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Recent studies indicate that math anxiety (MA) can already be found in schoolaged children. As early MA depicts a potential risk for developing severe mathematical difficulties and impede the socioemotional development of children, distinct knowledge about how to reduce MA in schoolaged children is of particular importance. Therefore, the goal of this systematic review is to summarize the existing body of research on MA interventions for children by identifying the approaches, designs, and characteristics as well as the effects of the interventions.
In the last decade, a considerable amount of research focused on math anxiety (MA).
MA can generally be defined as an “anxiety that interferes with manipulation of numbers and the solving of mathematical problems in a wide variety of ordinary life and academic situations” (
The development of MA and its relation to math performance has been investigated in only a few longitudinal studies (
Accordingly, MA could be elicited or increased over time because of math difficulties that often originate in early school years (
Performanceinhibiting effects might, however, also be caused by MA. Such types of MA might be originally developed from environmental factors (e.g., adult role models:
With regard to the described manifold link between MA and mathematical performance, it becomes clear that reducing symptoms of MA might be a relevant approach in supporting children’s mathematical development (
As described, MI might be of particular relevance in light of the described
The effects of CBI can be mainly explained with regard to the described
Most of the existing body of research on MA and MA interventions appears to focus on older adolescents and adults, as MA has been previously associated with more complex mathematics. At the same time, MA could already be observed in schoolaged children and might be associated with early mathematical functioning and numeracy. Therefore, early identification and intervention of MA seems to be of high relevance to prevent negative developmental outcomes. As research on early MA interventions is limited, the exact conditions and characteristics of successful interventions in schoolaged children remain unclear. To our knowledge, no existing work has summarized the existing evidence on the interventional approaches that target MA in childhood. Therefore, the objective of this study is to give an overview of interventional approaches in addressing MA in children and adolescents and to highlight potential characteristics of effective interventions. The study is guided by the following research questions:
1) What are the approaches, designs, and characteristics (e.g., setting, duration) of existing interventions aiming at the reduction of MA in school children?
2) What are the effects of these existing interventions?
Answers to these questions might contribute to the field of MA intervention research, as they might serve as a foundation and orientation for future intervention studies aiming at improving children’s emotional wellbeing and academic development in schools, especially regarding mathematics.
As MA has been addressed in previous research, we aim to identify characteristics of effective interventions based on the existing body of research. Therefore, we conduct a systematic (scoping) review. Thereby, we will describe the main findings of the included studies and highlight specific components using a narrative approach.
To identify all relevant studies, we used a twostep approach. In a first step we conducted a systematic search in the most widely used electronic databases in psychological and educational research. Therefore, we focused on the databases PsycINFO and PubPsych. PubPsych is a multilingual database that includes entries from additional databases, such as PSYNDEX, MEDLINE and ERIC (Educational Resources Information Center). We used the descriptors: math (ematics) anxiety AND intervention OR treatment OR therapy OR program OR training OR tutoring OR support OR strategies OR best practice, AND alleviation as well as its synonyms reduction OR decrease OR remediation. Additionally, a German translation of the descriptors was used. To prevent the exclusion of relevant studies at an early stage no filters were used except the exclusion of dissertations as full texts are often difficult to access. We additionally identified studies by hand search, i.e., visually scanning reference lists from relevant studies or theoretical papers. The literature search was conducted in July 2020 and October 2021.
Studies were eligible for the systematic review if they met all the following inclusion criteria:
• Participants received intervention or a combination of interventions.
• Participants were assessed with a quantitative and/or qualitative measure of MA.
• Participants were of schoolage (5–17 years old).
Studies were not eligible if they met one of the following exclusion criteria:
• The study was no intervention study (e.g., theoretical paper, literature review, metaanalysis, or correlation study).
• Participants did not match the target population (e.g., university students or (preservice) teachers).
• The study was published in a language other than English or German.
The selection of eligible studies was conducted in two stages. Firstly, we employed an initial screening of titles and abstracts against the inclusion and exclusion criteria. Screening procedures followed PRISMA guidelines (
The described inclusion and exclusion criteria were applied during the selection process (for an overview of the study selection process see
Study selection process following PRISMA guidelines.
Next to general information about the studies, such as author(s), year of publication, and title, we extracted relevant data to address our specific research questions. Regarding our first research question (approaches, designs, and characteristics of existing interventions) we coded all information given by the author(s) about the study design, interventions, and their respective settings. This included information about the general study approach (quantitative, qualitative, mixed method), the study design (preposttest, follow up, control/comparison group), the operationalization of MA, as well as data about sample size and age group of the participants. Regarding the intervention we extracted information about the content as well as the intended goal of the interventions. We also coded the duration of the interventions (overall time span and number of sessions), the duration of single sessions, the intervention mode (computerbased, facetoface), and the social arrangement (single, partner, small groups, class). Concerning our second research question (effects of these existing interventions) we coded the key results of the studies regarding the effectiveness of the intervention(s) to reduce MA as reported by the authors.
Relevant information has been coded using a spread sheet covering the previously described categories. The number of free text fields has been limited as much as possible to enable an unambiguous extraction and analysis of the data. Preferably fixed text such as yes/no decisions and dropdown lists has been used to code the data. The data extraction spread sheet has been previously piloted and adapted.
For a complete overview over all included studies (reference, sample, design, MA measure, operationalization type of MA, intervention, setting, and main findings) see
Overview of included studies.
Reference  Sample  Design  MA measure  MA operationalization type 
Intervention  Setting  Main findings 





