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Article

Beyond Reading: Psychological and Mental Health Needs in Adolescents with Dyslexia

by
Manuel-Ramón Morte-Soriano
and
Manuel Soriano-Ferrer
*
Department of Developmental and Educational Psychology, University of Valencia, 46010 Valencia, Spain
*
Author to whom correspondence should be addressed.
Pediatr. Rep. 2024, 16(4), 880-891; https://doi.org/10.3390/pediatric16040075
Submission received: 6 September 2024 / Revised: 6 October 2024 / Accepted: 9 October 2024 / Published: 15 October 2024
(This article belongs to the Special Issue Mental Health and Psychiatric Disorders of Children and Adolescents)
Versions Notes

Abstract

:
Background. Overall, children and adolescents diagnosed with dyslexia or ADHD show an increased risk for psychological and mental health problems, and dyslexia and ADHD tend to coexist frequently. Thus, the main objective of this study was to examine psychological and mental health problems in dyslexia. Method. Participated 95 adolescents with dyslexia (DG), comorbid dyslexia + attention-deficit hyperactivity disorder, combined subtype (D + ADHD-CG), and a comparison group with typical development (TDCG). Self-reported measures of anxiety and depression, and parent and teacher versions of the Strengths and Difficulties Questionnaire (SDQ) were used. Results. Self-reports of internalizing problems showed that adolescents in the GD and D + ADHD-CG groups had more depression and stated anxiety problems with a very high percentage above the clinical cut-off point than the CG. Both the parent and teacher reports showed that the DG and D + ADHD-CG groups obtained higher mean values and a higher number of adolescents above the clinical cut-off of internalizing, externalizing, and total problems than the TDCG. The comorbid D + ADHD-CG group had the highest internalizing and externalizing problems. Conclusions. In conclusion, our findings indicate that the internalizing and externalizing problems experienced by adolescents with dyslexia and comorbid ADHD should be recognized early and treated promptly by education professionals.

1. Introduction

Achieving school-age reading proficiency is a public health issue as it is a good determinant of health and longevity and is associated with many indicators of academic, social, career, and even economic success [1,2,3]. However, the process of learning to read is fraught with difficulties and frustrations for some children. The latest edition of the Diagnostic and Statistical System of Mental Disorders [4] encompasses these difficulties known by the term dyslexia within “specific learning disorders”, which impede the ability to learn or use specific academic skills such as reading, writing, or arithmetic. Moreover, the difficulties are unexpected and cannot be explained by the lack of teaching, visual or auditory problems, or intellectual disability [4,5,6]. Two recent meta-analyses [7,8] indicated that this specific learning difficulty is very frequent, affecting around 7% of the world population, depending on the transparency of the orthographic system of the language and culture. Specifically in Spain, the prevalence has been estimated at 6% of secondary school students [9,10].
In addition to academic difficulties, students with dyslexia are at high risk for mental health problems, which commonly include measures of internalizing problems [11,12,13,14,15,16] as well as high levels of externalizing problems [12,13,17]. Traditionally, in child psychopathology [18], internalizing behavior refers to problems that occur primarily within oneself such as anxiety, depression, social isolation, and somatic complaints. On the other hand, externalized behavior includes conflicts with other people and is characterized by impulsivity, hyperactivity, aggressiveness, and rulebreaking.
Students with dyslexia may be more vulnerable to experiencing internalized disorders (e.g., anxiety and depression), possibly due to a low opinion of academic competence coupled with repeated experiences of academic failure [15,19,20]. For example, a meta-analysis of 42 studies revealed that about 70% of students with learning disabilities experienced greater anxiety symptoms than students without learning disabilities [21]. Another meta-analysis [22] conducted to understand depression among students with learning disabilities found higher scores on measures of depression than their peers without learning disabilities, which was true regardless of who reported depression-related symptoms (i.e., self-report, parents, or teachers). Similarly, some recent systematic review and meta-analysis studies [21,23,24] found that poor readers were at greater risk of experiencing anxiety and depression than normal learners with moderate to large effect sizes. In relation to depressive symptomatology, some studies [11,25,26] have found strong links between severe and persistent reading disabilities and an increased risk of depressive mood. However, other studies [27,28,29,30] have shown discrepant results, possibly due to inconsistencies and heterogeneity across studies [21,31]. The lack of significant differences between dyslexia and controls could be attributed to the age of the participants included in the studies. In line with this, a review of studies [32] found an increase in emotional symptomatology with increasing age in participants with dyslexia. Thus, adolescents with dyslexia presented a higher level of self-perceived anxiety, depression, and somatic symptoms while in childhood, no significant differences between dyslexics and controls appeared [33].
On the other hand, many studies have reported an increase in externalizing problems such as antisocial and aggressive behaviors among poor readers [12,16,20,34,35,36]. Externalizing behaviors and withdrawal behaviors can distract children from instruction and classroom activities, interfering with their ability to learn, leading to delayed reading acquisition and low achievement [37].
Different studies [38,39,40] have confirmed that students with dyslexia experienced significantly more internalizing, externalizing, and attention and behavioral problems according to the ratings of teachers, parents, and even the participants themselves. Many of these problems were even found to be above the clinical cut-off point [40].
In fact, learning disabilities such as dyslexia and attention-deficit hyperactivity disorder (ADHD) show high comorbidity [16,41]. In addition, students with ADHD also show high comorbidity with learning disabilities [42,43] and present greater internalizing and externalizing problems as reported by parents and teachers than their control peers [16,44,45,46].
In general, research has highlighted that children diagnosed with dyslexia or ADHD show an increased risk of internalizing and externalizing problems, and that dyslexia and ADHD tend to show high comorbidity [16]. For this reason, the comorbid group of dyslexia plus ADHD carries a higher risk of internalizing and externalizing problems than children with only dyslexia [31]. Therefore, the main aim of this study was to examine whether internalizing and externalizing problems varied in adolescents with dyslexia, with and without comorbid ADHD, and combined subtype using different sources of information such as self-reports as well as ratings of parents and teachers.

