ADHD and Dyslexia: Telling Them Apart

ADHD and dyslexia are different conditions that often occur together. ADHD affects attention and self-control across the whole day, dyslexia affects reading and spelling words, and the clearest way to tell them apart in a child is to look closely at the reading errors themselves.

This guide is written from the reading side. It sets out what each one looks like when a child reads aloud, how often the two occur together, and who in Australia assesses which part.

What is the difference between ADHD and dyslexia?

ADHD is a difficulty with attention, activity level and impulse control that shows up in more than one place, such as home and school. Dyslexia is a difficulty learning to read and spell words accurately and fluently. A child with ADHD can usually work out a word but does not always keep their attention on the page. A child with dyslexia can be paying full attention and still not be able to work out the word. Put side by side, dyslexia vs ADHD looks like this:

What to compare	ADHD	Dyslexia
What it affects	Attention, activity and impulse control, in every part of the day	Reading and spelling words
Reading aloud	Mostly accurate, but skips words and lines and loses the place	Slow and effortful, with words misread or guessed
Sounding out a new word	Can do it when attention is on the word	Cannot do it reliably, even with full attention
Spelling	Careless slips in words the child knows	Spellings that do not match the sounds of the word
Listening to a story	May drift off partway through	Usually follows and enjoys it
Where the difficulty shows	Most tasks that need sustained effort	Tasks that involve reading or writing
Who assesses it in Australia	A paediatrician, child psychiatrist or psychologist	Usually a psychologist for a formal diagnosis

How do the reading errors differ?

The errors differ in kind. A child whose main difficulty is attention reads the words correctly more often than not, but the reading is uneven. Listen for:

Skipped small words, word endings and punctuation
A whole line missed, or the same line read twice
Losing the place after looking up
A wrong word that is fixed straight away when you point to it
Better reading in a short burst, or one to one, than at the end of a long page

A child with dyslexia makes errors that do not go away when you bring their attention back. Listen for:

A new word that cannot be sounded out, even slowly and with your help
Guessing from the first letter, such as “house” for “horse”
The same word read correctly on one line and wrongly on the next
Slow, effortful reading of a book the rest of the class finds easy
Spelling that leaves out or swaps sounds, even in short words

The International Dyslexia Association makes the same distinction: readers with dyslexia misread words, while readers with ADHD do not usually misread them but lose their place and skip over punctuation and endings. A quick check at home is to cover the page, show one unfamiliar word at a time and ask your child to read it. With nothing else to attend to, a child whose difficulty is attention can often do it. A child with dyslexia still cannot. This is a rough guide, not a test.

Can dyslexia look like ADHD?

Yes. Reading takes so much effort for a child with dyslexia that they tire quickly, fidget, look away and find reasons to stop. In a classroom that looks like inattention.

The difference is where it happens. A child whose inattention comes from dyslexia is often restless during reading and writing and more settled during hands-on maths, science experiments, sport or a story read aloud. In ADHD the difficulties are there across settings. healthdirect notes that a diagnosis needs symptoms that started before the age of 12, have lasted more than six months and cause difficulty in at least two settings. Ask the teacher whether the restlessness follows the reading or follows your child all day.

How often do ADHD and dyslexia occur together?

Often enough that both should be considered whenever one is suspected. The figures in peer-reviewed research are:

25 to 40 per cent. A twin study published in the journal Cortex summarised earlier research as showing that 25 to 40 per cent of children with either a reading disability or ADHD also meet the criteria for the other.
2 to 4 in 10. healthdirect, the Australian Government’s health information service, says between 2 and 4 in every 10 people with dyslexia also have ADHD.
45 per cent, for a wider group. A review of 17 studies in the Journal of Learning Disabilities found an average of 45.1 per cent of children with ADHD also had a learning disability. That figure counts writing and maths difficulties as well as reading, which is why it is higher than the others and should not be quoted as a dyslexia figure.

The same twin study found that the two conditions share a weakness in processing speed, and that the overlap is largely explained by genes that raise the chance of both. The research points to shared causes, not to one condition causing the other.

When both are present the difficulties add together. A review in Developmental Neuropsychology describes children with ADHD and a reading disorder as having more marked difficulties at school than children with either one alone. That is the reason to check for the second when the first has been found.

Who assesses ADHD and who assesses dyslexia in Australia?

Different professionals assess each one, and no one assessment settles both unless it has been set up to.

Professional	What they assess	What their report covers
Paediatrician or child psychiatrist	Attention, activity and impulse control, and other medical causes	Whether your child has ADHD, and treatment options
Psychologist	Thinking skills, attention, reading, spelling and maths	Whether your child has ADHD, a specific learning disorder such as dyslexia, or both, depending on the assessment you book
Speech pathologist	Reading, spelling and the speech and language skills underneath	Which skills are holding reading back and what to work on. Not a formal diagnosis of dyslexia, and nothing about ADHD

A GP is the usual starting point for an ADHD assessment, because a paediatrician or psychiatrist needs a referral. A formal diagnosis of dyslexia is usually made by a psychologist. The longer explanation is in who can diagnose dyslexia in Australia.

Take the same things to each appointment: school reports, the teacher’s comments, any earlier assessment reports and examples of your child’s reading and writing. The psychologist or paediatrician decides which earlier results they use and what further testing they do.

Is there a test for both ADHD and dyslexia?

There is no single test that covers both. Some psychologists assess learning and attention in the same assessment, so ask what is included when you book. A questionnaire or an online screener can only suggest that one or the other is worth a closer look. The free dyslexia screener on this site asks about reading and spelling only, and it is a screener, not a diagnosis.

What can a reading assessment show while you wait for an ADHD assessment?

A reading and language assessment does not depend on the ADHD question being answered first. It can show:

Whether your child can sound out words they have never seen when they are working one to one
How well they hear and work with the separate sounds in words, the skill that sits under reading and spelling
Whether their spelling errors follow the pattern of dyslexia or look like slips
How well they understand spoken language, which separates a reading difficulty from a language difficulty

If the reading skills are sound, attention becomes the more likely explanation. If they are not, the school has something specific to teach, and that teaching does not need to wait for the other assessment.

Dr Lauren Crumlish (PhD), Certified Practising Speech Pathologist, assesses reading, spelling and the language skills underneath, online, for school-aged children and teenagers across Australia. The fee is $890 or $1,290. The limits matter here. Dr Lauren does not assess or diagnose ADHD, and she does not diagnose dyslexia. Attention affects any test, so results from a child who found it hard to stay on task are read with that in mind. What she looks at is set out in what a dyslexia assessment looks at.

What should you do first?

Ask the teacher two questions: is the difficulty there in every subject or mainly in reading and writing, and can your child read an unfamiliar word when working one to one?
Have vision and hearing checked, so neither is missed.
If attention is a concern in more than one setting, see your GP about a referral.
If reading and spelling are a concern, compare what you see with the signs of dyslexia in primary school.
If you are not sure it is either, read what else can look like dyslexia, which covers language, speech, vision, hearing and handwriting.