educational barriers shaping lived experiences. We acknowledge that our clinical orientation may have influenced interpretation; to enhance reflexivity and reduce bias, standardized protocols and regular team discussions (including a neurodivergent team member) were held to ensure transparency, credibility, and interpretive rigor.

Results

Thematic Analysis

Thematic analysis of the interview data identified three primary categories of themes and subthemes related to dyscalculia: (a) number-related key deficits, (b) daily struggles, and (c) emotional and behavioral consequences, which will be described in turn below. For a schematic overview of the identified themes see Figure 1.

Figure 1.

Themes and Subthemes Derived From the Qualitative Interview Data: Potential Trajectory for Dyscalculia Related Difficulties and Consequences From Childhood to Adulthood Illustrating How Persistent Number-Related Key Deficits May Underlie Daily Struggles in Processing and Applying Numerical Information (e.g., in Money or Time Management), Which in Turn May Give Rise to Broader Emotional and Behavioral Consequences.

Number-Related Key Deficits

Participating adult university students with dyscalculia consistently demonstrated number-related key deficits, as outlined in DSM-V diagnostic criteria for dyscalculia. These deficits included impairment of number sense, difficulties memorizing arithmetic facts, performing accurate or fluent calculations, and with mathematical reasoning (DSM-V; APA, 2013). For instance, they experienced uncertainties in basic numerical skills like difficulties in reading, transcoding (converting numbers between formats—for example, verbal “twelve” to 12), and memorizing multiplication results. One student reported a persistent “lack of number sense,” while another indicated that numbers “don’t behave as expected” to them, capturing a pervasive sense of unpredictability and instability in mastering basic numerical skills. One participant reported experiencing number-color synesthesia (perceiving numbers in specific colors) combined with the problem that one cannot calculate with colors. Participants also reported deficits in arithmetic operations as basic as addition and subtraction. In particular, many highlighted substantial challenges with mental calculation and difficulties with adding/subtracting across tens. One participant articulated their difficulties with mental arithmetic, explaining: “In everyday mental calculations, my brain just switches off.” Furthermore, conversions of measurement units for time, length, and volume were indicated to be problematic.

A relevant number of participants also reported applying inefficient problem-solving strategies, especially counting strategies and rote memorization of results instead of understanding concepts and procedures. Participants themselves described these strategies as inefficient and exhausting, noting that they required considerable time and effort to complete even simple calculations, particularly under time pressure. All participants described mental drain when doing mathematics. Moreover, problems with time limits in exams and the need for additional time when dealing with numbers due to prolonged processing time in mathematical contexts were reported repeatedly.

These findings substantiate the persistence of number-related difficulties into adulthood. From a medical-model perspective, such deficits represent enduring symptoms of dyscalculia, while from a social-model perspective, their negative impact becomes evident in educational or daily settings that demand rapid, unsupported processing of numerical information.

Daily Struggles

In addition to academic challenges (e.g., time management in exams, managing mathematics-related course requirements, the need to change study program due to mathematical difficulties), a second theme emerged which had a notable impact on everyday life of our adult participants. In particular, almost all of them reported to experience notable everyday challenges related to money usage, time management, estimation skills, and applying mathematical concepts to real-world scenarios (e.g., “How often do I need to go skiing for a season pass to be worthwhile?” or “When do I have to set my alarm to make sure I leave the house on time?”). Participants also often expressed inability to verify change (money returned when paying cash) they receive and having to “trust the cashier” instead. To fully avoid challenges with cash transactions, many of them resorted to exclusively paying by card, as illustrated by the following representative quote

…because it is a real stress situation for me when I have to pay with cash. There have been several times when I accidentally gave the cashier too little money and that was extremely uncomfortable and embarrassing. So, whenever possible, I pay by card. (Participant 18)

Reported difficulties with time-related tasks often start with reading analog clocks. Some participants reported particular challenges when “the hand of the clock is between the half-hour and quarter-hour marks” (Participant 4) and some resorted to counting individual minute marks. One participant's experience, representative of many others, illustrates the profound impact of these challenges in daily life:

I don’t wear a watch to avoid being asked what time it is. I either wouldn’t be able to answer that question at all, or only after an excessively long and effortful period of consideration. (Participant 7)

One participant also indicated problems in reading bus or train timetables and other participants reported difficulties in time planning and estimating time. Establishing when to leave the house to arrive on time for an appointment was frequently reported as a daily challenge as described by one participant as follows:

When I have an appointment earlier than usual and need to get up earlier, I have to calculate how much earlier to set my alarm – and that's really difficult and exhausting for me. It takes a lot of effort to figure it out. (Participant 3)

However, difficulties in estimation were not limited to time. Many participants also mentioned problems with estimating quantities, prices, and physical distances, which considerably impairs their daily life. These daily struggles illustrate how numerical key deficits due to dyscalculia translate into functional limitations that can restrict participation beyond formal learning contexts.

