Assessment and Testing · Video
Is It ADHD, or Is It a Reading Problem?
They look almost identical at the kitchen table. They need completely different help. And in a quarter to a third of children, it is both.
The short answer
ADHD can absolutely make reading harder — a child who cannot sustain attention will lose the thread of a paragraph however well they decode it. But ADHD does not break the ability to turn letters into sounds. If your child can decode accurately when they are focused and still cannot read, attention is the problem. If they cannot decode a word even with your full attention on them, something else is going on — and the two co-occur in roughly a quarter to a third of cases.
Key takeaways
A child with ADHD can usually decode a word correctly when you have their attention. A child with dyslexia cannot, however focused they are. That is the line between the two.
Between a quarter and 40% of children with one of the two conditions also meet criteria for the other. Finding one is a reason to look for the other, not a reason to stop looking.
It is more visible, it disrupts the classroom, and it gets referred. A quiet child who is behind in reading does not interrupt anyone, which is why the reading difficulty is often the one still undiagnosed at eleven.
Improved attention does not teach decoding, and structured literacy does not improve attention. Each needs its own intervention, which is the practical reason the distinction matters at all.
This is the clearest natural test most families get. When ADHD treatment is working — the child can sit, focus and finish a task — and reading is still laboured and inaccurate, the reading difficulty was never an attention problem.
Chapters
- 0:00 Introduction: Is It ADHD or a Reading Disability?
- 0:36 Understanding ADHD and Reading Difficulties
- 1:10 How ADHD Symptoms Affect Reading and Comprehension
- 1:47 The Connection Between ADHD and Dyslexia
- 2:20 Warning Signs of an Underlying Reading Disability
- 2:52 Strategies to Help Children With ADHD Read
- 3:23 When to Seek a Professional Reading Evaluation
Same behaviour, different cause
Almost everything a struggling reader does looks the same from across the room. The difference is in why they are doing it, and that is visible if you know what to compare.
| What you see | If it is ADHD | If it is a reading disability |
|---|---|---|
| Loses track mid-page | Loses the thread anywhere — in a film, a conversation, a game — not only in text. | Loses it specifically in text, because decoding is consuming the attention that comprehension needs. |
| Reads a word wrong | Misreads from haste; usually gets it right when slowed down and asked again. | Misreads the same word repeatedly, including when slowed down, and often again a page later. |
| Understands when read aloud to | Not necessarily — attention affects listening too. | Yes, often far better than when reading it themselves. This gap is the signature. |
| Avoids homework | Avoids anything long or unstimulating, across subjects. | Avoids reading and writing specifically; may be happy with math or practical work. |
| Spelling | Usually careless rather than wrong — knows it, did not check it. | Phonetically rough, inconsistent, the same word spelled differently on one page. |
| On a good day | Reads noticeably better when rested, interested and focused. | Reads much the same. Effort and motivation change the stamina, not the accuracy. |
If a row sounds like both columns, that is information too. The combination is common, and a child showing the ADHD pattern on some rows and the reading pattern on others is the clearest reason to assess for both rather than settling on one.
When it is both
- Co-occurrence runs between 25% and 40%. Across clinic and research samples, a quarter to two-fifths of children with one of the two conditions also meet criteria for the other. That is far above chance, and it is why an assessment that finds one and stops is an incomplete assessment. Boada, R., Willcutt, E. G. & Pennington, B. F. (2012). Understanding the comorbidity between dyslexia and attention-deficit/hyperactivity disorder. Topics in Language Disorders, 32(3), 264–284.
- ADHD tends to be identified first. It is louder. A child who cannot sit still gets referred; a child who is quietly two years behind in reading often does not. By the time the reading difficulty is named, the child has frequently had an ADHD diagnosis for years.
- Each condition hides the other. Poor attention is a plausible explanation for poor reading, so nobody looks further. And a child whose reading is exhausting will appear inattentive during reading, so a reading difficulty can produce an ADHD referral that is not warranted.
- The practical consequence. Two conditions need two interventions. Addressing attention will not teach a child the relationship between sounds and letters, and the best structured literacy programme in the world will not help a child who cannot stay in the room. A plan that treats only the diagnosis you already have will underperform.
The question that usually settles it
Most families who have been managing ADHD for a while already have the evidence they need, and nobody has pointed it out to them. It is this:
When your child’s attention is at its best — whatever is responsible for that — what happens to the reading?
