ADHD or Learning Disabilities (LD)?

Your child was diagnosed with attention deficit disorder, and is taking ADHD medication, but he's still struggling at school. Could a learning disability be to blame? Learn the warning signs, and what parents can do to help.


Filed Under: Learning Disabilities, Diagnosing Children with ADHD, Comorbid Conditions with ADD,
Dr. Larry Silver explains the warning signs that your child might have a learning disability such as dyslexia.

Andrew was diagnosed with attention deficit hyperactivity disorder (ADD ADHD) in first grade. In the fifth grade, his parents brought him to see me for an evaluation after doing poorly in school. Although his hyperactivity and inattention were under control, he had difficulty retaining what he read and knowing what to write when he was assigned a paper. An evaluation showed that he had both Learning Disabilities (LD) and ADHD.

Melissa, an eighth-grader, was failing her courses. Her teachers encouraged Melissa’s parents to have her evaluated for ADHD. I found that, while she had difficulty maintaining attention when doing homework or independent work in class, she didn’t have problems in other settings.

Curiously, her problems had not been evident in elementary school. My assessment showed that her reading, writing, and math skills were weak for her grade level.

She also struggled with organization and time management. Testing confirmed she had a learning disability. The absence of a chronic and pervasive history of inattention ruled out ADHD.

Between 30 and 50 percent of those with ADHD also have a learning disability. The reverse is also true. As a result, it is wise for parents with a child with ADHD to have him evaluated for a learning disability. Melissa’s case illustrates another problem that can confuse parents. If a learning disability is not recognized early enough, a child might exhibit ADHD-like symptoms —fidgeting, doodling, looking around the room—that can mistakenly lead parents and teachers to conclude that he has ADHD. What to do?

First, what not to do. Don’t blame the victim —and don’t let teachers do it either. “She just doesn’t work hard enough,” “He’d have less trouble if he only paid attention”—have you heard such statements before, or have you said them to your child? No child wants to do poorly or to fail. Before you blame your child for his problems, try to find the reason for his lack of success.

Red Flags to Look For

The earlier you suspect your child may have a learning disability, the sooner you can get help. Here are some weaknesses to watch for.

In preschool, look for:

  • Communication problems, such as slow language development, difficulty with speech, problems understanding what is being said or in communicating thoughts.
  • Poor motor coordination and uneven motor development, such as delays in learning to walk, color, and/or use scissors.
  • Problems with memory, routine, and multiple instructions.
  • Delays in socialization, including interacting with other children.

In early elementary school, look for:

  • Problems with rapid letter recognition and with recognizing familiar words by sight. Difficulties learning phonemes (units of sound) and sounding out words.
  • Problems forming letters and numbers. Later, problems with basic spelling and grammar.
  • Difficulties learning math skills and doing math calculations.
  • Difficulty remembering facts.
  • Difficulty organizing materials (notebook, papers), information, and/or concepts. Losing or forgetting material, or doing work and forgetting to turn it in.
  • Not understanding oral instructions. Difficulty expressing oneself.

In later elementary school, look for:

  • Difficulty with independent reading and retaining what was read.
  • Difficulty organizing thoughts for written work.
  • Difficulty learning new math concepts and successfully applying them.
  • Increased difficulty organizing school and personal materials.

In middle school, look for:

  • Increased difficulty retaining what was read, organizing and writing papers, and mastery of more advanced math concepts.
  • Increased difficulty with organizing, planning, and developing learning strategies.

In high school, look for:

  • Increased difficulty with reading assignments, papers and/or math.
  • Increased difficulty with organization, as more independent work is expected.


This article comes from the Spring 2008 issue of ADDitude.

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