Emotional and Behavioral Consequences

Despite notable struggles during school, none of our participants was diagnosed and/or appropriately supported for dyscalculia during childhood. Reasons reported for this include parental reluctance to have their child tested and the belief held by teachers and parents that they simply needed to “try harder.” Furthermore, many students compensated for their difficulties with strong general cognitive abilities, diligence, and increased study efforts. This allowed them to complete their secondary education and enroll at university. Nevertheless, their difficulties had emotional and behavioral consequences based on negative learning experiences such as investing considerably more time than peers yet achieving poorer grades, being told they were lazy or unintelligent. This resulted in increased psychological strain affecting their functioning and mental well-being. Also, participants exhibited a tendency toward negative core beliefs, such as “I am simply too stupid for this.” and “I will always fail at this.” Such self-deprecating thoughts were common among participants, as one participant verbalized:

Whenever I see numbers, I feel like I have to prove myself – and at the same time, I’m convinced I’ll fail anyway. It makes me feel like a stupid person. (Participant 17)

The emotional impact associated with these negative learning experiences, including repeated and lasting feelings of shame, frustration, mental block when confronted with numbers, mathematics anxiety, and the associated negative beliefs continue to affect them. Additionally, these experiences led participants to adopt avoidance behaviors, such as refraining from discussing number-related topics or systematically avoiding situations bearing numbers or mathematics. This tendency was mentioned by many participants such as:

“I feel really embarrassed when people realize that I can’t do math at all. That's why I avoid games with numbers and calculating, like certain card games. When asked to join anyway, I panic and have to come up with excuses for why I can’t play right now.” (Participant 15)

Whenever feasible, participants reported to employ compensatory strategies, such as excessive use of calculators.

These findings suggest that number-related key deficits persisting into adulthood serve as building blocks for daily struggles regarding the processing and application of numerical information (e.g., when dealing with money and time). In turn, these appear to give rise to broader emotional and behavioral consequences (see Figure 1 for an illustration), which considerably impair quality of life and societal participation of those with dyscalculia.

Psychometric Assessments

The psychometric assessment revealed significant limitations in basic arithmetic operations: The Math4Speed test showed that all participants performed below the 16^th percentile in at least one of the four subtests (addition, subtraction, multiplication, division), with nine participants demonstrating performance clearly below the 16^th percentile across all four subtests. According to diagnostic guidelines subthreshold performance in a standardized test and the presence of symptoms early on, especially during the first years of schooling, are necessary for diagnosis (APA, 2013) as are subjectively reported difficulties and clinically significant impairments in everyday functioning (Schulte-Körne, 2014). Our study consistently confirmed this for all our participants.

Nevertheless, results of the ERT-JE were inconsistent across participants. Out of the 17 participants tested (one did not complete the quantitative assessment), nine participants showed severe problems on at least one of the four factors (i.e., mathematical order structures, arithmetic skills, size relationship, applied mathematics), whereas eight did not score below the 16^th percentile on any factor. Among these eight participants, three demonstrated below-average processing speed, while two showed below-average performance on the “single-step word problems” subtest.

Notably, six out of the 17 participants tested showed below-average, clinically relevant processing speed on the ERT-JE when compared to normative data for the end of 8^th grade (equivalent to around 14 years of age). Extended processing time primarily emerged when participants tried out different solution strategies. However, in most instances, participants simply skipped tasks that they could not solve, which frequently precluded processing times from getting long enough to reach clinical relevance. These participants were kept in the analysis because skipping items reflected the severity of their difficulties rather than invalid data, and omissions affected only processing speed, without compromising diagnostic interpretation.

