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Children with Mathematics
Learning Disabilities in Belgium
Annemie Desoete, Herbert Roeyers, and Armand De Clercq

Abstract
In Belgium, between 3% and 8% of the children in elementary schools have mathematics learning disabilities (MLD). Many of these chil-
dren have less developed linguistic, procedural, and mental representation skills. Moreover, a majority of the children have been found
to show inaccurate prediction and evaluation skills in Grade 3. MLD often become obvious in elementary school. Whereas some chil-
dren are retained, others are referred to special education. During the last 10 years, the number of children in special education and the
number of children with learning disabilities who are following a special guidance program in general education (inclusive education)
have increased. Children in Belgium with MLD can get therapy for about 2 years. Nevertheless, many problems continue unresolved
even in high school and adulthood.

F
rom 1974 to 1997, only 28 articles
on mathematics learning disabil-
ities (MLD) were cited in Psyc-
Info, whereas 747 articles could be
found on reading disabilities (Noel,
2000). Therefore, we agree with Gins-
burg (1997) and Hanich, Jordan, Kap-
lan, and Dick (2001) that children with
mathematics difficulties have been un-
derstudied, and their problems have
been underestimated. We know that
MLD can seriously limit a student’s ed-
ucational opportunities (Rivera-Batiz,
1992). Moreover, the disabilities often
persist into the college years (Miller &
Mercer, 1997), and many of these chil-
dren continue to function below the
arithmetical level of a 13-year-old child
(Cawley & Miller, 1989; Miller & Mer-
cer, 1997).
In this article, first we give a general
description of mathematics education
in Belgium. Second, we describe chil-
dren with MLD in our country. Third,
we discuss the problems with mathe-
matical problem solving in children of
average intelligence, both with and
without MLD, in Belgium. Finally, we
inventory the instructional interven-
tions and the accommodations imple-
mented to help students with MLD in
Belgium.
Mathematics Education
in Belgium
General Education
Belgium is a small country in the
heart of Europe with a population of
nearly 11 million. Belgium has French-
speaking and a Flemish-speaking com-
munities, along with a small German-
speaking community. This article relates
mainly to the Flemish-speaking com-
munity, or Flanders, although some
additional information is provided
concerning the French-speaking com-
munity. The situation in the French-
and German-speaking parts is similar
to that of the Flemish-speaking part.
In Belgium, most children start
kindergarten when they are 21⁄2 years
old. They get 31⁄2 years of kindergarten
education. At the age of 6, the children
go to primary school, where they learn
to read, write, and do mathematics.
Primary classes include roughly 20 to
30 children in a single classroom. Chil-
dren spend about 7 hours at school
every weekday, except Wednesday,
which has early dismissal. There is no
school on Wednesday afternoon. After
primary school, students enter sec-
ondary education. This is followed ei-
ther by vocational training or by col-
lege or university.
All Belgian children have to con-
tinue their education (and in most
cases remain at school) at least until
they are 18 years old. A small number
of children are educated at home, be-
cause since 1914, there has been com-
pulsory education in Belgium, but not
compulsory schooling. There are three
types of schools in Belgium: Catholic
schools, schools organized by the fed-
eral government, and schools orga-
nized by the cities or provinces. There
are no major differences between these
three types of schools, although each
operationalizes the obligatory central
developmental aims (ontwikkelingsdoe-
len) of the kindergarten and the out-
comes to be achieved at the end of ele-
mentary education (eindtermen) in a
slightly different way with respect to
the mathematics curriculum (wiskun-
deleerplan).
Schools are held accountable for stu-
dent performance. Inspection is orga-
nized at a central level. As in most Eu-
ropean countries, several systematic,
full inspections of the schools as a
whole are carried out in Belgium an-
nually (Standaert, 2001). The CIPO
(Context, Input, Process, Output) model

JOURNAL OF LEARNING DISABILITIES

VOLUME 37, NUMBER 1, JANUARY/FEBRUARY 2004, PAGES 50–61

is used for this inspection, and a
school’s performance is evaluated in
four key areas. This evaluation deter-
mines the results of each school with
respect to student performance (out-
put) and the way in which these results
have been achieved ( process), taking
into consideration the context in which
the school is operating (e.g., demo-
graphic, juridical, and administrative
data) and the input data (e.g., informa-
tion about pupils, school staff, and ma-
terial resources). In Flanders, the eval-
uation of the quality of teachers is left
to the local school or its governing
body, whereas the French-speaking
community of Belgium has a central
teacher assessment system (Standaert,
2001).
In the Flanders curriculum, 80% of
the children must acquire 80% of the
required minimum skills and knowl-
edge by the end of their primary school
education. Children who do not meet
these minimum aims and who read or
solve mathematics problems on the
level of third graders without learning
disabilities (LD) are referred to the
B-classes of secondary education (Hel-
linckx & Ghesquière, 1999). If their lost
ground is made up in the first year of
secondary education, then these chil-
dren can go back to the A-classes, where
they follow a general course of studies
aimed at preparing them for college or
university. About 20% of the children
with LD in special primary education
go to one of the A-classes in secondary
education (Hellinckx & Ghesquière,
1999). The other children follow a spe-
cialized course of vocational training.
