Learning Disabilities commonly occur with other related challenges and conditions or disorders, especially emotional ones. Similarly, ADHD is a complex disorder that affects an individual in many ways. Research supports that this diagnosis can commonly come with other related challenges or disorders.
Find Help for Children provides guidance in finding support services for children and teens with related challenges and other conditions.
Find Help for Adults provides adults with guidance in finding support services for related challenges and other conditions.
Learning Disabilities and ADHD can coexist with other mental health problems.
Learning Disabilities and Attention Deficit/Hyperactivity Disorder (ADHD) often ‘walk together’ with other conditions, most often mental health concerns but sometimes also other disorders. In the case of individuals with undiagnosed ADHD, common co-conditions such as anxiety or depression may tend to be diagnosed first and can obscure the need for further assessment leading to late ADHD diagnoses.
- Nearly 90% of children with ADHD have at least one other condition, and nearly 70% of children with ADHD have at least 2 other conditions.
- Nearly 80% of adults with ADHD have at least one other condition.
One of the most common co-existing disorders with LD is ADHD, with as much as 50% of individuals having both LD & ADHD.
ADHD is not a Learning Disability. Each is a distinctively neurologically based disorder. Each is recognized and diagnosed differently and treated in a different way.
Developmental Coordination Disorder (DCD) is a motor disorder that impairs everyday fine and/or gross motor movements, such as navigating stairs, getting dressed (e.g., doing up laces), handwriting, and typing. DCD can also impair speech if oral motor functioning is delayed.
Children with DCD are often described as “clumsy” or “awkward” in their motor movements. They commonly bump into things or drop things frequently.
An alternate term for Developmental Coordination Disorder (DCD) is Dyspraxia. Although sometimes considered a “motor-based Learning Disability,” it is a separate disorder. While 5-6% of children have DCD, 50% of children diagnosed with ADHD are also diagnosed with DCD. It is also common in children with Learning Disabilities and language disorders
A great resource for more information on DCD is www.canchild.ca.
Technically, giftedness isn’t a diagnosis because it isn’t considered a disability. However, some parents may want a psycho-educational assessment for their child if they wonder about giftedness. Within the context of a psycho-educational assessment, giftedness usually requires intelligence test scores that are in the top 2% of the population.
Different school boards and organizations define giftedness in different ways. Knowing whether a child is gifted can be helpful in determining what kinds of educational programming may be beneficial for them.
Twice Exceptional: People who are gifted can also have a diagnosis such as a Learning Disability or ADHD. These people are often referred to as ‘Twice Exceptional’. They can have exceptional ability in one area and struggle in another.
Learn more: Understood.org: The Challenges of Twice Exceptional Kids. Author; Peg Rosen.
Autism Spectrum Disorder (ASD) is a Distinct Disorder:
- While people with Autism Spectrum Disorder (ASD) can have many of the same learning, attention, and social-emotional challenges as those with Learning Disabilities and ADHD, it is a distinct disorder.
- ASD is a neurodevelopmental disorder where persistent deficits in social communication and social interaction are evident. For example, some individuals with ASD may show a lack of interest in peers and/or struggle with the back-and-forth nature of conversations.
- In addition, the individual must show restricted, repetitive patterns of behaviour, interests or activities. For example, some individuals with ASD struggle with deviating from a highly structured routine, experience sensitivities to sensory input, and/or have fixated interests.
- Some diagnoses that often co-occur for individuals with ASD include: Learning Disabilities, ADHD, Developmental Coordination Disorder, Intellectual Disabilities, and Language Disorders. Anxiety and depression must also be monitored.
- If the individual is struggling in social communication and social interactions but is not showing restricted and repetitive behaviour or interests, a diagnosis known as Social (Pragmatic) Communication Disorder may be considered.
For more information on ASD:
Struggling in academic subjects can impact emotions and mental health:
It is important to note that there is a significant interplay between Learning Disabilities, particularly in reading and writing, and behavioural and emotional symptoms, including mood, anxiety, social withdrawal, emotional dysregulation, negative emotionality, low frustration tolerance, aggression, and even serious rule-breaking behaviour.
Difficulties at school or work can significantly impact an individual’s ability to regulate their behaviour and emotions and vice versa. The individual is likely to become easily frustrated and avoidant of undesirable or difficult tasks, which can lead to avoidance (e.g., school refusal).