quantitative; prepost; control group  Math Anxiety Scale for children MASC; 
Hyp/retro (statelikeMA) and anxiety about failure in math (traitMA)  Active recreational math games (vs. regular math teaching)  Facetoface; Small group; 8 weeks; 3 sessions (45 min each) per week  Intervention group obtained lower MA scores and higher math performance than the control group 


quantitative; prepost; comparison group  Escala de Ansiedade à Matemática (Math Anxiety Scale) EAM; 
Hyp/retro (statelikeMA)  Numeracy musical training 
Facetoface; Small group; 8 weeks; 1 session (40 min) per week  Both groups obtained lower MA scores and higher math performance 


quantitative; prepost; comparison group  Math Anxiety Scale for students (MASS) revised by 
Hyp/retro (statelikeMA)  Quadratic functions training and Brain Integration in Education program BIE; 
Facetoface; 3 lessons  Reduction of MA in high MA group; No reduction of MA in low MA group 


qualitative; single case  Field notes, recordings, interviews  Not classifiable  Algebra training, individual support  Facetoface; Single  One student needed more support to address MA than the other; Both improved math performance 


quantitative; prepost; control group  Math Anxiety Scale for 1st and 2nd grade students 
No further information  Digital gamebased learning with diagnostic feedback (vs. without diagnostic feedback)  Computer; Single; 6 weeks; 2 sessions (40 min each) per week  Both groups obtained lower MA scores and enhanced levels of learning motivation 


quantitative; prepost; control group  Math Anxiety Scale for children MASC; 
Hyp/retro (statelikeMA) and anxiety about failure in math (traitMA)  Adaptive math training software 
Computer; Class; 6 weeks; 4 sessions (15 min each) per week  All groups obtained lower MA scores; Math performance only improved in the experimental conditions 


quantitative; prepost; control group  Questionnaire adapted from 
Hyp/retro (statelikeMA) and anxiety about failure in math (traitMA)  Selfregulated math learning (SRL) based on the IMPROVE method 
Facetoface; Class; 4 weeks; 4 h per week  Intervention group obtained lower MA scores and higher math problem solving than the control group 


quantitative; prepost; control group  Math Anxiety Scale (18 items; no further information)  No further information  Cooperative learning (vs. regular math teaching)  Facetoface; Class; 8 sessions  Intervention group obtained lower MA scores and increased help seeking behavior than the control group 


quantitative; prepost; control group  Math Anxiety Remote Sensing Scale (MARS) by 
No further information  Cooperative learning (vs. regular math teaching)  Facetoface; Small group  Intervention group obtained lower MA scores, higher math performance, and increased help seeking behavior than the control group 