General mathematics education in
Flanders seems to be doing quite well
for most children. The Program for In-
ternational Student Assessment (PISA)
recently compared the learning perfor-
mance of students in 30 different coun-
tries all over Europe, Asia, and Amer-
ica. This project revealed that the
15-year-old Flemish students did best
on mathematics (DeMeyer, De Vos, &
Van de Poele, 2002). Flemish students
obtained a second place on reading
skills, just after students from Finland,
and they scored third on science, after
VOLUME 37, NUMBER 1, JANUARY/FEBRUARY 2004
Korea and Japan. Especially children in
families with a high socioeconomic sta-
tus did well in this study. Children in
families with a lower socioeconomic
status had results comparable with
those of their peers in the other coun-
tries. Moreover, students in the French-
speaking part of Belgium did worse on
mathematics, reading, and science
than their Flemish-speaking peers in
the same country (Bormans, 2002;
Galle, 2001).
The mathematics curriculum in Bel-
gium changed in 1998 (Commissie
Wiskundeleerplan van het Gemeen-
schapsonderwijs, 1998; Vlaams Ver-
bond van het Katholiek Basisonder-
wijs, 1999). The former mechanistic
approach and even the structuralistic
approach (with “new mathematics”)
became history. Inspired by the exam-
ple of the Netherlands (Freudenthal,
1991; Treffers, 1991), a more construc-
tivistic realistic mathematics education
(RME) was introducted, which empha-
sizes the importance of students be-
coming active learners who construct
their own mathematics (Blöte, Van der
Burg, & Klein, 2001). The main para-
digm of RME is that the teaching of
mathematics should build on the pre-
vious knowledge of children derived
from their real-life experiences with
numbers. Dialectical constructivists
stress that the understanding of arith-
metic develops through active knowl-
edge construction, transformation, and
discovery within an approach involv-
ing scaffolding and does not merely
result from passive information acqui-
sition (Cobb, Yackel & Wood, 1992;
Muthukrishna & Borkowski, 1996).
They assume that people actively con-
struct their own knowledge by linking
prior knowledge to new knowledge.
The emphasis is on a more functional
use of basic mathematics concepts and
skills and on the use of schemata to as-
sist abstract thinking. Moreover, math-
ematics has become a tool for solving
all kinds of problems, for handling all
kinds of tasks, and for communicating
and working together through a more
interactive teaching process. In the RME
approach, children in small groups are
51
given the opportunity to discover ade-
quate strategies for themselves on a va-
riety of tasks presented in meaningful
and rich contexts (e.g., Milo, 2001; Van
Luit, 1999; Verschaffel, 1999).
This conceptual change has had con-
sequences for the content of mathe-
matics education (Verschaffel, 1995).
So-called structuralistic “new mathe-
matics” (e.g., A∪B) has disappeared
from the curriculum, and some num-
ber algorithms, formulas, and other
domain-specific data (e.g., prime num-
bers, nine control on multiplications,
theory of sets) have disappeared with
them. In contrast, the accent is now on
mental mathematics, on approximate
arithmetic or number sense, on mathe-
matics using the calculator (from
Grade 4), and on problem solving and
strategy use. However, there is still ac-
knowledgement of the importance of
older, established aims and contents,
such as perfect mastery of number con-
cepts. But in contrast with the tradi-
tional conception of mathematics learn-
ing as the passive and isolated
absorption of knowledge and proce-
dures, these concepts should be con-
structed actively by children, allowing
for individual learning trajectories
(Torbeys, Verschaffel, & Ghesquière,
2003).
RME focuses on adaptive expertise
(Baroody & Dowker, 2003) and on hav-
ing students create and discuss their
own solution procedures and on using
context problems to relate mathemat-
ics to real-life situations. RME has re-
sulted in a higher level of flexibility
and more conceptual understanding
for average students without LD (e.g.,
Blöte et al., 2001). However, children
with MLD have not done as well (e.g.,
Woodward & Baxter, 1997). Several
handbooks (e.g., Pluspunt, 2002) and
teaching methods based on the RME
approach that have been used for
Flemish children with MLD have re-
sulted in confused children who are
unable to solve math problems. This is
presumably because RME places sub-
stantial demands on metacognitive
skills, which may not be adequately
developed in children with MLD (De-
52
soete, Roeyers, & De Clercq, 2003b;
Mercer, Jordan, & Miller, 1996). It ap-
pears that children with LD profit less
from RME than their peers with age-
adequate learning skills. In clinical
practice, children with MLD seem to
need a more structured and direct in-
structional approach, in which the
teachers teach the conceptual under-
standing and demonstrate and repeat
the rules and procedural skills to be
learned. The RME goal of flexible use
of procedures often results in children
with MLD lacking the necessary struc-
ture and conceptual knowledge to de-
duce for themselves the procedural
skills needed to solve mathematical
problems. For this reason, there is con-
siderable debate in Flanders as to the
value of RME for these children (e.g.,
Feys, 1998; Kroesbergen, 2002; Milo,
2001; Van Luit, 1992, 1994).
Special, Inclusive, or Integrated
Education?