If the reading improves along with the focus, attention was the bottleneck. If your child can now sit for forty minutes, finish their homework and follow a three-step instruction, and the reading is still slow, still inaccurate, still a word-by-word grind — then the reading difficulty was never an attention problem, and it has been waiting underneath the whole time.
That observation is worth more than any checklist on this page, and it costs nothing to make. It is also the single most useful thing to bring to an assessment: “his attention is well managed now and the reading has not moved” tells an assessor more than a page of described symptoms.
When to ask for a reading evaluation
Any one of these on its own is worth acting on. Two together makes it urgent.
- Attention has improved and reading has not. The strongest single reason, for the reasons in the section above.
- Your child understands far more when a passage is read to them. A large gap between listening comprehension and reading comprehension points at decoding, not attention.
- The errors repeat. The same word missed today, next week and next month is not carelessness. Careless errors do not have favourites.
- Spelling is phonetically rough, not merely careless. Inattentive spelling tends to be right-ish and unchecked. A decoding difficulty shows up as spelling that does not map onto the sounds properly.
- An ADHD evaluation never assessed reading. Common, and not a criticism of anyone — an ADHD assessment is not a reading assessment and was never meant to be. If nobody has measured phonological processing and decoding, nobody has ruled it out.
A school evaluation is free and is the only route to an IEP — here is how to request one in writing, with a letter builder that writes it for you. For what the two routes each give you, see Dyslexia Testing in Sacramento.
Questions parents ask
Can ADHD cause dyslexia?
No. They are separate conditions with separate causes, and one does not produce the other. ADHD affects attention, impulse control and working memory; dyslexia affects the processing of language sounds and their connection to letters. What is true is that they occur together far more often than chance would predict — in roughly a quarter to two-fifths of children who have either one — which is why finding one is a reason to check for the other.
My child is on ADHD treatment and still can't read. Why?
Because treating attention does not teach decoding. If attention has genuinely improved — your child can sit, focus and finish work — and reading is still slow and inaccurate, that is a strong indication there is a separate reading difficulty underneath that has not been assessed. It is one of the most common situations we see, and it usually means the reading side was never measured.
Does an ADHD evaluation test for dyslexia?
Usually not. An ADHD evaluation assesses attention, impulsivity, executive function and behaviour across settings. A dyslexia assessment measures phonological awareness, decoding, fluency and spelling. There is some overlap in cognitive measures such as working memory and processing speed, but a standard ADHD evaluation does not test whether a child can turn letters into sounds. If nobody measured that, it has not been ruled out.
Which should we address first?
Usually both, in parallel, but attention tends to need to be functional before reading instruction can do its work — a child who cannot stay in the lesson cannot benefit from it, however good the lesson is. That is not an argument for delaying the reading assessment. Get the assessment now, so that the moment attention is manageable the instruction is already correctly targeted rather than starting from scratch.
Could the reading problem be causing the attention problem?
It can certainly look that way. A child for whom reading is exhausting will appear inattentive, restless and avoidant during reading — and if most of the school day involves text, that can resemble ADHD across the board. The distinguishing question is whether the inattention appears in situations with no reading in them: on the playground, in conversation, during a film. Inattention that is confined to text is pointing at the text.
Is it worth getting a second assessment if we already have an ADHD diagnosis?
If reading is still a problem, yes. An existing ADHD diagnosis is not in question — the point is that it may be incomplete. A reading assessment measures different skills and produces a different kind of recommendation, and it does not invalidate or replace anything you already have. Bring the ADHD report with you; a good assessor will want to see it.
Transcript
Video Transcript
About the Author
Dr. Leah Skinner, Ed.D.
Dr. Leah Skinner holds a Doctor of Education in Reading, Literacy and Assessment, a Master of Education with a specialization in dyslexia, and is a Certified Dyslexia Therapist and Special Education Advocate with over 22 years of experience. As the founder of READ Academy of Sacramento and a mother of five neurodivergent sons, four of whom have dyslexia, she brings both clinical expertise and personal understanding to every family she works with.
This video is based on the full article, Can ADHD Cause My Child to Struggle With Reading, or Is It Something Else?
Find out what the ADHD evaluation did not measure
A comprehensive reading assessment measures phonological processing, decoding, fluency and spelling, and says what instruction each one needs. If you already have an ADHD report, bring it — the two together give a far more complete picture than either alone.
READ Academy of Sacramento · WASC-accredited
2565 Millcreek Dr, Sacramento, CA 95833
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