quantitative; prepost; comparison group  Math Anxiety Scale by 
Hyp/retro (statelikeMA) and anxiety about failure in math (traitMA)  Computer assisted math instruction TOAM system 
Computer; Pairs; 20 min per session  Low achieving students in cooperative group obtained lower MA scores and higher math performance than in individual group; Both groups showed similar math selfconcept 


quantitative; prepost; control group  Abbreviated Math Anxiety Scale (AMAS; 
Hyp/retro (statelikeMA)  Calculation strategies training (vs. control training)  Facetoface; Small group; 8 weeks; 1 session (60 min each) per week  Intervention group obtained lower MA scores and higher math performance than the control group 


quantitative; prepostfollow up; control group  MAI 
Hyp/retro (statelikeMA)  Adaptive math training Calcularis e.g., 
Computer; Single; 6 weeks; 5 sessions (20 min each) per week  Intervention group obtained lower MA scores than waiting list control group; No difference in MA between intervention group and control training group; All groups improved similarly in their attitude towards math and math selfconcept 


quantitative; prepost; comparison group  Math Anxiety Level SEMA 
Hyp/retro (statelikeMA)  Adaptation of MathWise 
Facetoface; 8 weeks; Single; 3 sessions (45 min each) per week  Reduction of MA in High MA group; Math performance improved equally in both groups 


quantitative; prepost; control group  Math Anxiety Scale by 
Hyp/retro (statelikeMA) and anxiety about failure in math (traitMA)  Metacognitive strategy training (KnowWantLearnStrategy) (vs. regular math teaching)  Facetoface; Class; 8 weeks; 4 sessions (40 min each) per week  Intervention group showed no reduction of MA but obtained higher math performance and metacognition than the control group 


quantitative; prepost; control group  Math Anxiety Scale by 
Hyp/retro (statelikeMA) and anxiety about failure in math (traitMA)  Teaching math creatively (vs. regular math teaching)  Facetoface; Class; 6 weeks; 4 sessions (40 min each) per week  Intervention group obtained lower MA scores, higher math performance, and better attitudes towards math than the control group 


quantitative; prepostfollow up; control group  Child Math Anxiety Questionnaire – Revised CMAQR; 
Hyp/retro (statelikeMA)  Digital gamebased learning in reading and math (vs. regular math teaching)  Computer; 8 weeks; Single; 1–2 sessions (50 min each) per week  Intervention group showed no reduction of MA but performed better in number line estimation and reading competence than the control group 


quantitative; prepostfollow up; comparison group  StateMath Anxiety Questionnaire stateMAQ; e.g., 
StateMA (realtime assessment)  Adaptive educational math game 
Computer; 3 weeks; Single; 2 sessions (30 min each) per week  Both groups obtained lower MA scores and improved on early numeracy skills 
II – 



quantitative; prepost; control group  Math Anxiety Rating Scale (MARS) by 
Hyp/retro (statelikeMA)  Cognitive behavioral therapy based on 
Facetoface; Small group; 1 session (90 min each) per week  Intervention group obtained lower MA scores and higher math selfconcept than the control group 


quantitative; prepost; control group  Math Anxiety Rating Scale – Revised MARSR, 
Hyp/retro (statelikeMA)  Problem solving training (vs. class debate)  Facetoface; 8 sessions (60 min each)  Intervention group obtained lower MA scores than the control group 


quantitative; prepost; control group  Achievement Emotions Questionnaire – Mathematics (AEQM) – German 
Hyp/retro (statelikeMA)  Combined student and teacher workshops on e.g., emotions, motivation, learning goals, cooperative learning, and feedback (vs. student workshops only vs. waiting list)  Facetoface; 38 weeks; Class; 3–4 sessions (45 min each)  All groups obtained lower MA scores; Intervention group reported higher joy of learning than the waiting list control group and the student workshops only group 


quantitative; prepost; control group  Scale of Math Anxiety 
Hyp/retro (statelikeMA)  Coping strategies; mindful breathing; selfregulation (vs. waiting list)  Facetoface; Small group; 4 weeks; 3 sessions (45 min each) per week  Intervention group showed no reduction of MA or enhancement of math selfconcept but higher math performance than the control group 


quantitative; prepost; control group  Math Anxiety Rating Scale MARS, 
Hyp/retro (statelikeMA)  Expressive writing on feelings about math (vs. expressive writing on neutral topic)  Single; 15–30 min a day for 3 days  Intervention group reported reduced levels of general and MA and the control group had a reduction in MA. 