The general education system has not
met the needs of some children in Bel-
gium. Since 1970, separate special
schools have been created for some cat-
egories of children. For young children
(7–14 years) with reading, spelling, or
mathematics learning disabilities, Type
8 special primary education has been
set up. For children with LD, no special
education program has as yet been set
up either in kindergarten or in sec-
ondary schools. In the 1970s, about 3%
of school-age children went to special
schools (Types l through 8). However,
by the end of the 1990s, 3.91% were at-
tending such special schools. This was
the case for 0.73% of the children in
kindergarten, 5.92% of the primary
school children, and 3.65 % of the sec-
ondary school children. For Type 8
schools (children with LD), there has
also been a large increase in recent
years. In 1990–1991, there were 6,015
children in Type 8 schools, whereas in
2000–2001, 10,049 (+ 59.86%) of the
children in special primary education
in Belgium were being educated in
Type 8 schools. The number of children
JOURNAL OF LEARNING DISABILITIES
in Types l through 8 altogether repre-
sent 78.65% of the total number of chil-
dren in special primary education
(Mardulier, 2001). However, there
seems to be a large gender difference in
the choice of general versus special ed-
ucation. In 2000–2001 in Flanders, boys
went more often to special schools than
girls.
In general, the budget for special
primary and secondary education is
about 414 million euro, which means
that 9% of the total education budget is
spent on the 3.9% of the students, who
are receiving this kind of education
(Mardulier, 2001). With this extra bud-
get, special education is able to work
with smaller classes (about 10 children
in a class) using specially trained
teachers and a team of other specialists
(speech–language therapists, occupa-
tional therapists, ergonomic therapists,
psychologists, and sometimes psychia-
trists or other physicians) to assist in
the education of these children.
At the present time in Flanders, there
is a strong movement in favor of inclu-
sive education (Broekaert & Van Hove,
1995; Kennes, 2001; Lebeer, 2003; Van
Hove & Roets, 2000; Wuyts, 1996).
Some of its proponents are even insist-
ing on the abolition of special educa-
tion for children with LD. This inclu-
sive approach to education is aimed at
restructuring the schools in order to
meet the needs of the students who are
at risk and at promoting the value of
diversity within the human commu-
nity. The guiding principle is that
schools should accommodate all chil-
dren, regardless of their physical, intel-
lectual, social, emotional, linguistic, or
other characteristics. In this spirit, the
care coordinator (zorgcoördinator) has
an important task in general education
from September 2003 on.
An integrated education (Geïnte-
greerd onderwijs; GON) experiment was
started in 1980 on Flemish children
who had a physical or sensory disabil-
ity (Types 4, 6, and 7). In 1983, it was
generalized to all types of special edu-
cation, and in 1986, it was put into law.
School boards of general education
schools now have the possibility of co-
operating with schools for special edu-
cation where students with learning or
other disabilities are being educated.
As a result, it is becoming possible for
some children with disabilities to re-
main in general education for 1 or
2 years or, in the case of a severe dis-
ability, for an unlimited time. The gen-
eral education school then receives
pedagogical–didactic or therapeutic
assistance from a school for special ed-
ucation. The school for special educa-
tion receives an integration allowance
to assist the general education school
in educating children with disabilities.
Although the percentage of children in
special education has increased, the
number of GON students has also in-
creased in 10 years. In 1994–1995, there
were 36 children in Type 8 with a GON
status, whereas in 2000–2001, there
were already 190 children in the GON
education system (Mardulier, 2001;
Wuyts, 1996).
To summarize, general mathematics
education in Flanders seems to be
doing quite well for most children. Al-
though there is a strong movement in
favor of inclusive and integrated edu-
cation, separate special schools exist
for children with LD.
MLD in Flanders
General and Special Education
In Flanders, most learning disabilities
are not detected until primary school,
when reading disabilities often become
obvious. Likewise, many children with
MLD in primary school did not en-
counter severe difficulties with pre-
liminary mathematics learning in kin-
dergarten, although in some cases,
inefficient counting and not remem-
bering number names was already
present as a marker (Grégoire, Van
Nieuwenhoven, & Noel, 2003). Never-
theless, most children with MLD in
Belgium are detected in Grade 1, when
they have to master addition and sub-
traction, and, in some cases, even later
(in Grade 3), when they have to learn

to quickly retrieve the multiplication
tables or to select and apply various
problem-solving strategies in addition
to the basic mathematical operations.
In secondary education, college, or
university, students with MLD en-
counter numerous problems with
mathematics and physics and very few
teachers who understand their learn-
ing problems. This often results in low
self-concept and even in behavioral
problems. About 40% to 80% of stu-
dents with LD develop behavioral
problems (Thiery, 2001). Parents are
confronted with a very tumultuous pe-
riod in the life of these youngsters, up
to suicidal behavior in some of them.
Definition of LD in Flanders
Although various authors agree that
an operational definition of LD is
meaningful (e.g., Kavale & Forness,
2000; Swanson, 2000), most studies are
rather vague when it comes to charac-
terizing the children who fit in their
category of children with learning dis-
abilities. Several authors use different
terms for a deficit in mathematical
problem solving, such as mathematics
learning difficulties, mathematics learning
problems, mathematics learning disorder,
mathematics learning disability, mathe-
matics learning retardation, mathematics
learning deficiency, or dyscalculia (e.g.,
American Psychiatric Association, 1994;
Dumont, 1994; Fletcher & Morris, 1986;
Hellinckx & Ghesquière, 1999; Rourke
& Conway, 1997; Swanson, 2000;
Thiery & Anthonis, 2003; Van Luit,
1998; World Health Organization, 1997).
In our studies, in accordance with
the definition in the Diagnostic and
Statistical Manual of Mental Disorders
(DSM-IV; American Psychiatric Asso-
ciation, 1994), we use three criteria
to determine whether children have
mathematics learning disabilities (MLD).
