What is the impact of ADHD on learning to read?

The young people I work with are brilliant at seeing the ‘bigger picture’. They notice details in illustrations that have passed me by, are incredibly funny and emotionally astute, and have wonderful turns of phrase. But for those with Attention Deficit Hyperactivity Disorder, this neurodivergence can present challenges when learning to read. 

A little bit of science! Whilst ADHD often coexists alongside learning difficulties such as dyslexia, it is important to note that ADHD is a neurodevelopmental condition that affects brain function. However, some aspects of ADHD can lead to specific learning challenges by affecting the management systems (the executive functions) of the brain. This is due to the delay in the development and thickening of the prefrontal cortex areas responsible for these functions which include working memory, cognitive flexibility, self-monitoring, planning and organisation, time management, emotional regulation, inhibition, plus initiation and motivation.  It is also important to note that the term ‘deficit’ implies a lack of attention, whereas it can be more helpful to reframe this as a lack of attentional control - a difficulty or inability in managing distractions (including thoughts) and compulsions. 

The Reading Doctor Whitstable

I think of executive functions as the buses that drive us to our destinations, across a range of different interconnected routes.  If there are impairments or breaks in these routes, in the interconnected circuitry and neural pathways of the brain, then this will impact on the higher-order cognitive functions and behaviours needed to begin, work on and complete tasks.  Put simply, it is much harder for a bus to reach its final destination whilst dealing with diversions, grumpy commuters and excited toddlers, road-rage, bad traffic and beautiful scenery!  But how does this relate to reading? 

Self-regulation

Being able to manage distracting and irrelevant thoughts is a key factor in maintaining focus whilst reading.  A particular sentence may spark a happy memory and take the reader on a momentary journey away from the text, or ignite interesting questions which need answering immediately whilst simultaneously trying to sit still in a classroom, and this cognitive and physical effort hampers the ability to concentrate fully on the meaning of what is being read. 

‘Feeling’ time differently can also impact the regulation of pace (for instance, with the quick completion of tasks).  Fast and accurate word-reading speeds are sometimes seen as a marker of being a ‘good reader’, but if accompanied by missing punctuation, inaccurate expression and jumping lines without noticing, then this reading speed is hiding their ability to absorb what they are reading. 

Cognitive Flexibility 

The ability to quickly shift perspectives, switch between tasks and look at things differently, directly impacts reading success.  Understanding that words have different meanings depending on context, recognising that letters can make different sounds (i.e. ‘the school children are ready to read’), and responding to the visual sight of a word whilst then immediately interpreting its meaning and expressing this correctly whilst reading out loud, requires a constant shift of perspective.  This is a core executive function, and can pose difficulty for a young person with ADHD. 

Working memory

Working memory involves the retention of information whilst manipulating it and applying to different situations. It’s looking at a letter, remembering the sound it makes, and quickly blending to read. Or remembering the shape of the whole word if dyslexia means that segmenting and blending makes reading an even bigger challenge.  It’s remembering what you have read at the end of a lengthy paragraph, or the instructions given to you before returning to your work.   If we think back to the bus analogy, it’s hearing, understanding, remembering and responding to satnav instructions in the lead-up to a double-roundabout.  

This image highlights techniques used to support a year six pupil whose challenges with cognitive flexibility, self-regulation of distracting thoughts and working memory all collide to make independent reading very tricky.  

• Bright and engaging visual prompts provide scaffolds which support independent work on the links in their executive circuitry. 
  

• Doodles on the table capture inquisitive thoughts, allowing us to maintain a flow and fluency before returning to the questions later without having to remember what those questions were.  

• Thinking Sparks provide tools which support ‘reading to learn’ as well as ‘learning to read’  - using pictures cues, and ‘reading on and coming back’ to tricky words to use contextual information when challenges with working memory make relying purely on decoding unknown words very hard.  
  

• Making sure resources are at hand and ready to use as soon as they are needed to maintain focus. 

Overall, it is important to look at our pupils’ self-talk and resilience when in the zone between learning and mastering reading. Negative self-talk and ruminations are common in an ADHD brain, and for children this can lead to huge barriers across all areas of their learning.  But with a clear understanding of what ADHD is, honest and appropriate conversations with children and young people about why they are finding reading tricky, clear examples of what can help, individualised programmes of support including the use of adaptive technologies, and the space and time to celebrate their often unique and creative strengths and personalities, having ADHD should never be a barrier to learning for any child.