Feeling unable to meet others’ expectations and feeling powerless to change this can result in feelings of anxiety and depression and behaviours that may be perceived as oppositional (e.g., low frustration tolerance, inappropriate behaviour, noncompliance, poor judgement).
Difficulty processing information may add to emotional stress:
Emotional difficulties may also stem from, and certainly contribute to, a relative weakness in processing information. This would be particularly true within the context of a demanding classroom, workplace, or social situation that requires quick processing and responses. Indeed, in an environment where there are pressures to perform faster or keep up with the group, it would not be unusual for the individual to experience anxiety as a consequence of slow processing speed.
Poor visual perception (i.e., difficulty differentiating and paying close attention to visual information and cues, particularly when feeling pressured or under time constraint), has implications in other areas of functioning other than school achievement. That is, the individual may not pay as close attention to nonverbal communication as needed to be able to interpret the situation accurately and respond in a caring and sensitive manner to others. This may affect social interactions and relationships.
It is very common for individuals with LD and/or ADHD to develop secondary anxiety and depression due to their lifelong difficulties regulating their behaviour, which impacts their self-confidence. This is because they are more prone to loneliness and low self-esteem. For example, children with LDs are 70% more likely to have heightened anxious symptoms than those without LD, and at least 20% of individuals with ADHD also have anxiety.
All individuals experience worries and fears, and all people encounter daily stressors. For individuals with LD and/or ADHD, their worries and fears are often about their academic or work struggles, social challenges or emotion and behaviour dysregulation. When the worries impede a person’s day-to-day functioning, then he/she may be experiencing anxiety.
Anxiety disorders differ from developmentally typical fear (an emotional response to real or perceived threat) or anxiety (worry about a future threat) by being excessive or persisting for a longer than normal amount of time (e.g. typically lasting 6 months or more).
Since individuals with anxiety disorders tend to overestimate the danger in situations they fear or avoid, determining whether the fear or anxiety is excessive or out of proportion is made by a clinician. Many of the anxiety disorders develop in childhood and tend to persist if not treated. Most occur more frequently in females than in males (approximately 2:1 ratio).
Types of Anxiety Disorders:
- Separation Anxiety
- Generalized Anxiety Disorder
- Social Anxiety Disorder
- Specific Phobia
- Panic Disorder-Selective Mutism
Diagnosis & Treatment
For Children, anxiety disorders are best diagnosed by a psychologist, pediatrician, or child psychiatrist.
For Adults, anxiety disorders are best diagnosed by a psychologist, physician or psychiatrist.
Appropriate interventions for anxiety disorders are:
- Cognitive Behavioural Therapy
- Family Therapy
- Executive Function Coaching
Experiencing sadness is an expected part of child and adulthood. However, when the feelings of sadness are present more often than not and are accompanied by irritable mood, feelings of emptiness, changes in thinking and/or behaviour, then the individual may be experiencing a Depressive Disorder. Up to 20% of individuals with LDs will also have depression.
The common feature of depressive disorders is the presence of sad, empty, or irritable mood accompanied by changes in thinking and somatic (health) complaints. In children, there is often an increase in severe irritability, while in adults there is often a loss of interest or pleasure. How these disorders further differ is by duration, timing and cause. Most occur more frequently in females than in males (approximately 2:1 ratio).
Types of Depressive Disorders
- Disruptive Mood Regulation Disorder
- Major Depressive Disorder
- Persistent Depressive Disorder (Dysthymia)
Diagnosis & Treatment
For Children, diagnoses are best made by a psychologist, pediatrician, child psychiatrist.
For Adults, diagnoses are best made by a psychologist, physician, psychiatrist.
Appropriate interventions for Depressive Disorders are:
- Family Therapy
- Speech Disorders are not the same as Language Disorders. A Speech Disorder refers to any condition that affects a person’s ability to produce the sounds that form words.
- Speech Disorders can affect people of all ages.
- Common types of Speech Disorders include stuttering, apraxia, and dysarthria.
- Stuttering refers to interruptions in the flow of speech.
- Verbal apraxia refers to brain damage that impairs a person’s oral motor skills which affects their ability to form the sounds of speech correctly.
- Dysarthria occurs when damage to the brain causes muscle weakness in a person’s face, lips, tongue, throat, or chest which can make speaking very difficult.
- A Language Disorder can cause issues with understanding and/or using spoken and/or written language.