First, in accordance with the discrep-
ancy criterion, the child must perform
significantly lower on mathematics
than one would expect on the basis of
his or her general school results or in-
VOLUME 37, NUMBER 1, JANUARY/FEBRUARY 2004
telligence. Second, the severeness crite-
rion is applied, which is based on the
DSM-IV (pp. 46–51). We only speak of
MLD when the child’s difficulties with
mathematics, as measured by a valid
test, are found to be 2 or more standard
deviations (SD) below the norm. The
third criterion is the resistance criterion,
which refers to the teacher’s assess-
ment of the fact that the difficulties
remain severe even with the usual re-
mediation at school (remedial teaching
or school therapist). Teachers’ assess-
ments are used because, although
some researchers question the trust-
worthiness of these data, reviews indi-
cate that these judgments can serve as
worthy assessments of a student’s
achievement-related behavior (Meltzer,
Roditi, Houser, & Perlman, 1998;
Winne & Perry, 2000). Moreover, we
define mathematics learning problems
(MLP) as the unexplainable difficulties
that a child has with mathematics
when validated by a test in which the
child’s performance is between –2 SD
and –1 SD below the norm (severeness
criterion; e.g., Ghesquière, Ruijsse-
naars, Grietens, & Luyckx, 1996). These
difficulties must be noticed by the
teacher for them to be defined as a
mathematics learning problem.
The three criteria (severeness, dis-
crepancy, and resistance) may seem
very clear parameters for ascertaining
whether an individual child belongs to
the group of children with MLD. How-
ever, in clinical practice, the diagnosis
also depends on the tests chosen to
measure the severeness criterion. The
choice of these mathematics tests was
found to be crucial in a study of 85 chil-
dren in Flanders. No single test suc-
ceeded in identifying all 37 children
with MLD out of the 85 third graders
according to the discrepancy and resis-
tance criteria. Using a test of domain-
specific mathematics knowledge (mea-
suring number knowledge and mental
arithmetic), only 23 children with MLD
were detected. Using a test of math
word problems, only 16 children with
MLD were detected. On the basis of a
test of mathematics number facts, only
53
17 children with MLD were detected.
This study indicated that a combined
assessment—a test of number facts, at
least one test of domain-specific
knowledge, and a test of math word
problems—was needed to prevent the
choice of test from determining the di-
agnosis. The domain-specific test in
combination with the test of math
word problems was able to detect 27
out of the 37 children. The domain-
specific test combined with the test of
number facts was able to identify 34
out of the 37 children with MLD. Only
the combination of a test of domain
specific knowledge, a test of number
facts, and a test of math word problems
was found to be able to detect all 37
children with MLD (Desoete & Roey-
ers, 2000). It might be interesting to
combine the assessment of those as-
pects within one test (e.g., Grégoire,
1997) and to investigate if such a test
would detect all children with MLD.
Such studies are currently being pre-
pared (Grégoire et al., 2003).
Prevalence of MLD in Flanders
In October 2001, a prevalence study
was conducted among general educa-
tion second-, third-, and fourth-grade
students in Flanders (N = 3,978; see
Table 1).
In second grade, 2.27 % of the chil-
dren (2.11% boys and 2.42% girls) were
found to have MLD according to the
teacher and a mathematics test battery
(–2 SD on one of the tests; see Table 1).
About 1.51% of the MLD had to do
with a memory deficit, translated in se-
vere problems to retrieve number facts.
About 0.91% of the children had se-
vere difficulties dealing with domain-
specific mathematics knowledge and
skills. Moreover, in the third grade,
7.70 % of the children (7.15% boys and
8.32% girls) had MLD (see Table 1). In
4.41% of the cases, these children had
severe difficulties with number fact
retrieval. In 3.74% of the cases, these
children had severe difficulties with
domain-specific mathematics knowl-
54 JOURNAL OF LEARNING DISABILITIES

comprehension and production skills are

TABLE 1
the cognitive skills that are necessary
Prevalence of Mathematics Learning Disabilities in Flanders by
for the reading, writing, and compre-
Grade, Gender, and Diagnostic Test
hension of numbers composed of one
Grade 2 Grade 3 Grade 4 or more digits (e.g., read 5 or 14; Mc-
Boysa Girlsb Boysc Girlsd Boyse Girlsf Closkey & Macaruso, 1995; Van Borsel,
Diagnosis/Test (%) (%) (%) (%) (%) (%) 1998). Problems with these cognitive
skills lead to mistakes such as 15 + 9 =
MLD 18 (confusion between 5 and 2 and 9
Total 2.11 2.42 7.15 8.32 6.99 6.22 and 6). Operation symbol comprehension
NF 1.21 1.81 4.43 4.39 3.26 2.52
and production skills are cognitive skills
DS 0.91 0.91 3.29 4.24 4.66 4.29
that enable the reading, writing, and
MLP comprehension of operation symbols
Total 23.27 23.67 27.79 23.15 24.89 25.90
NF 19.33 14.37 16.16 16.01 14.91 10.96
(such as +, –, ×, =, <, >; e.g., Veenman,
DS 11.78 13.31 11.73 13.81 10.87 15.26 1998). Problems with these cognitive
skills lead to mistakes such as 15 × 9 =
AMA
NF 79.46 83.81 79.39 79.59 81.83 86.66 24. Number system comprehension and
DS 87.31 85.93 84.98 81.95 84.47 80.44 production skills are the cognitive skills
dealing with number system knowl-
Note. MLD = mathematics learning disabilities (−2 SD below norm); MLP = mathematics learning problems edge and the position of decades and
(−1 SD below norm); AMA = adequate mathematics abilities (less than −1 SD below norm); NF = based on
units (e.g., Veenman, 1998). Children
number facts, DS = based on domain-specific test.