2. Materials and Methods

2.1. Participants

Ninety-five adolescents aged 12 to 15 years, together with their parents and teachers, participated in this study: 34 with dyslexia (DG), 28 with dyslexia + attention-deficit hyperactivity disorder (D + ADHD-CG), and 33 with typical development (TDCG). At the time of the study, all participants, from 13 secondary schools, lived in Spain and their mother tongue was Spanish. Table 1 shows the sociodemographic characteristics of all of the participants.
Dyslexia group (DG). Thirty-four adolescents with dyslexia, ranging in age from 12 to 15 years (mean age = 12 years and 10 months, SD = 0 year and 11 months; 79% male) participated. The DSM-5-TR [4] criteria specified to identify students with a specific learning disorder were used: (a) scores at or above 80 on an intelligence test [47], in order to exclude students with cognitive impairments; (b) absence of evidence or history of neurological damage, significant economic disadvantage, emotional disturbance, hearing or visual abnormalities, or any other significant disabling condition; and (c) a reading achievement score at or below the 25th percentile on the word and/or pseudoword reading skills subtests (accuracy and/or speed) of the Standardized Reading Skills Battery PROLEC-SE-R [48]. Two participants (5.9%) had been retained in a grade, 50% (n = 17) had received services in the school resource room prior to this study, and 79.4% (n = 27) had been reported by their teachers as needing help with their homework.
Table 1. Descriptive characteristics of adolescents and their families.
Table 1. Descriptive characteristics of adolescents and their families.
DG
(N = 34)		D + ADHD-CG (N = 28)TDCG
(N = 33)		Statistics
M (SD)M (SD)M (SD)F (2, 92)pηP2
Adolescent Age12.88 (0.98)13.19 (1.2)12.71 (0.76)1.750.170.03
Adolescent IQ103.1 (8.9)103.4 (12.4)102.5 (15.5)0.0340.960.00
Age mother42.2 (4.4)44.9 (5.1)44.5 (5.3)2.910.060.06
Age father46.3 (5.1)47.4 (4.5)47.6 (4.9)0.760.290.02
Adolescent Sexn (%)n (%)n (%)X(2)2p
Male27 (79.4)21 (75)25 (75.8)0.2010.90
Female7 (20.6)7 (25)8 (24.2)
Marital Statusn (%)n (%)n (%)X(2)2p
Married/living together33 (97.1)26 (92.9)30 (90.9)1.1160.57
Alone/widower/divorced1 (2.9)2 (7.1)3 (9.1)
Mother’s occupation an (%)n (%)n (%)X(6)2p
Without paid job8 (23.5)0 (0)8 (24.2)28.720.001
Skill level 117 (50)8 (28.6)14 (42.4)
Skill level 27 (20.6)20 (71.4)6 (18.2)
Skill level 32 (5.9)0 (0)5 (15.2)
Skill level 40 (0)0 (0)0 (0)
Father’s occupation an (%)n (%)n (%)X(8)2p
Without paid job0 (0)5 (17.5)0 (0)24.780.002
Skill level 13 (8.8)0 (0)5 (15.2)
Skill level 224 (70.6)23 (82.1)19 (57.6)
Skill level 36 (17.6)0 (0)7 (21.2)
Skill level 41 (2.9)0 (0)2 (6.1)
Note. a Based on the International Standard Classification of Occupations [49].
Dyslexia + Attention-Deficit Hyperactivity Disorder group (D + ADHD-CG). Twenty-eight adolescents participated, meeting both dyslexia and the combined subtype of ADHD, according to the DSM-5-TR criteria [4]. All adolescents had a previous diagnosis of ADHD combined subtype by mental health services, which was confirmed prior to their participation in this study. Thus, all of them presented the following criteria: six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity according to parent and teacher assessments; persistence of symptoms for more than 6 months; and onset of symptoms before the age of 12 years. In addition, ADHD symptoms would interfere with the subject’s daily academic and/or social functioning. Exclusion criteria applied included having an IQ below 80, autism, psychosis, epilepsy, or any other neurological or genetic disease. The age range of the 28 adolescents in the D + ADHD-CG group ranged from 12 to 15 years (mean age = 13 years and 2 months, SD = 1 year and 2 months; 75% male). Less than 50% of the adolescents were receiving psychopharmacological (42.4%: n = 14) or psychological (36.4%; n = 12) treatment. Two participants (7.1%) had been retained in a grade, 67.9% (n = 19) had received services in the school resource room prior to this study, and 100% (n = 28) had been informed by the teacher that they needed help with their homework.
Typical Development Comparison Group (TDCG). Thirty-three adolescents in the typically developing control group attended regular classrooms and did not receive educational services outside their regular classroom. All participants in the CG group met the following criteria: (a) average or above average academic performance in all areas according to their teachers’ reports; (b) scores of 80 or above in intelligence; and (c) a reading achievement score equal to or above the 50th percentile on the word and pseudoword reading skills subtests of the Standardized Reading Skills Battery PROLEC-SE-R [48]. The age range of the 33 adolescents was between 12 and 15 years (mean age = 12 years and 8 months, SD = 0 year and 9 months. 75% male). None of the adolescents had been retained in a grade or attended the resource room. However, 6.1% (n = 2) had needed help with their homework. In some cases, information on the children’s academic and developmental history was obtained from the school’s psychoeducational support services, and in other cases, this information was obtained from the student’s family.
Demographic characteristics about the adolescents and families are presented in Table 1. There were no statistically significant differences between the three groups of adolescents in IQ and sex. In relation to the families, there were no statistically significant differences between the three groups in terms of parents’ age nor marital status. However, statistically significant differences were found in the mother’s occupation, X(8)2 = 28.72, p < 0.001, and in the father’s occupation, X(8)2 = 24.78, p < 0.002, so these variables were used as a covariate in the later analysis.

