Co-occurring Conditions
When your child receives a dyslexia diagnosis, it can feel like a light has finally been switched on. It explains the exhausting reading sessions, the unpredictable spelling, and the massive effort it takes to get through a piece of written homework. However, as time goes on, you might start to notice other struggles that do not seem to neatly fit the classic dyslexia profile.
Perhaps your child is constantly losing their belongings, struggling to catch a ball, finding mental maths completely baffling, or having an incredibly hard time paying attention in class.
If this sounds familiar, your child is not alone. In fact, having "pure" dyslexia is the exception rather than the rule.
The groundbreaking 2024/2025 Delphi Study on dyslexia formally highlighted that neurodevelopmental conditions rarely travel alone. Research shows that anywhere from 40% to 70% of children with dyslexia will also meet the criteria for at least one other specific learning difficulty. This overlap is known as "co-occurrence," and understanding it is the key to unlocking the exact, tailored support your unique child needs within the UK education system.
Why Do These Conditions Overlap?
In the past, professionals tended to look at learning difficulties as entirely separate boxes. If a child struggled to read, they were put in the dyslexia box; if they couldn’t sit still, they were put in the ADHD box; if they were clumsy, they were put in the dyspraxia box.
Modern science has shown us that the brain does not work this way. Experts now use a "multiple deficit model" to explain how learning differences develop. This means that these conditions share many of the same underlying genetic and cognitive "building blocks." For example, a weakness in processing speed is a shared risk factor for both dyslexia and ADHD. A weakness in working memory is a shared risk factor for dyslexia, dyspraxia, and language disorders. Because these conditions share so many of the same neurological roots, if a child has the genetic risk factors for one, they naturally have a higher probability of experiencing others.
Here is a highly detailed look at the most common conditions that co-occur with dyslexia, what they look like, and how they are identified in the UK.
Developmental Coordination Disorder (DCD) / Dyspraxia
While dyslexia is fundamentally a processing difficulty affecting reading and spelling, DCD (commonly known as dyspraxia in the UK) is a lifelong neurodevelopmental condition affecting fine and gross motor coordination. Up to 70% of children with DCD also show evidence of dyslexia and phonological problems.
What it looks like in daily life: A child with dyspraxia may have been late to reach physical milestones like walking or crawling. They often have a "noisy sensorimotor map," meaning their brain struggles to accurately relate what they see to how they move their body through space.
- Gross Motor: They may seem unusually clumsy, prone to tripping or bumping into things, and struggle with team sports, catching a ball, or learning to ride a bike.
- Fine Motor: They often find it hard to manage buttons and shoelaces, use cutlery effectively, or use scissors.
- Executive Function: DCD heavily impacts visual-spatial memory and personal organisation. Remembering PE kits, navigating the school timetable, or keeping a tidy desk can be a daily battle.
The Classroom Overlap with Dyslexia: Both dyslexia and dyspraxia make writing exhausting, but for different reasons. A dyslexic child struggles with the phonetics and memory of spelling. A dyspraxic child struggles with the physical execution of handwriting (sometimes called dysgraphia), leading to a tight, awkward pencil grip and slow, painful, and messy work.
The UK Diagnostic Pathway: A specialist dyslexia assessor cannot formally diagnose DCD/dyspraxia in a child under 16. If motor difficulties are suspected, your child must be referred to a GP to rule out other medical or neurological conditions. The GP will then typically refer your child to an Occupational Therapist (OT) or a community paediatrician for a formal diagnosis and targeted motor-skills support.
Attention Deficit Hyperactivity Disorder (ADHD)
ADHD is a neurobiological condition affecting attention, impulsivity, and hyperactivity. It is incredibly common for a child to have both dyslexia and ADHD (overlapping in up to 40% of cases), which can make a traditional classroom environment particularly challenging.
What it looks like in daily life: ADHD is driven by differences in how the brain uses dopamine, often leading to a "delay aversion"—meaning the child’s brain is constantly seeking immediate reward and stimulation.
- Inattention: A child might be easily distracted, highly disorganised, forgetful, or prone to daydreaming and "zoning out." They may struggle to follow multi-step instructions because their working memory becomes overloaded.
- Hyperactivity/Impulsivity: They may be constantly fidgety, unable to sit still at the dinner table, prone to talking excessively, or likely to act and speak before thinking.
- Emotional Dysregulation: Children with ADHD often experience intense, overwhelming emotions and may have a very low frustration tolerance, leading to outbursts.
- Strengths: Children with ADHD are often highly creative, energetic, and capable of incredible "hyper-focus" when engaged in a topic they are passionate about.
The Classroom Overlap with Dyslexia: Because reading and writing are so mentally taxing for a child with dyslexia, they can quickly become fatigued and frustrated, which sometimes looks like an attention issue. They may act out or avoid the task. However, if a child truly has comorbid ADHD, their attention issues will be present across all areas of life—not just during reading tasks.
The UK Diagnostic Pathway: Like DCD, ADHD in children is diagnosed medically, not educationally. If a dyslexia assessor spots strong indicators of ADHD, they will advise you to visit your GP to request a referral to the Child and Adolescent Mental Health Services (CAMHS) or a community paediatrician for a comprehensive clinical evaluation.
Developmental Language Disorder (DLD)
Dyslexia and DLD are distinct conditions, but they frequently overlap because they both heavily impact how the brain processes language. Astonishingly, around 50% of children with early speech and language delays go on to develop dyslexia.