quantitative; prepost; comparison group  Think out loud (selftalk measure)  Not classifiable  Coping strategy training (students with learning disability (LD) vs. students without LD)  Facetoface; Small group; 6 weeks; 1 session per week  LD group showed increase in positive selftalk compared to group without LD group indicating enhanced coping with MA. 


quantitative; prepost; control group  Math Anxiety Rating Scale MARS, 
Hyp/retro (statelikeMA)  Cognitive behavior group therapy (vs. control group not further described)  Facetoface; Small group; 7.5 weeks; 2 sessions (90 min each) per week  Intervention group obtained lower MA scores than the control group 


quantitative; prepost; control group  Math Anxiety Rating Scale – Revised MARSR, 
Hyp/retro (statelikeMA)  Embodied agent with instructional guidance and anxiety treating messages (vs. embodied agent with instructional guidance only)  Computer; Class; 1 week; 4 sessions (45 min each) per week  Both groups obtained lower MA scores and higher math performance 


quantitative; single case design with multiple baselines  FennemaSherman Math Anxiety Scale – Revised (FSMASR: FSANX subscale)  Hyp/retro (statelikeMA)  Mindfulnessbased cognitive therapy  Facetoface; Single; 6 weeks; 2 sessions (45 min each) per week  All three students showed decreased levels of MA. 


quantitative; prepost; control group  Abbreviated Math Anxiety Scale (AMAS; 
Hyp/retro (statelikeMA)  Identifying and coping with MA related feelings (vs. control training)  Facetoface; Small group; 8 weeks; 1 session (60 min each) per week  Intervention group obtained lower MA scores but no increase in math performance compared to the control group 


quantitative; prepost; control group  Modified Abbreviated Math Anxiety Scale (mAMAS; Carey et al., 2017)  Hyp/retro (statelikeMA)  Expressive writing on math homework problems and feelings (vs. expressive writing on homework problems only)  Single; 2 weeks; every day  No reduction of MA in both groups 


Mixedmethod; prepost  Math Anxiety Scale for children MASC; 
Hyp/retro (statelikeMA) and anxiety about failure in math (traitMA)  School counseling (e.g., identifying and expressing feelings; stress reduction, and relaxation)  Facetoface; Small group; 6 weeks; 2 sessions per weeks  Some students obtained lower MA scores and higher math performance compared to the pretest; Teachers reported more confidence and participation in math class 


quantitative; prepostfollow up; control group  Maths Anxiety Rating Scale for Children MASC, 
Hyp/retro (statelikeMA) and anxiety about failure in math (traitMA)  Systematic desensitization modified from 
Facetoface; 1 session; 1 h  Intervention group obtained lower MA scores and higher math performance than the control group 


quantitative; prepost  Short Math Anxiety Rating Scale (sMARS) based on MARS 
Hyp/retro (statelikeMA)  Behavior modification; Super brain yoga  Facetoface; 6 weeks  Students obtained lower MA scores and higher math performance compared to the pretest 




quantitative; prepost; control group  Math Anxiety Scale (no further information)  No further information  Graphing calculator (vs. no graphing calculator)  Facetoface; Class; 10 weeks  Intervention group obtained lower MA scores and higher math performance scores than the control group 


quantitative; prepostfollow up; control group  Math SelfEfficacy and Anxiety Questionnaire (MSEAQ; 
Hyp/retro (statelikeMA) and anxiety about failure in math (traitMA)  Flipped classroom (vs. regular math teaching)  Computer and facetoface; Single and class  Intervention group obtained lower MA scores than the control group; Both groups increased math performance 