an = 662. bn = 661. cn = 699. dn = 637. en = 644. fn = 675. having problems with these skills often
make mistakes with the place of a
number on a number line and do not
edge and skills. Furthermore, in the order to prevent the choice of test from know how many decades and units
fourth grade, 6.59% of the children determining the diagnosis. there are, for example, in 15. Procedural
(6.99% boys and 6.22% girls) had MLD skills are domain-specific cognitive
in Flanders (see Table 1). MLD diag- skills involved in calculating and solv-
noses were based on number fact re- Mathematics Problems in ing mathematics tasks in number prob-
trieval and domain-specific knowl- Children With and lem formats (e.g., 15 + 9 = __ or 81 –
edge in 2.88% and 4.47% of the cases, Without LD 5 = __; e.g., McCloskey & Macaruso,
respectively. 1995; Noel, 2000; Veenman, 1998).
About 25.47% of the second graders In the last decade, substantial progress Problems with these cognitive skills
had MLP according to the teacher and has been made in characterizing the lead to mistakes such as 15 + 9 = 105 or
a mathematics test battery (–1 SD on cognitive and metacognitive skills that 114. Language comprehension skills are
one of the tests), in Grade 2 (see Ta- are important for success in mathemat- cognitive conceptual skills that enable
ble 1). In Grade 3 and Grade 4, the ical problem solving (Boekaerts, 1999; children to understand and solve one-
prevalence rates of MLP were 25.58% Geary, 1993; Grégoire & Van Nieuwen- sentence word problems (e.g. 9 more
and 25.41%, respectively. The mean hoven, 1999; Hacker, Dunlosky, & than 15 is __). Language plays a central
mathematics scores for boys and girls Graesser, 1998; Lucangeli & Cornoldi, role according to several authors (e.g.,
in second, third, and fourth grade did 1997; Montague, 1997; Simons, 1996; Campbell, 1998; McCloskey & Maca-
not differ on domain-specific knowl- Wong, 1996). On the basis of this re- ruso, 1995). Veenman (1998) stressed
edge or on number fact knowledge. search and of an analysis of 150 math the importance of general conceptual
In summary, several authors use dif- protocols of third graders in our study, knowledge in mathematics. Van Borsel
ferent concepts for overlapping phe- a conceptual model of mathematical (1998) went even further and defended
nomena as mathematics difficulties. problem solving was developed (De MLD as a special kind of language dis-
Moreover, the prevalence rate of MLD Clercq, Desoete, & Roeyers, 2000; De- order. We would not go so far. How-
in lower elementary schools in Bel- soete, 2002; Desoete, Roeyers, & De ever, we can see that if children do
gium varied from 2.27% to 7.70%. We Clercq, 2002a, 2002b; see Figure 1). not know what “more” means, then
argue that the diagnosis of children A variety of studies based on differ- word problems such as “9 more than
with MLD must be made carefully. ent theoretical approaches have pro- 15 is what?” cannot be solved correctly.
More specifically, it is important in vided information regarding the cog- Mental representation skills are cognitive
young children to test number facts as nitive skills that are important for skills that enable an adequate mental
well as domain-specific mathematics young children in learning how to representation of the problem or task
and general conceptual knowledge in solve mathematical problems. Numeral (e.g., Geary, 1993; Montague, 1997; Ver-

meer, 1997; Verschaffel, 1999). A men-
tal representation is required in most
word problems, because the simple
translation of key words in a problem
(e.g., “more”) into calculation proce-
dures (e.g., “addition”) without repre-
sentation leads to blind calculation or
number crunching. This superficial ap-
proach leads to errors, such as answer-
ing “24” to questions such as “15 is 9
more than __ ,” “27 is 3 less than __ ,”
and “48 is half of __.” Contextual com-
prehension skills are cognitive skills that
enable the solving of tasks in word
problems consisting of more than one
sentence (e.g., “Bert has 14 Digimon™
[Akiyoshi Hongo] cards. Griet has 5
Digimon cards more than Bert. How
many cards does Griet have?”). In chil-
dren with MLD, problems involving
these tasks (cognitive complexity)
were found to be related to problems
with working memory (and cognitive
overload) and knowledge base and ex-
pertise (Baddeley, 1999; Logie & Gil-
hooly, 1998; McCloskey & Macaruso,
1995). Relevance skills are cognitive
skills enabling the solving of word
problems with irrelevant information
included in the assignment (e.g., “Bert
has 14 Pokémon™ [Nintendo] cards
and 3 Digimon cards. Griet has 5 Poké-
mon cards more than Bert. How many
Pokémon cards does Griet have?).
Children can have difficulty ignoring
and not using information (e.g., “3
Digimon cards”) in an assignment.