What it looks like in daily life: While dyslexia primarily affects the ability to decode written words, DLD affects the ability to understand and use spoken language.
- Receptive Language: A child with DLD might struggle to understand complex explanations, follow long verbal instructions, or grasp the "hidden" meaning behind sarcasm, jokes, or idioms (like "pull your socks up").
- Expressive Language: They may use immature grammar for their age (like saying "him doing cuts" instead of "he is cutting"), have a limited vocabulary, rely on vague words like "stuff" or "thingy," or find it incredibly hard to tell a story in the right chronological order.
The Classroom Overlap with Dyslexia: If a child has both conditions, they will not only struggle to read the words on the page accurately (dyslexia), but they will also struggle to understand the meaning of the sentences they are reading (DLD). If your child can read a page of a book perfectly out loud but cannot tell you what just happened in the story, an underlying language disorder may be present.
The UK Diagnostic Pathway: If your child has persistent difficulties understanding or using spoken language, they should be referred to a Speech and Language Therapist (SaLT). In the UK, many NHS SaLT services operate an "open referral" system, meaning parents or schools can refer a child directly without needing to go through a GP.
Dyscalculia and Specific Maths Difficulties
Dyscalculia is a specific, persistent learning difficulty that affects the ability to understand numbers and acquire mathematical skills.
What it looks like in daily life: A child with dyscalculia lacks an intuitive "number sense," also known as numerosity.
- They might struggle to tell which of two numbers is larger without explicitly counting them out.
- They often rely heavily on counting on their fingers well beyond the age their peers do.
- They find it nearly impossible to learn times tables by rote, read an analogue clock, or handle money and calculate change in a shop.
- They may learn a maths rule mechanically one day and completely forget how to apply it the next.
The Classroom Overlap with Dyslexia: Many dyslexic children struggle with maths, but usually because maths is full of language (like confusing word problems) and requires a strong working memory to hold numbers in mind while calculating. They might also sequence numbers incorrectly (writing 42 instead of 24). However, a child with comorbid dyscalculia struggles with the core concept of quantity itself. They cannot "see" the relationships between numbers.
The UK Diagnostic Pathway: A specialist teacher or educational psychologist who holds an Assessment Practising Certificate (APC) and has specific training in mathematical cognition can assess for and identify dyscalculia alongside dyslexia.
Autism Spectrum Condition (ASC)
While distinct from specific learning difficulties, Autism Spectrum Condition (often referred to as ASD) is another neurodevelopmental condition that can co-occur with dyslexia. ASC affects how people see the world and interact with others.
What it looks like in daily life:
- Social Communication: Difficulties interpreting people's feelings, understanding body language, or maintaining back-and-forth conversations.
- Restricted/Repetitive Behaviors: A strong need for routine, deep fascinations with highly specific interests, or repetitive movements.
- Sensory Processing: Over- or under-sensitivity to sensory input, such as finding classroom noise physically painful or being highly distressed by the texture of certain clothes or foods.
The Classroom Overlap with Dyslexia: Autistic learners often have "spiky" cognitive profiles. Some may excel at decoding words early on (hyperlexia) but struggle profoundly with reading comprehension. If an autistic child also has dyslexia, the combined challenge of social communication and language processing can make navigating the school day highly stressful. Like ADHD, autism requires a multi-disciplinary medical diagnosis (usually via CAMHS or paediatric services).
The Invisible Overlap: Mental Health and Anxiety
It is vital to acknowledge that children with complex, overlapping learning profiles are at a significantly higher risk for anxiety, depression, and low self-esteem.
When a child is constantly battling a neurotypical school environment that does not cater to their unique brain—struggling to read the board, forgetting their books, dropping their pencil, and failing to understand the teacher’s instructions—their nervous system is under immense stress. Behavioural outbursts, school avoidance, or extreme withdrawal are often simply the outward signs of this invisible, internal exhaustion.
What This Means for Your Child
When we stop trying to force children into a single diagnostic label, we can start providing the comprehensive, wrap-around support they actually need.
If you suspect your child has more than just dyslexia, here is what you can do:
- Look at the Whole Child: Observe your child's struggles outside of reading and spelling. Are they struggling with balance? Do they forget spoken instructions immediately? Does maths cause severe anxiety? Keep a detailed log of these observations.
- Advocate for Comprehensive Assessment: If you are seeking a formal SpLD assessment, ensure the assessor knows about your broader concerns. A modern assessment will investigate cognitive building blocks like working memory and processing speed, which can flag the need to investigate other conditions.
- Seek the Right Professionals: Understand that an educational assessor identifies learning profiles (like dyslexia and dyscalculia), while medical professionals (GPs, Paediatricians, CAMHS) diagnose conditions like ADHD, Autism, and DCD/dyspraxia.
- Tailor the Interventions: A child with a dual diagnosis needs dual support. For example, a child with both dyslexia and dyspraxia won't just need a phonics-based reading tutor; they need permission to type their exams instead of handwriting them. A child with dyslexia and DLD needs interventions that explicitly build their vocabulary and reading comprehension, not just their phonics.
Having a child with co-occurring conditions can feel overwhelming, but it is important to remember that these learning differences have absolutely no bearing on your child's intelligence. With a clear roadmap of their unique, brilliant brain, the right accommodations, and a fierce focus on their individual strengths, children with complex learning profiles can absolutely thrive.