quantitative; prepost; control group  Selfreported perceived Math Anxiety and attitude towards math  Hyp/retro (statelikeMA)  Girlsonly math teaching (vs. mixed gender teaching)  Facetoface; Class  No reduction of MA or increase in perceived math competence in intervention group (single sex girls) but higher math performance and course enrolment than in control group (coed girls) 


quantitative  FennemaSherman Math Anxiety Scale FSMAS, 
Hyp/retro (statelikeMA)  Neuropsychological feedback while playing math computer game ( 
Computer; Single; 2 sessions in 2 days; 4 data gathering waves per session  MA was reduced 
Hyp/retro = hypothetical/retrospective questions about anxiety in mathrelated situations.
Most of the included studies applied either a mathematical intervention (MI) approach (see section I in
The study samples differed between the two main intervention approaches (MI and CBI) in regards to the age groups of the participants. 82% of the MI studies targeted school age children (6–12 years), whereas 57% of the studies within the CBI approach focused on adolescents (13–17 years). Regarding the sample size and choice of study design there appears to be no systematic difference between MI and CBI studies. The majority of the included studies applied a quantitative study design to examine the effects of various interventions on MA. Thereby, the sample size of the included studies varies strongly,
Different quantitative measures have been used to assess the level of MA (for an overview see
The MI covered a wide range of different activities and programs, such as educational games or formalized math programs. Due to the amount of activities, only selected studies are presented in more detail below. The study selection does not constitute an evaluation of the quality of the studies. For a comprehensive overview of all MI see the first section of
The CBI also included different techniques and activities, such as coping strategy training or expressive writing. Due to the amount of activities, only selected studies are presented in more detail below. The study selection does not constitute an evaluation of the quality of the studies. For a comprehensive overview of all CBI see the second section of
The interventions were either carried out facetoface (67.6%) or via computer (23.5%). Three studies (8.8%) did not fit into one of the two categories.
Within the mathematics intervention approach computers were predominantly used to train basic arithmetic operations in primary school children (e.g.,
The interventions were either held in classrooms (29.4%), small groups (32.4%), or individual settings (26.5%). Four studies (11.8%) did not specify the setting of their intervention. There were no significant differences between the settings in regards to the intervention approach.
On average, the included studies applied interventions for
The intervention effects reported by the authors were mixed. 59% of the studies reported a positive effect of the intervention on MA in the intervention group compared to no effect in the control/comparison group (e.g.,
21% of the studies found a positive effect of intervention(s) on MA in both the intervention as well as the control/comparison group (e.g.,
15% of the studies did not find a positive effect of the intervention on the students’ level of MA (e.g.,
The findings did not differ in relation to the applied MA questionnaires. The only study that used a realtime assessment (stateMA) reported a positive effect of a math training on MA, approx. 80% of the studies using questionnaires with hypothetical/retrospective items (statelikeMA/anxiety in mathrelated situations) reported lower MA after the intervention and approx. 90% of the studies using questionnaires focusing anxiety about failure (traitMA) and anxiety in mathrelated situations (statelikeMA) reported lower MA after the intervention.
The goal of this study was to summarize the existing body of research on MA interventions for school children. Therefore, we conducted a systematic (scoping) review and presented the results in a narrative manner.
Generally, the overall number of eligible studies identified in this review was still relatively small, for example compared to general mathematical intervention studies (
More than half of the included studies primarily focused on math performance rather than MA. Hence, MA was often assessed as an affective covariate but was not necessarily the actual target of the intervention. Despite that, almost half of the included MI still reported a positive sideeffect of the intervention on students’ MA compared to the control/comparison group. This supports the assumption that MI can reduce anxiety responses, but might also allow children to reevaluate dysfunctional cognitive beliefs (“I am bad at math”) and to stimulate the formation of new basic cognitive assumptions (e.g., increase of math selfconcept).
As for the CBI, more than half of the included studies reported a positive effect of the intervention on the level of MA compared to the control/comparison group. At the same time, the effect of CBI on math performance was comparatively low. One possible explanation could be that the physiological arousal that comes with an anxious response (e.g., increased heart rate, faster breathing) can also support performance. Therefore, reducing this arousal through breathing or selfregulation exercises might not always be beneficial to enhance performance. Instead reappraising the arousal as a sign of challenge or excitement rather than threat, might help children to capitalize on the performance enhancing effects of their physiological response see Biopsychological model of Challenge and Threat, (