Importantly, however, the ERT-JE's reliance on 8^th-grade norms limits its potential to accurately identify basic numerical deficits in adults, as normative data for adults, especially for the population of university students, is not available. For an overview of the results from the diagnostic process (psychometric assessments [presented in percentile ranks] and clinical interview) see Table 1.

Table 1.

Results From Diagnostic Process (Psychometric Assessments and Clinical Interview).

	Math4Speed				ERT-JE					Clinical interview
Participant number	Addition	Subtraction	Multiplication	Division	mathematical order structures	Arithmetic skills	Size relationship	Applied mathematics	Processing speed	Relevant since early schooling	Functional impairment
1	0	5	1	7	62	45	73	40	23	✓	✓
2	0	2	3	1	62	21	51	31	23	✓	✓
3	4	29	7	20	39	4	9	61	52	✓	✓
4	-	-	-	-	39	7	1	16	100	✓	✓
5	19	38	29	7	85	45	73	50	14	✓	✓
6	1	2	3	4	85	34	23	71	4	✓	✓
7	0	4	1	4	62	7	23	11	36	✓	✓
8	4	2	29	20	85	53	42	61	1	✓	✓
9	2	2	18	23	30	5	17	11	23	✓	✓
10	2	2	7	4	47	45	91	16	2	✓	✓
11	46	15	62	20	85	17	12	31	52	✓	✓
12	1	7	5	0	21	2	-	-		✓	✓
13	23	29	5	20	62	17	23	31	89	✓	✓
14	10	12	58	4	85	21	29	50	89	✓	✓
15	1	1	5	11	39	10	17	5	14	✓	✓
16	2	9	3	15	62	53	60	31	23	✓	✓
17	0	2	3	4	30	13	19	5	14	✓	✓
18	13	18	3	11	30	7	60	31	36	✓	✓

Note. ERT-JE = Eggenberger Calculation Test for adolescents and adults.

Results of the psychometric assessments are presented as percentile ranks. Percentile ranks ≤ 16 are considered clinically significant and are marked in bold. Presence of relevant diagnostic criteria according to the clinical interview, indicated by ✓.

Discussion

In our study, we investigated academic but also everyday implications and emotional consequences of dyscalculia as a neurodevelopmental condition in adult university students. Using an integrative mixed-methods approach combining psychometric testing with reflective thematic analysis of anamnestic interview data, we aimed to capture both measurable and experienced personally relevant consequences of dyscalculia. Integration of qualitative and quantitative findings revealed that standardized test results often underestimated the severity of participants’ difficulties. Several students who scored within typical ranges on the ERT-JE nevertheless described profound challenges in daily life. This discrepancy emphasizes that the impact of dyscalculia cannot be fully understood through existing assessment tools alone but requires consideration of subjective and contextual experiences. This underlines the need to interpret diagnostic results through both medical- and social-model perspectives, acknowledging that neurodevelopmental differences and environmental constraints interact dynamically.

In fact, results indicated three main themes reflecting dyscalculia in adults: (a) number-related key deficits, (b) daily struggles, and (c) emotional and behavioral consequences, which we will discuss in turn before considering the psychometric results. As expected, our findings demonstrated that all participants reported—partly severe—number-related key deficits such as uncertainties in basic numerical skills, deficits with basic arithmetic operations, and inefficient problem-solving strategies. This is in line with previous research indicating that such difficulties with basic numerical skills not only impact children's academic performance but also significantly affect their daily lives (Mahmud et al., 2020). The present results extend these findings to adulthood, suggesting that core numerical deficits remain stable, with participants reporting continued impairments of their academic achievement and everyday experiences. The daily struggles reported were closely related to persisting number-related key deficits and could be interpreted as secondary symptoms. Uncertainties in basic numerical skills, a lack of number sense, and notable challenges with arithmetic operations, particularly mental calculations, impact everyday life severely. These manifested in notable everyday strains relating to money usage (e.g., dealing with change, having to trust the cashier, avoiding cash payments), time management (e.g., reading analog clocks, bus or train timetables), estimating quantities, prices, physical distances in everyday life), and transferring mathematical concepts to real-world scenarios (“When do I have to set my alarm to make sure I leave the house on time?”). These examples illustrate that dyscalculia can constrain everyday situations requiring (implicit or intuitive) numerical reasoning.

