Children who start elementary school with difficulty associating small exact quantities of items with the printed numerals that represent those quantities are more likely to develop a math-related learning disability than are their peers, according to a study supported by the National Institutes of Health.

The children in the study who appeared to have difficulty grasping the fundamental concept of exact numerical quantities — that the printed numeral 3, for example, represents three dots on a page — went on to be diagnosed with math learning disability by fifth grade.

Other early factors correlated with a math learning disability were difficulty recalling answers to single-digit addition problems, distractibility in class, and difficulty understanding that more complex math problems can be broken down into smaller problems that can be solved individually.