The mixed effects of the MI and CBI on MA and performance might indicate that a combination of both approaches could be most beneficial for school children. This means, on the one hand, to develop sound arithmetic skills that build not only the foundation for more complex math content but would also help children to form a positive math selfconcept. On the other hand, combined interventions could also provide children with cognitivebehavioral tools to cope with their anxious thoughts and arousal in math related situations. These tools should, however, take effect models into account, such as the Biopsychological model of Challenge and Threat (
Furthermore, almost a quarter of the described studies, that either apply MI or CBI, reported positive effects on MA for both the intervention and the control/comparison group. This surprising result raises questions on potential third factors that led to a reduction of MA in these studies, and that have not yet been taken explicitly into account. These third factors could be school and teachingrelated variables that might be associated with the development of MA (e.g., teacher’s beliefs). At the same time, the differences between the control groups of the included studies hinder potential discussions of these third factor variables. Of course, methodological issues might explain the nonexisting differences between control and intervention groups (e.g., nonrandomized controls leading to an unbalanced study design, unknown background interventions). In addition, reductions in the level of MA in both groups might be explained by the applied MA measures. To make differentiated conclusions about impacts of intervention programs on mathrelated anxiety reactions and/or math anxious cognitive beliefs, it may be useful for future studies to carefully consider the conceptualizations of MA questionnaires. E.g., intervention programs focusing emotionalregulation strategies could benefit from realtime assessments, measuring mathrelated anxiety reactions (stateMA), whereas studies that incorporate CBI might be more likely to evaluate effects on cognitive beliefs and traitdispositions. However, to account for all influences, it would be best to consider both situation and dispositionrelated approaches.
When comparing the mode and settings of the MI and CBI, it becomes clear that the majority of CBI was based in a onetoone or small group setting. A classroombased application of CBI was rare. Hence, future research might try to apply CBI or to combine CBI and MI on a classroom level. Despite the fact that interventions addressing MA are of relevance for students with high levels of MA, all students might profit from adequate strategies targeting anxiety related cognitions.
To conclude, a few limitations of our systematic review need to be mentioned. Firstly, the review only included intervention studies that target MA. This approach might have excluded a range of studies and findings, that highlighted the relevance of potential variables that might also be associated with the development of MA but had not been part of an intervention study (e.g., environmental factors). Secondly, although we tried to capture all relevant information of the included studies as accurate and complete as possible, the transparency within the studies was lacking at times. This implies, that important information might be missing or incomplete for some of the included studies. Especially missing information on the format and duration of the interventions makes it difficult to compare the effectiveness of the different approaches. And thirdly, our review is not a metaanalysis. Insights in described effects are therefore on a descriptive level and do not allow a direct statistical comparison or aggregation of the described effects.
In the end, no clear picture can be drawn yet of how effective MA intervention for school children should look like. However, this literature review still offers valuable insights into the current state in the field of MA intervention research. Both approaches (MI and CBI) show potential positive effects. The findings of this review at hand might therefore serve as an orientation for future research and for the development of effective interventions that aim to reduce MA in children.
The raw data supporting the conclusion of this article will be made available by the authors on request, without undue reservation.
LO, MB and MBR drafted the theoretical background. MB and MBR were responsible for data analysis and discussion of the findings. All authors contributed to the article and approved the submitted version.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors, and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
We thank Julia Gehlhaus, Lisa Marie Flebbe, and Kristin Busse for their support in screening and evaluating the studies for this systematic review and for piloting the data extraction spread sheet as part of their Bachelor theses. We acknowledge support from the Open Access Publication Fund of the University of Wuppertal.