Taken together, these daily struggles had a notable impact on students’ societal participation in everyday life, consistent with Kaufmann et al. (2022), who previously documented limitations in academic and occupational participation in students with dyscalculia. However, our results go beyond those reported by Kaufmann et al. (2022) as the reported daily struggles found in our study indicate that participation limitations extend to everyday life situations such as handling money or time planning.

Importantly, however, number-related key deficits not only resulted in daily struggles, but together with the latter, also had severe emotional and behavioral consequences. Participants’ difficulties with basic numerical and arithmetic skills led to negative learning experiences, including repeated failure, and demeaning feedback. From a learning psychology perspective, such repeated experiences of failure and negative feedback can induce avoidance behavior (Foerster et al., 2001). Emotional consequences, such as shame and math anxiety, further contribute to such avoidance tendencies. In a previous study, Jansen et al. (2016) investigated emotional factors that mediate the relationship between mathematical skills and the use of mathematics in daily life. They concluded that individuals with poorer mathematical skills may use mathematics less frequently in their daily life because of these emotional factors. The results of our study corroborate this notion. Due to negative learning experiences, emotional factors (fear of embarrassment, shame, math anxiety) and behavioral factors (avoidance tendencies) cause them to avoid situations in their daily lives that require mathematics. As this is not always possible, participants reported steady emotional challenges, including stress, shame, frustration, or even anxiety in their daily life. This can corroborate reduced participation in everyday activities.

Additionally, the reported daily struggles frequently occur in everyday situations that require spontaneous and swift mental calculations. These challenges may, at least in part, be attributable to experienced math anxiety in such contexts. As argued by Ashcraft and Kirk (2001), anxiety-induced intrusive thoughts associated with mathematics may deplete limited working memory resources, thereby further compromising mathematical performance. Given that a considerable number of our participants reported experiencing math anxiety, this factor may constitute an additional cognitive and emotional burden, that adds to daily struggles and contributes to heightened distress in such situations.

While numerous studies investigated the emotional impact of learning difficulties in children and adolescents (e.g., anxiety and depression, Alesi et al., 2014; Nelson & Harwood, 2011), research on behavioral and emotional consequences of dyscalculia in adults remains scarce. Our study therefore contributes to expanding the neurodiversity discourse by highlighting dyscalculia in adults as an underrecognized form of neurodivergence. By focusing on adults, it demonstrates that neurodevelopmental differences continue to shape lived experience and participation beyond childhood.

Considering our findings from both a medical- and social-model perspective provides a more comprehensive understanding of adult dyscalculia. From a medical-model perspective, dyscalculia represents a neurodevelopmental condition marked by persistent numerical difficulties. Yet, its negative impact often stems from the lack of appropriate support and intervention that may help affected individuals compensate for their specific challenges. Growing cognitive and organizational demands of adulthood, such as managing finances, time, and academic responsibilities, make these difficulties experienceable in different life contexts. From a social-model perspective, experiences of shame and anxiety leading to avoidance behavior meaning reduced participation are not inherent to dyscalculia itself but attributable to insufficient or inadequate support. Recognizing this interplay highlights the need for approaches that combine diagnostic clarity with accessible, evidence-based interventions tailored to adults with dyscalculia.

When interpreting the results of the current study, some limitations should be considered. First, participants were recruited from a single university clinic, which may limit generalizability of findings to other contexts. Participants were self-selected individuals seeking support and diagnostic clarification, which may have biased the sample toward those experiencing more pronounced difficulties. It is therefore possible, that individuals with dyscalculia who experience less severe difficulties or who do not actively seek diagnostic support were not represented in this sample, resulting in a potential self-selection bias.

In addition, the study focused exclusively on university students with dyscalculia, a group that likely possesses comparatively high cognitive, compensatory, and educational resources. Therefore, it is reasonable to assume that our participants should have been able to draw on alternative strengths, enabling them to finish high school successfully and enroll in further education despite their significant mathematical difficulties as well as emotional and behavioral consequences. As a result, generalizability of findings to the broader adult population with dyscalculia may be limited. Adults, who do not manage to finish high school, potentially due to even more severe numerical difficulties, inadequate support, or socioeconomic disadvantages, may face even more substantial barriers and hardships in everyday life. However, this remains speculative, and further research into dyscalculia in adults and its consequences is needed to substantiate this claim.