- It makes it hard for someone to find the right words, communicate ideas, form clear sentences when speaking, understand what another person says, and organize information that they hear.
- An individual may have difficulty with receptive language skills (i.e. difficulty understanding what others say, difficulty following simple directions, etc.), expressive language skills (i.e. difficulty sharing thoughts, ideas and feelings, limited vocabulary, etc.), or both.
- An individual may also have difficulty with pragmatic language skills, which refer to the social language skills that we use in our daily interactions with others. This includes what we say, how we say it, our non-verbal communication (eye contact, facial expressions, body language etc.) and how appropriate our interactions are in a given situation.
- A language disorder is not the same as a hearing issue or a speech disorder. Individuals with Language Disorders typically have no trouble hearing or pronouncing words. Their challenge is mastering and applying the rules of language, like grammar.
- Language Disorders can be acquired or developmental.
- An acquired language disorder, like Aphasia, shows up only after the person has had a neurological illness or injury (e.g. stroke, head injury).
- A developmental language disorder tends to show up in childhood.
- About 5% of school-aged children have a Language Disorder.
- Some research suggests that children with Language Disorders also have problems with reading and writing. In fact, it is not uncommon for children with language and/or speech disorders to be later identified as having a Learning Disability, particularly in the literacy areas.
Intelligence test scores would be lower in a person with an Intellectual Disability as compared to someone with a Learning Disability.
Intellectual Disabilities, as defined by the DSM-5, require three things:
- Significant challenges in reasoning, problem solving, abstract thinking, and planning, which is measured using an intelligence test.
- Significant challenges in daily living skills, which include things like communication skills, self-care, managing money, being independent in the community and at home.
- Evidence that the challenges started when the person was a child.
For more information about Intellectual Disabilities, visit American Association of Intellectual and Developmental Disabilities.
As the name suggests, FASD is a disability as a result of alcohol exposure in the womb. It affects the development of the fetus’ brain to varying degrees depending on the amount of alcohol and length of exposure. As with other disabilities, individuals with FASD have their unique strengths and challenges, and can benefit from early intervention and therapy, but may also require lifelong support.
Foothills Fetal Alcohol Society FASD (Fetal Alcohol spectrum Disorder) Support program.
Canada FASD Research Network – CanFASD
Obsessive-Compulsive Disorder (OCD) is a negative cycle of obsessive and compulsive behaviours that are unwanted and intrusive but that an individual has little control over. They may be thoughts, images, or behaviours and can often be triggered by intense or distressing situations or feelings.
Learn more at Alberta OCD Foundation
Tic Disorders (including Tourette’s syndrome):
Many children may experience tics at some point during their childhood. Tics are sudden, rapid, recurrent, nonrhythmic motor movements or vocalizations. But when these tics become persistent, cannot be resisted, and interfere with functioning, a tic disorder may need to be considered. Approximately 1 in 4 children have some tic disorder, and tic disorders are more common in children with ADHD.
There are two main types of tics: verbal and motor. In each, there are also simple and complex tics.
- Simple verbal tics include sounds such as grunting, coughing, and throat clearing.
- Complex verbal tics include words and phrases. While coprolalia, or swearing, is often shown in movies, it is relatively uncommon.
- Simple motor tics include movements such as blinking and single movements.
- Complex motor tics include combinations of motor movements. When both multiple motor and vocal tics have been present, a diagnosis of Tourette’s Disorder may be suggested.
Oppositional Defiant Disorder (ODD) co-occurs with ADHD in approximately 25% – 50% of children. It is important to note that children and adolescents with untreated or not adequately treated ADHD often misbehave, not because they are intentionally oppositional, but because of their difficulty remembering rules and inhibiting their responses. They may develop aversion to school or mentally-demanding tasks due to difficulty in sustaining mental effort, forgetting instructions, and impulsivity.
Learn More: Article: Half of All Kids with ADHD Have a Learning Disability or Related Condition. Article by Larry Silver, MD. Published in ADDitude.
Addiction is a chronic disease. People with addictive disorders can be aware of their problem but are unable to stop it even if they want to.
Misuse is different from addiction. Substance misuse does not always lead to addiction, while addiction involves regular misuse of substances or engagement in harmful behavior.
Many people experience both mental illness and addiction. The mental illness may be present before the addiction. Or the addiction may trigger or make a mental disorder worse.
Symptoms of addiction often include:
- declining physical health
- an inability to cease using a substance or engaging in a behavior.