Children with MLD often think that all
the numbers have to be used in order
to solve a mathematical problem, and
will therefore answer “22.” Number
sense skills are the ninth category of
cognitive skills. These skills enable the
solving of tasks such as “the answer to
5 more than 14 is nearest to__. Choose
between 5, 10, 15, 70 and 50.” The abil-
ity to estimate without calculating the
exact answer is called number sense. In
clinical practice, almost all children
with MLD have problems with num-
ber sense tasks (e.g., Sowder, 1992). In
our study, significant partial correla-
tions were found between all cognitive
skills except between linguistic and
procedural skills, linguistic and opera-
VOLUME 37, NUMBER 1, JANUARY/FEBRUARY 2004
tion symbol comprehension skills, lin-
guistic and relevance and number
sense skills, and mental representation
and relevance and number sense skills
(Desoete, Roeyers, & Buysse, 2000).
It is nowadays widely accepted that
metacognition also influences mathe-
matical problem solving (Brown, 1987;
Carr & Jessup, 1995; Desoete, Roeyers,
& De Clercq, 2003a; Hacker et al., 1998;
Lucangeli, Cornoldi, & Tellarini, 1998;
Veenman, Kerseboom, & Imthorn,
2000; Verschaffel, 1999). In recent stud-
ies, however, the term metacognition
has come to be used in multiple and
nearly unrelated senses to refer to a
wide range of phenomena (Borkowski,
1992; Carr & Biddlecomb, 1998; Schoen-
feld, 1992; Wong, 1996). Metacognitive
knowledge has been described as knowl-
edge and deeper understanding of
one’s own cognitive skills and prod-
ucts (Flavell, 1976, 1979). Within meta-
cognitive knowledge, Cross and Paris
(1988) and Jacobs and Paris (1987) dis-
tinguished between declarative knowl-
edge, procedural knowledge, and con-
ditional knowledge. Metacognitive skills
relate to the voluntary control that peo-
ple have over their own cognitive skills
(Veenman, in press). The number of
metacognitive skills being distin-
guished varies from 3 to 10 (Desoete,
2001). Substantial data have been ac-
cumulated on 4 metacognitive skills:
prediction, planning, monitoring, and
evaluation (Lucangeli & Cornoldi,
1997; Lucangeli et al., 1998). Simons
(1996) described a third metacognitive
component (metacognitive beliefs) as the
broader general ideas and theories
(e.g., self-concept, self-efficacy, motiva-
tion, attribution, and conceptions of in-
telligence and learning; see Figure 1)
that people have about their own and
other people’s cognition (McCombs,
1989; Vermeer, 1997; Wong, 1996). A
principal components analysis of
metacognition revealed three metacog-
nitive components that explained 66%
to 67% of the common variance (Des-
oete, Roeyers, & Buysse, 2001). Predic-
tion and evaluation were found to be
interrelated as one of these compo-
nents. As both these metacognitive
55
Cognition
Numeral comprehension and
production
Operation symbol compre-
hension and production
Number system comprehen-
sion and production skills
Procedural skills
Language comprehension
Context comprehension
Mental representation
Selecting relevant informa-
tion
Number sense
Metacognition
Metacognitive Knowledge
Declarative knowledge
Procedural knowledge
Conditional knowledge
Metacognitive Skills
Prediction
Planning
Monitoring
Evaluation
Metacognitive Beliefs
Self-concept
Self-efficacy
Motivation
Attribution
Conception of intelligence
and learning
FIGURE 1. Mathematical problem
solving: A conceptual model.
skills were measured either before or
after the solving of exercises, we la-
beled this metacognitive component
off-line (measured) metacognition. In 165
third graders, we were able to differ-
entiate between different mathematics
ability groups on the basis of the off-
line metacognitive component (Des-
oete, Roeyers, & Buysse, 2001).
Recent studies have underlined the
importance of several cognitive and
metacognitive skills for the purpose of
distinguishing between children with
MLD, children with MLP, and children
with age-appropriate mathematics per-
formance in Flanders (Desoete, 2003;
Desoete & Roeyers, 2002).
In terms of cognition, several chil-
dren with combined domain-specific
and automatization MLD were found
56
to have less developed language com-
prehension skills (Desoete & Roeyers,
2001). Moreover, several children with
domain-specific MLD were found to
have less developed mental represen-
tation skills. However, children with
merely automatization MLD (and age-
appropriate domain-specific mathe-
matics knowledge and skills) did not
fail on mental representation tasks,
and some even had higher scores than
peers without MLD (Desoete & Roey-
ers, 2001). These findings support the
idea that some children with specific
MLD use blind calculation techniques
depending on a simple translation of
key words in an instruction. Finally,
several children with domain-specific
MLD had problems with procedural
skills, using several erroneous proce-
dures (Desoete & Roeyers, 2001; Van
Lehn, 1990).
In terms of metacognition, a majority
of children with MLD were found to
have less accurate prediction skills
than their peers without LD. Younger
children outperformed all children
with MLD in the area of prediction
skills on tasks designed for first-grade
students (so-called easy tasks). Fur-
thermore, children with specific MLD
had less accurate prediction skills re-
lating to number system knowledge
and procedural calculation. Also, chil-
dren with combined MLD and reading
disabilities were found to have less ac-
curate prediction skills in word prob-
lems involving language-related and
mental representation tasks. Moreover,
a majority of the children with MLD
had less accurate evaluation skills than
their peers without LD. Furthermore,
children with MLD had problems es-
pecially in estimating their chances of
success on the easy tasks. Finally, chil-
dren with MLD scored worse in the
evaluation of number knowledge and
procedural calculation than did younger
children who were their equals in the
area of mathematical problem solving
(Desoete, 2003; Desoete & Roeyers,
2002; Desoete, Roeyers, & De Clercq,
2001).
