Study suggests link between reading difficulties and anxiety

There is a relationship between struggles learning to read and anxiety in children, a new study by the Black Dog Institute and Macquarie University suggests.
 
Published in the Applied Cognitive Psychology Journal, the research involved 284 children aged 7–12 years old from schools based in New South Wales.   
 
Participating children were all assessed on a one-on-one basis for their reading skills, anxiety, attention and behaviour. The results were then compared against baseline findings drawn from previous studies that found around 16% of children have significant and severe reading problems, while around 7–14% experience anxiety.
 
This Black Dog Institute and Macquarie University study showed that 38% of the children assessed had both poor reading and anxiety, while 28% struggled with their reading and 17% struggled with anxiety. The remaining children had reading levels at or above levels for their age.
 
‘We wanted to see if we could profile children with reading and anxiety problems, to help us better identify and support children with these difficulties,’ Dr Deanna Francis, Postdoctoral Research Fellow at the Black Dog Institute said.
 
‘While we assessed children for a range of anxiety problems, we found that children with reading problems were more likely to have social anxiety. This means that these kids tended to worry about being embarrassed or negatively evaluated by their classmates.
 
‘We have a hunch that this is closely related to the idea of “reading anxiety”, but we need to look into this a little further.’
 
Dr Andrew Leech, a GP, educator and advisor with a special interest in paediatrics and mental health, told newsGP the link makes sense and working out whether the anxiety is causing the reading problems or if it is the other way around is something primary care physicians, along with the child’s educators and parents, are well-placed to assess.
 
‘Screening for anxiety in children who have delayed learning … is really crucial and we need to think broadly around children with learning difficulties,’ he said.
 
‘We know there is a strong correlation between mental health difficulties and learning difficulties.  
 
‘General practitioners might be one of the only health professionals that think and have an opportunity to bring this link up.’
 
There is a chance the link between mental health issues and learning problems ‘might go under the radar’ at schools, Dr Leech said, because teachers are busy dealing with the learning aspects of the children.
 
‘Having that open mind to screen for mental health difficulties and just asking how things are going at school and at home in general [is important] … and, depending on their age group, we can adapt those questions accordingly,’ he said.
 
‘Asking whether they find reading and writing to be a daunting experience or whether they are very comfortable with it – they can be very simple questions.’
 
The study found a ‘very tentative suggestion in the data that there may be a specific yet weak association between reading accuracy and social anxiety’, compared with other forms of anxiety, like generalised anxiety or separation anxiety.  
 
Dr Leech points out that, because there are so many different types of screening tools available, it can be difficult to objectively measure anxiety in children.
 
While multiple screening tools may be needed to obtain a diagnosis, seeing the child over an extended period, getting to know them and understanding their struggles in a general practice setting is vital. 
 
‘It is not just a one consult thing,’ Dr Leech said.
 
‘We are trained in the DSM [Diagnostic and Statistical Manual of Mental Disorders] criteria for anxiety disorders and it is the same for children, but I think arriving at a diagnosis also comes from the history and getting to know that child.
 
‘It is not always clearcut. I rarely make just a one label diagnosis; it is often a blend of many different types of anxieties that come and go in severity over a period of time. 
 
‘Labelling a child is not always necessary or helpful. It is more about just understanding what the triggers to their worries are.’
 
Children with anxiety present very differently to adults and GPs need to be aware that behavioural changes or physical complaints may be related to forms of anxiety, Dr Leech explains.
 
‘I have a lot of children presenting with recurring abdominal pain or nausea,’ he said.
 
‘When you ask the right questions, you start to figure out that it is occurring every Sunday night – right before school – or on Monday morning at school drop off.
 
‘Certain patterns of those physical symptoms may actually be related to anxiety. You, of course, have to do a medical screening as well because you have to make sure it is not something causing it.
 
‘But it is important to be mindful of anxiety causing physical symptoms.’
 
There are still a lot of unknowns about why anxiety rates among children seem to be rising and this study may help clinicians better understand one of the potential triggers, according to Dr Leech. 
 
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