There is a pressing need for feasible, scalable interventions that address children’s and adults’ math anxiety and result in enhanced math learning. In this article, we suggest a pathway toward intervention development. First, we consider what is known about the mechanisms of math anxiety. To treat math anxiety, we must understand both how and why math anxiety interferes with mathematical learning, thinking, and problem-solving. We then review current approaches to ameliorating math anxiety. Finally, we consider pathways of developing more effective and robust interventions for math anxiety across the lifespan. We highlight clinical approaches to math anxiety and advocate for a double-pronged approach to “break the cycle” of math anxiety transmission from adults to children.

Playful fraction picture books, together with math instructional content called “back matter,” may promote fraction learning, which is crucial because fractions are difficult and often disliked content. However, open questions remain regarding how different types of back matter may affect caregivers’ ability to use fraction picture books as a teaching tool. The current study offers a novel investigation into how back matter affects caregivers’ (N = 160) fraction understanding (i.e., equivalence and arithmetic) and subjective beliefs about math using a pretest/posttest design. We contrasted existing back matter text with research-informed back matter text crossed with either circle area or number line visual displays. Caregivers’ performance improved from pretest to posttest in the Researcher-Generated + Circles condition (fraction equivalence) and in the Existing + Circles, Researcher-Generated + Circles, and Researcher-Generated + Number Lines conditions (fraction arithmetic). In addition, caregivers were aware of their learning; they predicted improvements in their fraction arithmetic performance over time. These findings suggest that brief interventions, such as back matter in children’s picture books, may improve adults’ fraction understanding.

Comparing health risks is challenging. We tested whether a worked-example intervention with number line (NL) visual displays improved adults' risk comparison accuracy, whether pretest confidence moderated learning, and which individual differences related to accuracy. Replicating prior work, U.S. adults randomly assigned to the intervention (n = 883) were more accurate than control participants (n = 949) at solving health-related math problems with number line visual displays and a transfer problem without a visual display. One day later, most participants were accurate and there were no differences between conditions, potentially because participants with better math skills and attitudes participated at follow-up. However, there was a small effect on accuracy 1 day later among those who learned from the intervention. Adults were more likely to learn from the intervention if they made a low-confidence pretest error. Identifying as male, accurately estimating numbers on number lines, lower math anxiety, higher educational attainment, and being older were associated with greater risk comparison accuracy.

Dealing with numbers is an inherent aspect of interpreting health statistics, and negative emotions may interfere with medical decision making. One emotionally charged decision-making context is parents making medical decisions for their children. Knowing which factors–such as anxiety specific to math contexts–are associated with parents’ negative emotions during the decision-making process may inform ways to better support families as they make critical medical decisions. The current study involved secondary data analyses of an experiment with 249 parents. Participants were randomly assigned to make hypothetical health decisions for themselves, their child, or a stranger. We examined which domain-specific math (e.g., math anxiety), domain general (i.e., need for cognition), and demographic variables (e.g., parents’ health-care coverage) were associated with ratings of negative emotional activation immediately after making the decisions. Results indicated that two factors were significantly associated with parents’ ratings of negative emotional activation: (1) the person they were making decisions about (i.e., higher negative emotion activation if they were randomly assigned to make hypothetical health decisions about their child versus themselves or a stranger), and (2) parents’ ratings of their own math anxiety (i.e., parents with higher self-reported math anxiety also reported higher negative emotional activation). Future research may further consider the joint roles of emotional activation and math anxiety in how parents make health decisions for their children. Further, understanding how much math anxiety causally contributes to people’s overall negative emotional activation could lead to a more nuanced understanding of negative emotional activation in health decision making.

Rational numbers (i.e., fractions, percentages, decimals, and whole-number frequencies) are notoriously difficult mathematical constructs. Yet correctly interpreting rational numbers is imperative for understanding health statistics, such as gauging the likelihood of side effects from a medication. Several pernicious biases affect health decision-making involving rational numbers. In our novel developmental framework, the natural-number bias—a tendency to misapply knowledge about natural numbers to all numbers—is the mechanism underlying other biases that shape health decision-making. Natural-number bias occurs when people automatically process natural-number magnitudes and disregard ratio magnitudes. Math-cognition researchers have identified individual differences and environmental factors underlying natural-number bias and devised ways to teach people how to avoid these biases. Although effective interventions from other areas of research can help adults evaluate numerical health information, they circumvent the core issue: people’s penchant to automatically process natural-number magnitudes and disregard ratio magnitudes. We describe the origins of natural-number bias and how researchers may harness the bias to improve rational-number understanding and ameliorate innumeracy in real-world contexts, including health. We recommend modifications to formal math education to help children learn the connections among natural and rational numbers. We also call on researchers to consider individual differences people bring to health decision-making contexts and how measures from math cognition might identify those who would benefit most from support when interpreting health statistics. Investigating innumeracy with an interdisciplinary lens could advance understanding of innumeracy in theoretically meaningful and practical ways.