Studies at the group level certainly
revealed interesting information. There
JOURNAL OF LEARNING DISABILITIES
is, however, a certain risk of misinter-
preting these studies, because they
cannot be automatically applied to in-
dividual children. Not all children
with MLD were found to have the
same inadequate cognitive or metacog-
nitive skills. For example, children
with a mathematics automatization
disability did not fail on linguistic, pro-
cedural, or mental representation tasks
(Desoete & Roeyers, 2001). Moreover,
only a small majority of the third
graders with MLD had inaccurate off-
line metacognitive skills. Furthermore,
a minority of the children without
learning problems also had a severe
deficit (–2 SD) on off-line metacogni-
tive skills (Desoete, 2001).
Taking all these findings together,
what we see is a broad spectrum of
MLD that manifest themselves in a
great variety of individual cognitive
and metacognitive profiles in young
children. It might, therefore, be impor-
tant to assess cognitive and off-line
metacognitive skills in children with
MLD. Certainly procedural, linguistic,
mental representation, prediction, and
evaluation skills have to be tested in
order to detect whether these skills are
appropriately developed. Moreover, a
general protocol of cognitive or meta-
cognitive intervention for all children
with MLD might represent overcon-
sumption of therapeutic resources be-
cause not all individual children were
found to have below-average perfor-
mance on tasks depending on these
skills. This leads us to the final section,
namely the inventory of the instruc-
tional interventions and accommoda-
tions implemented to help students
with MLD in Belgium.
Instruction for Children with
MLD in Belgium
When problems with mathematics are
detected, the teacher or parent can ask
the advice of the school psychologist.
In most cases, problems with mathe-
matics are regarded as problems to be
solved within the classroom and
within the school system. The school
psychologist and the care coordinator
(zorgcoördinator) then look at exercises
done in the classroom and, if necessary,
give an additional mathematics test.
Special groups may be formed within
the classroom for several hours during
the week in order to differentiate be-
tween fast and slow learners (broader
care or zorgverbreding). In addition,
STICORDI (Stimulating, Compensat-
ing, Relativating, and Dispensating)
measures can be agreed upon in some
kind of pedagogical charter. When
broader care is insufficient, then bring-
ing in a remedial teacher (taakleer-
kracht) is the usual next step. Here the
children are given special exercises in a
special classroom for 6 months (on an
individual basis or in small groups) in
an attempt to remedy their problems.
After 6 months to 1 year, children
with resistant, severe problems with
mathematics in primary school often
move to one of the rehabilitation cen-
ters or centers specialized in handling
educational problems to get a more
elaborate assessment. After an inter-
view with the parents, the child, the
teacher, and sometimes the school psy-
chologist, and after an elaborate series
of tests, interviews, and observations,
the diagnosis and label of LD is often
given.
Some of the children with LD are
also advised to repeat a year in general
education. In Flanders, 10% of all sixth
graders have repeated 1 or more years
of primary school (Hellinckx & Gh-
esquière, 1999). In other cases, children
are referred to special education (Type
8), although, as previously mentioned,
there is a strong movement toward in-
clusive education.
In Flanders, young children of aver-
age intelligence up to the age of 15 who
have a learning disability, a score lower
than Percentile 4 on a mathematics test,
and a need for a multidisciplinary ap-
proach, can follow a course of therapy
for 2 years (two or three times a week)
in a rehabilitation center. Moreover,
there are some situations in which psy-
chologists and educators, and in some
cases also remedial teachers and care
coordinators, set up a special thera-

peutic program for these children. This
program sometimes fits within the
general education system, although for
many children, it is provided by psy-
chologists and other specialists outside
the school. In other cases, when a spe-
cific isolated mathematics retardation
of 1 year (for 7- to 9-year-olds) or 2
years (for 9- to 14-year-olds) is found,
a monodisciplinary therapy is advised,
and the children go to private mathe-
matics therapists (in Flanders, often
specialized speech–language thera-
pists or specialized physiotherapists).
The different approaches taken to
therapy for children with MLD in Flan-
ders can vary greatly. However, most
therapists apply a rather cognitive/
metacognitive and task-analytical
therapy based on the learning of algo-
rithms and heuristics. The instruction
principles are isolation (orientation,
demonstration, practice, shortening,
control, working faster, knowing when
and where to use the principles), inte-
gration, and generalization (Ruijsse-
naars, 2001). This is frequently combined
with stimulating a realistic sense of self-
esteem in young children and a correct
identification of their successes and
failures in school performance. Often,
therapists also use self-instructional
techniques, for example to teach chil-
dren how to handle word problems
(“read the instructions,” “see if you un-
derstand all the words,” “make a dia-
gram or drawing of the situation,”
etc.). A minority of therapists in Flan-
ders use a more psychomotor ap-
proach to dealing with mathematical
problems in young children. However,
in many cases, a combination of thera-
peutic approaches is used from a more
eclectic perspective. The form that the
course of therapy actually assumes de-
pends to a great extent on the assess-
ment of the problems of the individual
child.
