ADHD and Dyslexia: Living Well With a Double Diagnosis

Attention deficit hyperactivity disorder (ADHD) and dyslexia are two distinct conditions that can both cause reading difficulties.

ADHD is a neurodevelopmental disorder characterized by trouble focusing, struggling to sit still, and impulsivity, which may affect a person's overall ability to function at work or school. Dyslexia is a specific learning disability that affects a person's relationship with reading and decoding language.

In addition to overlap in characteristics, it is common for people with ADHD to also have dyslexia and vice versa. This article will explore why these conditions often occur together, how they are diagnosed and management strategies.

Do ADHD and Dyslexia Occur Together?

ADHD and dyslexia are different conditions that share some similar characteristics. Individually, they each affect an estimated 5% to 10% of the population. They can also occur together and tend to do so at a rate that is higher than chance. About 25% to 40% of people with ADHD also have dyslexia. The statistic is the same for people with dyslexia who also have ADHD.

Symptoms of Dyslexia

Dyslexia is a specific learning disability. In general, people with dyslexia have difficulties with:

• Phonological processing (the manipulation of sounds)
• Spelling
• Rapid response to visual-verbal cues

Symptoms of ADHD

ADHD typically manifests in two ways:

• Inattentiveness: Difficulty with focus, organization, and other mental tasks
• Hyperactivity and impulsivity: Restlessness and difficulty with impulse control

People with ADHD may have signs of inattentiveness, hyperactivity and impulsivity, or both.

Symptoms Found in Both ADHD and Dyslexia

People with ADHD and/or dyslexia are typically of average or above-average intelligence, though they may underachieve in settings such as school. People with either or both conditions can have difficulties with reading and writing.

People with ADHD may:

• Skip over punctuation
• Leave off endings
• Lose their place
• Have difficulty with organization and proofreading

People with dyslexia may:

• Have major problems with accuracy
• Misread both large and small words
• Have significant problems with spelling, grammar, proofreading, and organization

People with ADHD and/or dyslexia may:

• Have difficulty paying attention due to the fatigue from the effort it takes to read or write
• Have trouble with reading comprehension
• Not enjoy reading and avoid it
  

Dyslexia and ADHD in Adults

 Both dyslexia and ADHD manifest differently in adults than in children.

Adults With ADHD

Adults with ADHD may:

• Become easily distracted and have difficulty paying attention to people and tasks, or hyperfocus on a task or activity such as their phone or a TV show
• Be physically or mentally restless, fidget, or have many simultaneous thoughts
• Have trouble completing even "simple" tasks
• Overlook details and make errors in work (or have incomplete work)
• Have trouble remembering conversations and following directions
• Get bored easily and seek stimulation
  
• Forget things such as appointments, deadlines, and paying bills
• Procrastinate and have trouble starting and finishing projects
• Be messy or disorganized (house, car, desk, etc.), and frequently misplace things such as keys, wallet, phone, etc.
• Underestimate how long it will take to complete a task and have trouble with punctuality
• Interrupt, blurt out thoughts, and other socially inappropriate behavior
• Have difficulty sitting in long meetings
• Have poor self-control and act recklessly and/or spontaneously
• Become easily frustrated, stressed out, and irritable
• Have a short temper and be sensitive to criticism

Adults With Dyslexia

Adults with dyslexia may:

• Read at a slow pace and with great effort, including things like subtitles
• Avoid reading for pleasure and reading aloud
• Have a lack of fluency in speaking, including the frequent use of “um’s” and imprecise language, general anxiety when speaking, tripping over parts of words, and struggling when put on the spot
• Have trouble remembering and pronouncing the names of people and places, and confusing names that sound alike
• Experience extreme fatigue when reading
• Have difficulty with rote clerical tasks
• Have poorly organized written work and have difficulty expressing themselves in writing, even if they are very knowledgeable about the subject
• Have difficulty with planning and writing things such as essays, letters, reports, etc.,
• Have trouble taking or copying notes
• Spell poorly
• Have trouble remembering things like a PIN or telephone number
• Have difficulty meeting deadlines
  

Dyslexia and ADHD In Children

Both dyslexia and ADHD typically start in childhood and evolve over time.

Children With ADHD

Children with ADHD have similar symptoms to adults with ADHD but are more likely to exhibit hyperactivity and impulsiveness than adults, who typically present with inattentiveness. 

Children with ADHD may:

• Not pay close attention to details and make "careless" mistakes in schoolwork or during other activities
• Have difficulty paying attention, even during play, and be easily distracted by thoughts or external stimuli
• Seem to not be listening when spoken to
• Have trouble with follow-through, such as following instructions finishing schoolwork, completing chores, etc., and may forget about them
• Have trouble with organization, both of their belongings and of their time and activities
• Avoid or dislike tasks such as schoolwork, homework, reading, and other activities that require sustained mental effort
• Frequently lose things they need, like school supplies
  
• Fidget, squirm, have trouble staying seated, run or climb excessively when it's not appropriate, and other restless behavior
  
• Be loud or talkative while playing or doing activities
• Seem to be constantly "on the go"
• Blurt out or interrupt, such as answering questions before they have been completely asked, interrupting people who are speaking, finishing other people's sentences, intruding on others' conversations or games, and having trouble waiting for their turn

Children With Dyslexia

Dyslexia symptoms and characteristics can change with age and experience. As children get older, they may find ways to manage or compensate for their difficulties with dyslexia, although the condition itself will persist and show in other ways.

Pre-schoolers with dyslexia may:

• Have trouble learning common nursery rhymes
• Have trouble learning and remembering the names of letters in the alphabet and be unable to recognize letters in their name
• Mispronounce familiar words or use “baby talk”
• Have trouble recognizing rhyming patterns (hat, sat, cat, etc.)

