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As Dr Gorzny rightly states, sensory deficits (for example, visual disorders) should be excluded before a diagnosis of dyscalculia is made. According to anecdotal case reports, learning disabilities are sometimes associated with heterophoria, which Dr Gorzny mentioned. It should be emphasized, however, that many children with a diagnosis of dyscalculia do not have visual impairments and that the main symptoms of dyscalculia—that is, massive difficulties in acquiring basic calculating skills in spite of adequate schooling and good intellectual capacity (1)—can therefore occur independently of vision defects. In this context it is worth mentioning the results of recent psychophysical studies, according to which children with severe dyscalculia (a PR<10) have reduced sensitivity to coherent motion perception (2). These subtle problems of visual processing are, however, measurable only by using special experimental testing procedures and do not seem specific to dyscalculia (that is, they may be associated with different learning disabilities). Whether such reduced sensitivity for movement perception is associated with heterophoria, as was stated by Dr Gorzny, remains an unanswered question for now.

The letter by Dr Calia refers to psychosocial difficulties, which are often associated with learning disabilities and is a plea for greater attention for these secondary problems, especially in the school environment. We would like to thank Dr Calia for his committed position. The psycho-emotional and psychosocial problems that are often associated with learning disabilities (3) should assume the same order of importance for the diagnosis and treatment planning of learning disabilities as cognitive (learning) disabilities in the narrower sense.

DOI: 10.3238/arztebl.2013.0146c

Prof. Dr. rer. nat. Liane Kaufmann

Institut für Angewandte Psychologie
UMIT-Universität für Gesundheitswissenschaften,
Medizinische Informatik und Technik
Hall in Tirol
liane.kaufmann@tilak.at

Prof. Dr. med. Michael von Aster

Klinik für Kinder- und Jugendpsychiatrie

Psychotherapie und Psychosomatik

DRK-Kliniken Berlin Westend

Conflict of interest statement

The author declares that no conflict of interest exists. .

1.
Dilling H, Mombour W, Schmidt MH: Internationale Klassifikation psychischer Störungen. ICD-10 Kapitel V (F). Klinisch-diagnostische Leitlinien (6., vollständig überarbeitete Auflage). Bern: Huber 2008.
2.
Sigmundsson H, Anholt SK, Talcott J: Are poor mathematical skills associated with visual deficits in temporal processing? Neuroscience Letters 2010; 469: 248–50. CrossRef MEDLINE
3.
Kohn J, Wyschkon A, Esser G: Psychische Auffälligkeiten bei umschriebenen Entwicklungsstörungen: Gibt es Unterschiede zwischen Lese-Rechtschreib- und Rechenstörungen? Lernen und Lernstörungen 2013; 2: 7–20. CrossRef
4.
Kaufmann L, von Aster M: The diagnosis and management of dyscalculia. Dtsch Arztebl Int 2012; 109(45): 767–78. VOLLTEXT
1.Dilling H, Mombour W, Schmidt MH: Internationale Klassifikation psychischer Störungen. ICD-10 Kapitel V (F). Klinisch-diagnostische Leitlinien (6., vollständig überarbeitete Auflage). Bern: Huber 2008.
2.Sigmundsson H, Anholt SK, Talcott J: Are poor mathematical skills associated with visual deficits in temporal processing? Neuroscience Letters 2010; 469: 248–50. CrossRef MEDLINE
3.Kohn J, Wyschkon A, Esser G: Psychische Auffälligkeiten bei umschriebenen Entwicklungsstörungen: Gibt es Unterschiede zwischen Lese-Rechtschreib- und Rechenstörungen? Lernen und Lernstörungen 2013; 2: 7–20. CrossRef
4.Kaufmann L, von Aster M: The diagnosis and management of dyscalculia. Dtsch Arztebl Int 2012; 109(45): 767–78. VOLLTEXT

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