Summary
Flemish students seem to do quite well
on mathematics compared with young-
sters in other countries. However, be-
VOLUME 37, NUMBER 1, JANUARY/FEBRUARY 2004
tween 3% and 8% of students in Flan-
ders have MLD in primary school.
Moreover, MLD seems to be very per-
sistent, leading to residual problems
with mathematics in adolescence and
even in adulthood.
We have argued that although many
authors agree that an operational defi-
nition of LD is meaningful, most stud-
ies are rather vague when it comes to
objectively defining the characteristics
on the basis of which they identify chil-
dren with learning disabilities. Over-
lapping concepts and terms are fre-
quently used to deal with a wide range
of phenomena relating to children who
have difficulties with mathematical
problem solving. In an effort to be
more explicit, we have adopted three
criteria (discrepancy criterion, severe-
ness criterion, and resistance criterion)
for ascertaining whether an individual
child belongs to the group of children
with MLD.
Moreover, we have stressed the need
for care in the assessment and diagno-
sis of children with MLD. More specif-
ically, we have referred to the impor-
tance of using a combination of
mathematical tests for young children,
including at least one test of number
facts and one test of domain-specific
mathematics knowledge or word prob-
lems, in order to avoid basing an entire
diagnosis on a single test. Further-
more, we have found that teachers’
judgments seem to be an absolute re-
quirement for confirming the test re-
sults. Our research revealed the impor-
tance of also testing the reading skills
of children with MLD in order to dif-
ferentiate children with a specific
mathematics learning disability from
children with combined LD. Further-
more, quite a number of children with
MLD were found to have less devel-
oped linguistic, procedural, and men-
tal representation skills, and a majority
of the children with MLD were found
to have inaccurate off-line metacogni-
tive skills. It may be advisable also to
assess the cognitive and metacognitive
skills of young children with MLD.
We further clarified that in Belgium,
most young children with LD remain
57
in general education in kindergarten.
Once the children are in primary
school, the learning disabilities often
become obvious. With the new mathe-
matics curriculum and the realistic ap-
proach (RME), additional research is
certainly needed to determine their
effect on children with MLD. Once
the problems with mathematics are
detected, the school psychologist is
consulted. This psychologist often
suggests a differentiated approach
(broader care) or remedial teaching for
6 months. If this is not sufficient, a
more elaborate assessment is carried
out, and a therapy plan is established.
This therapy is partially financed by
the government for a period of 2 years.
After this period, in theory, the MLD
should be remedied. However, in prac-
tice, children in secondary or higher
education with MLD encounter even
more difficulties, which may lead to a
very low self-concept and to behavior
problems. These findings indicate that
more in-depth research is certainly
needed on the prevention and early de-
tection of signals indicating potential
MLD in preschool children. Moreover,
studies on adolescents and even adults
with MLD would be useful in order to
gain more insight into the emotional
and behavioral impact of their disabil-
ities.
The findings from recent studies also
provided evidence that educational in-
terventions for students with LD can
produce positive effects of respectable
magnitude (Desoete & Roeyers, 2003;
Desoete, Roeyers, Buysse, & De Clercq,
2002; Efklides, Papadaki, Papantoniou,
∪
& Kiosseooglou, 1997; Masui & De
Corte, 1999; Swanson, Hoskyn, & Lee,
1999). However, a number of problems
that students with MLD encounter con-
tinue to make themselves felt into
adulthood. In Belgium, most therapists
were found to apply a rather cognitive/
metacognitive therapy, based on the
learning of algorithms and heuristics.
This approach was often found to be
combined with efforts to remedy the
emotional aspects of the learning dis-
ability. In most cases, a combination of
therapeutic approaches is used for an
58
individual child, depending on the as-
sessment results.
It is important to keep in mind that
we have restricted most of our studies
to third graders with MLD in Flanders.
Therefore, on several aspects, further
research can be recommended. On the
one hand, cognition and off-line meta-
cognition needs to be studied in
younger and older children and in
children with below-average or above-
average intelligence. Moreover, indi-
vidual studies of children with MLD
are clearly needed to help us translate
the findings at the group level into re-
medial measures specifically suited to
individual children. We believe that
the research data derived from such
studies would improve our under-
standing of individuals with MLD.
In conclusion, we have found that
MLD can be very persistent. We have
also found that a well-elaborated as-
sessment and intervention procedure
is of key importance, because there ap-
pears to be a broad spectrum of MLD
that come to expression in a broad
range of highly individual cognitive
and metacognitive profiles in young
children.
ABOUT THE AUTHORS
Annemie Desoete, PhD, is a researcher at
Ghent University in Ghent, Belgium. Her re-
search interests are in the area of mathematics
learning disabilities. Herbert Roeyers, PhD, is
assistant professor of clinical psychology at
Ghent University. His research interests are in
the area of developmental and behavioral dis-
orders. Armand De Clercq, PhD, is professor
of applied mathematics. His research interests
are in the area of computer science. Address:
Annemie Desoete, Ghent University, Depart-
ment of Clinical Psychology, Research Group
Developmental Disorders, Henri Dunantlaan
2, B-9000 Gent, Belgium; e-mail: Anne.
Desoete@UGent.be
AUTHORS’ NOTE
This study was supported by the Artevelde
College in Ghent and the Stichting Integratie
Gehandidapten (SIG), to whom the authors ex-
tend their thanks.
JOURNAL OF LEARNING DISABILITIES
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