By Scarlet Leong
Specialist Psychologist
SpLD Assessment Services Team
Teachers have complained that your child is unable to focus in class. He seems to be in his own world, tends to fidget with his belongings, or often gets up to walk around the class. At home, 10 minutes is the longest that you are able to get your child to attempt his homework. But that’s not all – common words are difficult for your child to read and spell, and writing is a task that he tries his best to avoid. From the internet, teachers and hearsay, you have an inkling of something called attention deficit hyperactivity disorder (ADHD), as well as dyslexia. Both sound like something that your child seems to have. But which is it? Or is it both?
DYSLEXIA AND ADHD CO-OCCUR
Dyslexia and ADHD are commonly diagnosed in childhood, and they often co-occur. Distinguishing between dyslexia and ADHD may seem challenging because they may have similar presentations such that it’s difficult to tell what’s causing the behaviour you’re seeing. Is your child not reading/learning because he can’t stay in his seat? Or is your child not able to focus because he can’t read? While the conditions may present themselves similarly, they are diagnosed differently and given different interventions. Hence, it is important to understand the main issue that your child is facing. To do so, we will need to have a comprehensive and holistic information-gathering process.
ASSESSMENT
To ascertain dyslexia, it is important to go through a dyslexia assessment. Such an assessment usually comprises an evaluation of your child’s cognitive (or more commonly known as an IQ test), phonological as well as literacy abilities. Typically, an individual with dyslexia will present with reading and spelling skills that are not age-appropriate, alongside weaknesses in his/her phonological awareness. Taken together with reported literacy concerns from parents and teachers, it may suggest a learning difficulty.
However, imagine that we have a child who shows these aforementioned difficulties, yet also often seems to daydream and/or is constantly on the go. Does he have ADHD as well?
The best way is to have your child go through an attention assessment (which includes teacher and parent questionnaires, as well as non-literacy attention tasks) to know conclusively. Nonetheless, there may be some (non-exhaustive and non-definitive) differences in approaches to tasks that you can observe before deciding the appropriate assessment for your child.
- For individuals with dyslexia, inattentive behaviours are predominantly present in academic settings. In contrast, those with ADHD are likely to show concentration difficulties across various settings (e.g. home, school).
- Both individuals with dyslexia or ADHD may be slow in their reading. Individuals with dyslexia may be having difficulties decoding the words, which results in poor fluency. Those with ADHD, they may be reading slowly because they have trouble concentrating on the task. If they get to pick a book that they have an interest in, you may find your child reading more quickly.
- Sometimes, individuals with dyslexia or ADHD may make mistakes in their reading as well. For those with ADHD, common errors may include skipping words or lines, or adding or dropping suffixes. While they may also substitute words, they typically do not show as many decoding errors as what would be observed from an individual with dyslexia. The decoding errors that individuals with dyslexia make may often lack phonetic semblance to the given words.
- Frequent spelling errors may also occur in both types of individuals. For those with dyslexia, their errors may show poor letter-sound knowledge (e.g. spelling “cake” as “cof”), whereas individuals with ADHD may have errors due to impulsivity/inattention, with common errors being adding or omitting letter(s).
If you are still unsure as to which is it – dyslexia or ADHD, bringing your child for both dyslexia and ADHD assessment may provide a more thorough investigation of their difficulties. In turn, this will better inform appropriate interventions for your child going forward. Despite the challenges that individuals with dyslexia and/or ADHD may face, with continued encouragement and appropriate forms of support in place, they have the potential to be successful in their future endeavours.
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