In the complex world of childhood neurodevelopment, some conditions present clear symptoms with straightforward interventions. Others, like PANDAS, bring a confusing mix of psychiatric, neurological, and academic struggles—sometimes emerging seemingly overnight. Among the cognitive consequences of PANDAS are difficulties in math and spatial reasoning, areas also impacted by dyscalculia and visual-spatial processing disorders. Understanding how these conditions intersect is essential for timely intervention.
What is PANDAS?
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections, occurs when a child’s immune system reacts to a streptococcal infection by producing antibodies that mistakenly target the brain, particularly the basal ganglia. This results in a sudden onset of psychiatric symptoms such as obsessive-compulsive behaviors, anxiety, emotional volatility, and sometimes motor tics.
One lesser-known but increasingly recognized effect of PANDAS is academic regression—particularly in handwriting, reading, and math. Parents often report that their child, previously competent in schoolwork, suddenly struggles with basic tasks, including number sense and spatial organization.
Visual-spatial difficulties: When perception goes awry
Visual-spatial disorder affects a child’s ability to interpret visual information about where objects are in space. These children may have trouble judging distance, copying shapes, understanding maps, or aligning numbers correctly on a page. While the eyes may function normally, the brain struggles to interpret spatial relationships, which are crucial for both navigation and academic tasks.
Visual-spatial challenges can become particularly evident in early primary school when children are asked to perform tasks like copying from a board, using manipulatives in math, or organizing information on a worksheet. These tasks require a blend of spatial awareness, motor planning, and working memory—functions that can be impaired in children with PANDAS due to inflammation in neural circuits.
Understanding dyscalculia: A math-specific learning disorder
Dyscalculia is a brain-based learning disability that affects numerical understanding. Children with dyscalculia may struggle with counting, understanding number magnitude, estimating, recalling math facts, or following the steps of a problem. While the severity and profile can vary, the core issue is a persistent difficulty with mathematical reasoning and problem-solving.
Importantly, dyscalculia frequently co-occurs with visual-spatial processing problems. For example, a child struggling to understand spatial relationships may also struggle with aligning numbers in long division, reading graphs, or interpreting geometric diagrams.
Where they overlap
The relationship between PANDAS, visual-spatial deficits, and dyscalculia is not linear but interwoven. PANDAS often causes sudden changes in cognitive functioning, particularly in skills related to the basal ganglia and cerebellum—brain regions implicated in both motor control and procedural learning.
When a child experiences a flare-up of PANDAS, their ability to organize thoughts, coordinate movements, and manage visual-spatial information may deteriorate. In turn, math performance suffers—not just due to skill loss but also due to increased anxiety, perfectionism, and compulsive behavior, which are hallmarks of PANDAS.
In other cases, a child with pre-existing dyscalculia may exhibit intensified symptoms following a PANDAS episode, leading to a layered presentation that can complicate diagnosis and intervention.
The diagnostic puzzle
Misdiagnosis is a common risk. A child who was previously performing well in math may suddenly show symptoms of dyscalculia, leading to the assumption of a long-standing learning disorder. However, the onset pattern and coexisting emotional changes may point to a medical trigger like PANDAS. Conversely, long-standing difficulties may be overlooked if new behavioral symptoms dominate the clinical picture.
For clinicians, educators, and parents, distinguishing between these conditions—or recognizing their co-occurrence—is vital. Interventions must address both the underlying neurological inflammation in PANDAS and the cognitive learning challenges associated with dyscalculia and visual-spatial disorder.
Supporting the child holistically
Effective intervention includes medical treatment for PANDAS (typically antibiotics and immune-modulating therapies), along with targeted educational support for math and spatial difficulties. Cognitive retraining and math remediation programs tailored to the child’s profile are crucial.
Ultimately, the goal is to reduce the academic and emotional toll on the child by recognizing the multifaceted nature of their challenges. Children can recover lost skills and thrive academically with early recognition and interdisciplinary care.
A success story
Hannah was diagnosed with PANDAS, which caused a loss of academic abilities, particularly in visual-spatial processing and math. Listen to Hannah’s story of overcoming the symptoms of a visual-spatial disorder and dyscalculia.
Edublox offers cognitive training and live online tutoring to students with dyscalculia and other learning disabilities. Our students are in the United States, Canada, Australia, and elsewhere. Book a free consultation to discuss your child’s learning needs.
References for PANDAS, Visual-Spatial Disorder, and Dyscalculia: How They Overlap; How to Help
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PANDAS, Visual-Spatial Disorder, and Dyscalculia: How They Overlap; How to Help was authored by Sue du Plessis (B.A. Hons Psychology; B.D.), an educational specialist with 30+ years of experience in the learning disabilities field.