Kindergartners and first-graders with dyslexia may:

• Base reading on cues other than the words on the page, such as saying “puppy” when the written word is “dog” when the page includes a picture of a dog
• Not understand that words "come apart"
• Dislike reading, say that it is hard, or avoid reading as much as possible
• Be unable to sound out simple words
• Not associate letters with sounds (such as the letter P with the “puh” sound)

Second-graders to high-schoolers with dyslexia may:

• Be slow in learning reading skills and read slowly and awkwardly
• Have difficulty sounding out unfamiliar words
• Appear not to have a strategy for reading new words
• Dislike and avoid reading out loud
• Pause, hesitate, use vague language, use a lot of “um’s” etc. while speaking
• Mix up words that sound similar, such as saying “tornado” when they mean “volcano”
• Mispronounce long, unfamiliar, or complex words
• Need extra time to respond to questions or finish tests
• Have trouble remembering things such as dates, names, telephone numbers, etc.
• Have extreme difficulty learning a new language
• Have poor spelling and messy handwriting
• Have low self-esteem
  

Tips for Parents and Teachers

It's important to remember that children with ADHD and/or dyslexia are intelligent and capable. They can often find ways to get by well enough, but to do this, they are usually working much harder than typical students. Providing support that eases the stress of the extra effort helps them show their strengths and abilities.

In the classroom, this often takes the form of accommodations, whether through formal means such as an individualized education program (IEP), or designed by the educator.

Some accommodations may include:

• Extra time for reading or test-taking
• Allowing the use of technology such as computers
• Recording lectures to review again later
• Using audio recordings along with the printed text to listen to as they read

Parents/guardians can help by making sure their child is getting the treatment they need, such as medication for ADHD, reading specialists for dyslexia, therapy, or any other treatments suggested by their child's healthcare and education professionals.

Each child with ADHD and/or dyslexia is an individual with different needs and strengths. Working as a team that includes educators, parents/guardians, and the child can help find strategies that work for each child.

Getting an Evaluation

Even when they occur together, ADHD and dyslexia are different conditions and are evaluated separately.

Where to Go

The first stop for an ADHD evaluation is usually a primary healthcare provider, who will ask questions, perform a physical exam, and may order tests to get an idea of overall health and rule out other possibilities for the symptoms.

From there, the healthcare provider may refer the person to a mental health professional for further evaluation.

Dyslexia is usually first noticed by educators. A diagnosis is typically made through evaluations administered by educational professionals such as:

• Clinical psychologists
• Educational psychologists
• School counselors
• Special education instructors
• School administrators

Strategies for Managing ADHD and Dyslexia

ADHD and dyslexia have different treatment plans. For example, medication is often prescribed for ADHD, but not for dyslexia alone. To make sure treatment is optimal, both conditions should be addressed individually.

For people with both ADHD and dyslexia, strategies that address one or both conditions can help overall. For example, a 2016 study suggests that stimulant medication may help improve reading as well as ADHD symptoms in people who have both ADHD and dyslexia.

In addition to formal treatment, there are strategies that can help people with ADHD and dyslexia in different areas of their lives.

Reading Tasks

• Work with a trained reading specialist
• Allow for extra time for reading and writing tasks
• Engage in (or provide children with) reading materials that are interesting
• Teach/learn note-taking skills
• Use multisensory learning
• Read to children, and repeat the same books multiple times
• Create a relaxed environment for reading
• Make use of technology
• Use a bookmark or ruler under the line you are reading
• Use active reading
  

Focus

• Create a routine
• Manage and minimize distractions
• Break bigger tasks down into smaller, more manageable ones
• Speak clearly and precisely when speaking to or giving instructions to a person with ADHD and dyslexia
• Eat regularly, and consume a variety of healthy foods
• Get plenty of sleep and exercise
• Use organization strategies such as lists, calendars, and apps
  

Social Health

• Engage in social skills training, which involves role-playing
• Join support groups and programs
  

Mental Health

• Address any co-morbid or coexisting conditions such as anxiety
• Participate in therapies such as cognitive-behavioral therapy (CBT)
• Address the conditions by name
  

In the Workplace

• Use the services of a tutor trained to teach skills specific to that job or role
• Insist on reasonable accommodations as covered by The Rehabilitation Act of 1973 (RA) and the Americans with Disabilities Act of 1990 (ADA)
• Take notes and/or record audio during tasks such as meetings and seminars
• Work on keeping your workspace organized
• Give yourself extra time when leaving for work, interviews, appointments, meetings, etc.
• Designate 15 minutes at the end of the day to plan and organize for the next day
• Finish one task before beginning another
• Take intermittent breaks and move around
• Use reminders such as sticky notes or alarms
• Color-code files

Summary

ADHD and dyslexia are separate conditions that often occur together. While they have different characteristics, both can cause problems with reading and writing.

Both conditions begin in childhood and persist into adulthood.

Management for people who have both ADHD and dyslexia involves treating each separate condition, such as medication for ADHD and reading intervention for dyslexia. Some coping strategies help manage common problems between both conditions, such as reading comprehension.

A Word From Verywell

 When a child is having difficulty reading, it may be hard to determine the cause. Among other possibilities, both ADHD and dyslexia can cause problems with reading and writing. ADHD and dyslexia also affect adults and can interfere with areas such as employment.

If you suspect you or your child has ADHD, dyslexia, or both, speak with a healthcare provider. Your child's school can also assist you with determining and addressing learning disabilities such as dyslexia. With help, both of these conditions can be managed successfully.