Mathematical problem solving is a process involving metacognitive (e.g., judging progress), cognitive (e.g., working memory), and affective (e.g., math anxiety) factors. Recent research encourages researchers who study math cognition to consider the role that the interaction between metacognition and math anxiety plays in mathematical problem solving. Problem solvers can make many metacognitive judgments during a math problem, ranging from global judgments such as, "Do I care to solve this problem?" to minor cue-based judgments such as, "Is my current strategy successful in making progress toward the correct solution?" Metacognitive monitoring can hinder accurate mathematical problem solving when the monitoring is task-irrelevant; however, task-relevant metacognitive experiences can lead to helpful control decisions in mathematical problem solving such as checking work, considering plausibility of an answer, and considering alternate strategies. Worry and negative thoughts (i.e., math anxiety) can both interfere with the accuracy of metacognitive experiences as cues in mathematical problem solving and lead to avoidance of metacognitive control decisions that could otherwise improve performance. The current paper briefly reviews and incorporates prior literature with current qualitative reports (n = 673) to establish a novel framework of regulated attention in mathematical problem solving (RAMPS).

Ordinal processing plays a fundamental role in both the representation and manipulation of symbolic numbers. As such, it is important to understand how children come to develop a sense of ordinality in the first place. The current study examines the role of the count-list in the development of ordinal knowledge through the investigation of two research questions: (1) Do K-1 children struggle to extend the notion of numerical order beyond the count-list, and if so (2) does this extension develop incrementally or manifest as a qualitative re-organization of how children recognize the ordinality of numerical sequences. Overall, we observed that although young children reliably identified adjacent ordered sequences (i.e., those that match the count-list; '2-3-4') as being in the correct ascending order, they performed significantly below chance on non-adjacent ordered trials (i.e., those that do not match the count-list but are in the correct order; '2-4-6') from the beginning of kindergarten to the end of first grade. Further, both qualitative and quantitative analyses supported the conclusion that the ability to extend notions of ordinality beyond the count-list emerged as a conceptual shift in ordinal understanding rather than through incremental improvements. These findings are the first to suggest that the ability to extend notions of ordinality beyond the count-list to include non-adjacent numbers is non-trivial and reflects a significant developmental hurdle that most children must overcome in order to develop a mature sense of ordinality.

BACKGROUND:People report negative attitudes towards fractions and percentages relative to whole numbers (WNs, Sidney, Thompson, Fitzsimmons, & Taber, 2021), and these attitudes may relate to an individual's interpretation of what experiences with these number types signify. Because fractions are challenging, individual differences related to beliefs about challenge, such as endorsement of a growth versus fixed mindset (Dweck, 2006) and interpretations of easy or difficult experiences (Fisher & Oyserman, 2017), could relate to attitudes towards fractions relative to other number types.AIMS:Two studies tested whether gender, math skills, mindset beliefs, and perceptions of difficulty relate to negative math attitudes towards specific number types.SAMPLES:Two samples of college students (Study 1: N = 491; Study 2: N = 415), approximately 19 years of age (17% male, 51% first year students) participated.METHODS:Participants rated attitudes pertaining to WNs, fractions, and percentages, endorsement of a growth mindset, and perceptions of ease and difficulty.RESULTS:Replicating prior work (Sidney, Thompson, Fitzsimmons, & Taber, 2021), college students endorsed more negative attitudes about fractions than WNs and percentages. Self-reported ACT scores related to all number-type attitudes, endorsement of the belief that 'difficult tasks/goals are important' related to fraction attitudes, and endorsement of the belief that 'easy tasks/goals are possible' related to whole number attitudes. Endorsement of a growth mindset did not relate to specific math attitudes.CONCLUSIONS:People struggle to integrate their whole number and rational number representations, and one reason people hold negative attitudes about fractions may be that they view them as difficult and even impossible.

The advent of COVID-19 highlighted widespread misconceptions regarding people's accuracy in interpreting quantitative health information. How do people judge whether they accurately answered health-related math problems? Which individual differences predict these item-by-item metacognitive monitoring judgments? How does a brief intervention targeting math skills-which increased problem-solving accuracy-affect people's monitoring judgments? We investigated these pre-registered questions in a secondary analysis of data from a large Qualtrics panel of adults (N = 1,297). Pretest performance accuracy, math self-efficacy, gender, and math anxiety were associated with pretest item-level monitoring judgments. Participants randomly assigned to the intervention condition, relative to the control condition, made higher monitoring judgments post intervention. That is, these participants believed they were more accurate when answering problems. Regardless of experimental condition, those who actually were correct on health-related math problems made higher monitoring judgments than those who answered incorrectly. Finally, consistent with prior research, math anxiety explained additional variance in monitoring judgments beyond trait anxiety. Together, findings indicated the importance of considering both objective (e.g., problem accuracy) and subjective factors (e.g., math self-efficacy, math anxiety) to better understand adults' metacognitive monitoring.