Related Challenges with LD & ADHD
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.
ASD Diagnosis:
- 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.
Excessive Worries
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
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
- Agoraphobia
- 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
- Yoga
- Medication
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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:
- Therapy
- Family Therapy
- Medication
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- 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.
Social Emotional Needs
Lifelong struggles with attention, distraction, and/or impulsivity can negatively impact a person’s social and emotional well being and can interfere with learning.
The following are common social-emotional needs of individuals with ADHD and Learning Disabilities.
Low Self-Esteem and Fear of Failure
It is very common for someone with ADHD or LD to have negative thoughts about themselves and their abilities. These thoughts can limit the learner’s willingness to try in learning situations. Negative reactions of others in response to ADHD symptoms and more frequent experiences of failure can lead to a “fear of failure” and an avoidance of new situations. We could call it ‘the little engine that can’t’ because learners are often saying to themselves “I know I can’t; I know I can’t”.
Learned Helplessness
Individuals with ADHD and Learning Disabilities are more likely to find external reasons for both success and failure than their peers. When they experience success, they attribute it to luck or the teacher marking easily – they do not attribute success to their own efforts or ability. Repeated failure and these attributions often result in “learned helplessness” where the individual stops trying because they think that their efforts are useless. LD and ADHD students begin to doubt their own abilities, leading them to doubt that they can do anything to overcome their school difficulties.
Emotional Sensitivity, Anxious Feelings
Individuals with ADHD and LD experience many fears and ongoing emotional stress. They often fear failure and fear being exposed – that is, they fear others finding out that they struggle to attend and learn. Many struggle financially, with employment and in relationships. This stress may lead to anxiety and depression and these emotions interfere with learning.
Sleep
Sleep is very important for everyday functioning, and people who do not get enough sleep can demonstrate symptoms that are similar to people with ADHD. Lack of sleep can also make ADHD symptoms worse, so it is very important to set aside enough time for sleep every night.
Learn more at the Sleep Foundation
Emotional Regulation
Difficulty with emotional regulation is a central feature of children with ADHD. Deficits in executive functions make it much more difficult for individuals with ADHD to control their emotions and maintain appropriate self-regulation. Essentially, the person is reacting before he/she has a chance to hear all of the information presented, think through his/her choices, and develop alternate plans for behavior. This will have an impact on academic or work tasks, following rules, managing social situations and relationships.
Behavioural impulsivity takes away from his/her ability to think about how to initiate tasks and carry out multi-step instructions, and will make task/goal-directed persistence and flexibility in managing tasks more difficult.
While not the cause of aggressive behaviours, it is likely that ADHD makes an individual vulnerable for coping with frustration through emotionally impulsive behaviours rather than calm problem solving.
Acting Out
Another possible response is to ‘act out’ to avoid situations where they might feel embarrassed or to avoid admitting when they do not understand something because they do not want to feel ‘stupid’ or have others think they are ‘stupid’.
Social Skills
Social skills’ problems are just as, if not more, important than academic problems in the development of a child with ADHD or Learning Disabilities. Research suggests that adequate social functioning, including healthy peer relationships, plays a primary role in the optimal development of a child. But for many individuals with ADHD, their difficulties with inattention, impulse control and any learning disabilities also affect their ability to develop positive social skills.
Difficulties may show up as:
These challenges, along with difficulties related to disinhibition (i.e., difficulty to control oneself), preoccupations, rigid thinking, and regulating emotions also impact these children’s ability to make and maintain friendships.
Yet, there is hope. Social skills are not inherently acquired – they must be learned. Although most of us are able to pick such skills up implicitly, these children need to be taught explicitly what to do and when to do it! Children who receive social skills training can learn to modify their social skills and become socially competent adults. Children with better social skills tend to be better accepted by their peers, have better coping skills, and have better school and social adjustment.
Learn More at Social Thinking
Families, to find information about how to access social skills programs for your child, go to: Find Help – Social Skills Services