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By , Editorial Team Published

Dyslexia and Anxiety: Which Way Round?

Poor reading and anxiety travel together, and the longitudinal evidence suggests the reading difficulty mostly comes first. That changes what to do about it.

4 min read

Flat pop-art illustration in teal, orange and yellow. A child in a striped t-shirt leans over an open book at a desk, pencil in one hand and their head resting on the other, looking down at the page.

Key takeaways

  • A meta-analysis of the research found poor readers face a moderately raised risk of internalising problems, and that the raised risk sits more with anxiety than with low mood.
  • Four large longitudinal datasets found reading ability at age seven predicted anxiety, reading self-concept and peer difficulties at age nine, while the same measures at age five did not predict reading at seven.
  • That asymmetry is the useful part: for anxiety specifically, the reading difficulty tends to come first, so the anxiety is largely a consequence rather than a cause.
  • Inattention and behaviour ran the other way in the same data, predicting later reading, which is why the two should not be lumped together as one story about mental health and reading.
  • The practical consequence is that treating the reading and treating the anxiety are not competing priorities, and delaying either while the other is addressed is the thing the evidence argues against.

Poor reading and anxiety travel together, and the longitudinal evidence suggests the reading difficulty mostly comes first. A meta-analysis found poor readers at moderately raised risk of internalising problems, and that the risk sits more with anxiety than with low mood. [francis-2019-internalising]

What “which way round” actually means here

It means asking whether the reading difficulty produced the anxiety or the anxiety produced the reading difficulty, and the answer changes what you do on a Monday morning. If anxiety were driving the reading, treating the anxiety would be the lever. If the reading is driving the anxiety, then reading intervention is doing double duty and reassurance alone will not hold.

Cross-sectional research cannot answer this, because measuring both things on the same day tells you they occur together and nothing more. Only data that follows the same children across years can put the two in an order.

What the longitudinal data found

Reading ability at age seven predicted anxiety, reading self-concept, peer relationships and bullying at age nine, while the same emotional measures at age five did not predict reading at age seven. [mcarthur-2022-tracking] That analysis pooled four large datasets from the United Kingdom, the United States and Australia.

The asymmetry is the finding. Reading came first and the emotional consequences followed, rather than the two simply moving together. It is about as clean a directional signal as observational data produces, which is not the same as proof and is a great deal more than an association.

The same data asked two different questions, and only one of them came back with an answer Illustrative
0 25 50 75 100 How well the earlier measure predicted the later one 72 Earlier reading, later anxiety 14 Earlier anxiety, later reading
0 25 50 75 100 How well the earlier measure predicted the later one 26 Earlier reading, later attention 68 Earlier attention, later reading

A schematic of the directional pattern described in this section, drawn to show the shape of the asymmetry rather than reported effect sizes.

Why attention is a separate story

Because it ran the other way. In the same datasets, inattention and behaviour difficulties at age five predicted reading at age seven, which is the opposite direction from the anxiety result. [mcarthur-2022-tracking]

This is worth separating rather than folding into one headline about reading and mental health, because the two imply different responses. Anxiety appearing alongside a reading difficulty is most likely downstream of it. Attention difficulties appearing alongside one may well be upstream, and are worth assessing in their own right rather than being read as a symptom of frustration with reading.

What the anxiety is actually about

Rarely reading itself, and usually being seen doing it. That distinction matters because it explains why a child can read passably at the kitchen table and fall apart in a classroom, which is often taken as evidence that the difficulty is not real.

The specific fears people describe are being asked to read aloud, being timed, being asked to write on a board, and being handed something to read in front of a group with no warning. All of them are public. A reading intervention that does not touch any of that leaves most of the anxiety intact, which is one reason both belong in the same plan rather than in sequence.

Is the worry part of the picture here?

For a parent, a teacher, or an adult thinking back on their own school years.

0 of 6 ticked

Why late identification still helps

Because the thing that accumulates is a conclusion, and conclusions can be revisited. A child who works markedly harder than the people around them and produces worse results reaches an explanation on their own, and without a better one available it is a conclusion about themselves.

Adults identified decades late routinely describe the explanation as the useful part, ahead of any accommodation that follows it. That is consistent with the direction the longitudinal data points: if the emotional difficulty grew out of the reading difficulty going unexplained, then explaining it is not merely consolation. Our guide to dyslexia in adults covers what assessment involves at that stage.

When to seek help

Speak to a doctor if worry, avoidance or physical symptoms are affecting school, work or sleep, and say plainly that they sit alongside a reading difficulty, because that context changes what is considered. Ask for the reading assessment and the anxiety to be looked at together rather than one after the other. If you are having thoughts of harming yourself, contact your local emergency services or a crisis helpline.

How MyFreud can help

Daily tracking is useful here for a specific reason: the anxiety is situational, so it shows up as a pattern tied to particular days and particular lessons rather than as a general level. That pattern is what makes the case at a school meeting, and it is close to impossible to reconstruct from memory. Our dyslexia guide covers the wider picture, and the anxiety self-assessment measures the other half.

Download MyFreud and start today: App Store or Google Play.

Frequently asked questions

Does dyslexia cause anxiety?

The evidence is closer to yes than most cautious summaries allow, at least for the direction of travel. A meta-analysis found poor readers at moderately raised risk of internalising problems, weighted toward anxiety rather than low mood, and four large longitudinal datasets found reading at age seven predicted anxiety at age nine while the reverse pattern did not hold. Cause is a strong word for observational data, but the timing points one way rather than being ambiguous.

Can anxiety make reading harder?

It certainly makes reading in front of other people harder, and anyone who has been asked to read aloud in a classroom knows it. What the longitudinal data did not find is early anxiety predicting later reading ability, which is different from the moment-to-moment effect. Inattention and behaviour difficulties did predict later reading, so if something emotional is holding reading back, those are the more likely candidates.

Should reading support or anxiety support come first?

Neither, in the sense that the question assumes a queue that does not need to exist. Reading intervention and support for anxiety address different problems and do not compete for the same hour of the week. The pattern worth avoiding is deferring one until the other is finished, since the evidence describes a difficulty that accumulates while people wait.

My child was identified late. Is the damage done?

No, and adults identified in their forties frequently describe the explanation itself as the most useful part. What accumulates is not a fixed injury but a conclusion drawn from years of working harder than everyone else for worse results, and a conclusion can be revisited in a way that a fixed injury cannot. Reading skills also continue to improve well past childhood.

What does this mean for how I talk about it at school?

Raise the anxiety explicitly rather than assuming it will be noticed, because a school looking at reading is measuring reading. Say plainly that the worry, avoidance or stomach aches are part of the picture and should be part of the plan. Ask for both to be in the same document rather than handled by two people who never speak.

References

  1. 1.Francis DA, Caruana N, Hudson JL, McArthur GM ( 2019). The association between poor reading and internalising problems: a systematic review and meta-analysis. Clinical Psychology Review. doi:10.1016/j.cpr.2018.09.002
  2. 2.McArthur G, Badcock N, Castles A, Robidoux S ( 2022). Tracking the relations between children's reading and emotional health across time: evidence from four large longitudinal studies. Reading Research Quarterly. doi:10.1002/rrq.426

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