From a methodological perspective, while the qualitative findings may not be generalized, they still offer transferable insights for similar populations. The lack of adult-specific norms for the ERT-JE also limits diagnostic precision and may mask subtle difficulties in adults with stronger compensatory abilities. Finally, although our clinical backgrounds may have shaped interpretation, reflexive awareness and the integration of both medical- and social-model perspectives aimed to ensure a balanced understanding of dyscalculia.

Implications

Our findings highlight that adult university students with dyscalculia face persistent daily struggles due to their number-related key deficits. This can limit societal participation in everyday life beyond academic and occupational settings, supporting and extending Kaufmann et al.'s (2022) earlier findings. However, our results extend beyond academic and occupational barriers, indicating more general consequences in everyday life. Importantly, number-related key deficits not only resulted in daily struggles, but also had notable emotional and behavioral consequences. Repeated experiences of failure and negative feedback led to avoidance behaviors, shame, and math anxiety (Foerster et al., 2001; Jansen et al., 2016). Consequently, participants often avoid math-related situations, yet their difficulties are often unavoidable, causing emotional distress and reducing societal participation. While the emotional impact of learning difficulties on children is well-documented (Alesi et al., 2014; Nelson & Harwood, 2011), research on adult university students with dyscalculia remains scarce.

Additionally, our results highlight the urgent need for effective assessment tools to diagnose dyscalculia in adults, particularly in university students. While the Math4Speed test revealed notable deficits in arithmetic fluency under time pressure, the ERT-JE produced more heterogeneous results, with some participants not falling below clinical thresholds despite experiencing impairments. However, qualitative data suggest that correct answers are often reached through exhausting and inefficient problem-solving strategies. This discrepancy shows that while timed tasks capture speed related impairments, untimed assessments may fail to reflect the severity of the underlying difficulties, especially when individuals compensate through increased effort. As the ERT-JE is standardized on 8^th-grade students and lacks adult-specific criteria, it risks underestimating impairments in this population.

Moreover, the results of the ERT-JE are in line with the idea that, given sufficient time, individuals can eventually find the correct solution, but they struggle significantly under time pressure. This conforms with daily struggles reported by participants, which seem to arise particularly in situations subjectively perceived as time-sensitive, such as paying when shopping or in a restaurant. This highlights the real-world impact of such fluency deficits. Furthermore, negative emotional factors, such as math anxiety, reported by most participants, may capture working memory resources (Ashcraft & Kirk, 2001; Vukovic et al., 2013), thereby making daily mathematical tasks even more difficult. This should be considered when designing interventions for adults with dyscalculia, which should not only address (basic) mathematical skills but also target emotional and behavioral consequences, including math anxiety and avoidance behavior. Integrative approaches combining basic numerical training, psychoeducation, and environmental accommodations may help mitigate daily challenges and enhance participation in academic and everyday contexts.

Conclusions

The current study set out to investigate consequences of dyscalculia in university students. Thematic analysis of anamnestic interview data revealed substantial behavioral and emotional consequences for participants, extending well beyond their academic into their everyday life and resulting in severe psychological strain. Additionally, our findings underscore the urgent need for improved assessment tools and interventions tailored to adults. Current diagnostic methods fail to capture everyday mathematical difficulties and the considerable mental effort individuals invest to cope with these challenges often remains insufficiently reflected by standardized assessments. While there have been increasing efforts in recent decades to support school-age children with dyscalculia (Monei & Pedro, 2017), there is still a notable lack of interventions for adults, particularly for those in higher education settings like universities. This lack of support—none of our participants was diagnosed and/or appropriately treated for dyscalculia during childhood—can contribute to emotional distress and avoidance behaviors. Enabling support is therefore crucial to improving participation and quality of life for university students with dyscalculia.

Supplemental Material

sj-png-1-ndy-10.1177_27546330251406911 - Supplemental material for Neurodivergent Conditions Critically Limit Societal Participation—The Case of Dyscalculia in Adults

Supplemental material, sj-png-1-ndy-10.1177_27546330251406911 for Neurodivergent Conditions Critically Limit Societal Participation—The Case of Dyscalculia in Adults by Laura Staller, Korbinian Moeller, Elisabeth Margarete Weiss and Verena Dresen in Neurodiversity