The addiction may cause health problems as well as problems at work and with family members and friends. The misuse of drugs and alcohol is the leading cause of preventable illnesses and premature death
There is no single reason why young people use alcohol and other drugs, and there is no simple way to prevent use and abuse of alcohol, other drugs or gambling activities.
There are both risk factors and protective factors that play a role in determining whether young people will experience harmful effects from substance use or gambling. Family factors such as effective parenting practices are among the strongest predictors and protective influences for alcohol and drug use among youth.
People who start using drugs at a young age suffer the most when they rely on drugs to help them cope with the challenges of growing up: making friends, facing fears, sexual pressures, and the need to perform well at school, at work or in sports. They miss out on the chance to develop life skills, and when they want to quit, they have to catch up with their peers before they can have a normal drug-free life.
Many people with untreated ADHD try to self-medicate to improve functioning. Adults with ADHD smoke more and have more trouble quitting. Children with ADHD start smoking younger and smoke more.
A common myth about ADHD is that use of stimulant medications may lead to substance abuse. In fact, untreated ADHD is a significant risk factor for substance abuse in adolescence and adulthood, whereas ADHD medication is associated with an 85% reduction in risk for substance use disorders in youth with ADHD.
Non-substance related addictions involve being unable to stop certain activities, such as gambling, eating, shopping, sex, work, and excess use of the internet or video gaming. In these circumstances, a person has a behavioral addiction.
Behavioural addictions are not currently diagnosed as mental health conditions under the DSM-5. However, there is growing evidence that these are addictive conditions that cause impairment in normal functioning and share similarities with substance addictions including tolerance and withdrawal.
At least 8% of youth show harm from playing video games, which means a higher proportion of youth experience harm from gaming than adults do from alcohol, other substance abuse, or gambling. Games can be a positive way to socialize, escape, relieve stress, experience excitement and challenge, and explore identity and creativity.
Although it is rare for players to have problems as a consequence of gaming, it is common to see an increased preoccupation towards playing which can create concern for parents.
Excessive gaming becomes a serious concern when youth neglect important tasks, argue with family members, struggle to reduce or take a break from play, or withdraw from other interests. In such cases, gaming may contribute to poor social skills, isolation, lower grades, weight gain, and time away from family, studies, and interests.
The Canadian Pediatric Society recommends no screen time for children under 2 years of age, under 1 hour per day for children age 2-4 years, and under 2 hours daily for most others.
Gaming is only addictive for some people, not everyone; in fact, 92% of gamers do not meet the clinical criteria for problematic gaming. Youth who are non-aggressive, are prosocial, have positively developed ethical frameworks, have good focus in social and academic spheres, and have boundaries set by/with parents are at reduced risk of gaming abuse.
Youth who are aggressive/pre-aggressive, have narcissistic tendencies or poor social skills, have anti-social or violent tendencies, or have ADHD are at increased risk for gaming abuse.
Internet Gaming Disorder, an emerging diagnosis, most commonly co-occurs with ADHD, anxiety and depression.
Youth with a mental health disorder use 2-3 times the screen time compared to the general population.
Treatment for gaming addiction involves addressing the untreated mental health issues or history of trauma that predisposes the youth to gaming abuse, not the gaming itself.
Hyperfocus: ADHD youth can “hyperfocus” on games because they are highly stimulating and trigger the dopamine system (the brain’s reward system).
Video games do not train ADHD youth how to better sustain attention for long periods; rather, the youth play for long periods because the game is designed to provide constant distraction that is stronger than other (real world) distractors and keeps them focused on the game. Over time, tolerance develops and the player needs a “bigger hit.”
There are many treatment options for young people and their families in Alberta. Options include group counselling, a support group, regular visits with an addiction counsellor (outpatient treatment), or more intensive treatment such as detoxification or residential treatment programs.
Youth detox provides stabilization and support to help youth withdraw from substance use and get ready for treatment.
Youth residential treatment offers intensive live-in programs for substance abuse and related issues.
There are also many treatment opportunities for families.
Disclaimer: The Learning Disabilities & ADHD Network does not support, endorse or recommend any specific method, treatment, product, remedial centre, program, or service provider for people with Learning Disabilities or ADHD. It does, however, endeavour to provide impartial and, to the best of our knowledge, factual information for persons with Learning Disabilities and/or ADHD.