2.2. Measures

Intelligence. We used Factor g-R [47] to assess the general mental capacity without the interference of verbal stimuli. The reliability of the Spanish adaptation of this intelligence test is 0.93. In the current sample, the Cronbach’s alpha was 0.87.
Standardized Reading Skills Battery. Each adolescent’s word and pseudoword reading skills were measured with the Standardized Reading Skills Battery PROLEC-SE-R [48]. Word reading requires the correct identification of 96 words that vary greatly in frequency, length, and spelling structure, and pseudoword reading consists of pronouncing 48 pseudowords. In word and pseudoword reading, task completion is timed. These reading batteries had an adequate internal consistency with a Cronbach’s alpha > 0.95 for words and 0.77 for pseudoword reading in both the normalization sample and the current one.
Demographic Information Questionnaire. Parents supplied information about their sex, occupation [49], and marital status. They also responded to items about their child’s past and current schooling (e.g., number of grade retentions and whether they received help with their homework).
Anxiety. Adolescents completed the Spanish adaptation of the State-Trait Anxiety Inventory for Children STAIC; [50]. The STAIC distinguishes between a general proneness to anxious behavior rooted in personality (trait anxiety subscale) and anxiety as a fleeting emotional state (state anxiety subscale). Each subscale includes 20 Likert-type items, scoring on a 3-point scale ranging from 1 (almost never) to 3 (almost always). The Cronbach’s alpha is reported to be above 0.90 [50].
Depression. The Child Depression Inventory CDI; [51] is composed of 27 items that assess depressive symptomatology. The CDI assesses two scales: dysphoria (depressive mood, sadness, worry, etc.) and negative self-esteem (judgments of ineffectiveness, ugliness, meanness, etc.) and provides a total depression score. Each of the items has three response options that score 0 (no symptomatology), 1 (mild symptomatology), or 2 (severe symptomatology). Half of the items begin with the option that reflects the greatest severity of the symptom, and in the rest, the sequence of presentation is reversed. The score is obtained by adding each of the values attributed according to the child’s choice of response; therefore, the higher the score, the greater the intensity of depressive symptomatology presented, and a maximum score of 54 can be obtained. A score of 19 on the total scale represents the 90th percentile (a frequent cut-off point for screening depressed samples), and the scale usually has an alpha coefficient above 0.80 [51].
Emotional and Behavioral problems. The Spanish version of the Strengths and Difficulties Questionnaire (SDQ) for parents and teachers [52,53], which is designed to gather information about the emotional and behavioral difficulties experienced by children from 4 to 17 years old, was used. The SDQ queries positive and negative attributes displayed by the adolescents in the past 6 months across five subscales: emotional symptoms (e.g., often unhappy, down-hearted), conduct problems (e.g., often has temper tantrums or hot temper) and hyperactivity-inattention (e.g., restless, overactive, cannot stay still for long), peer relationship problems (e.g., tends to play alone), and prosocial behavior (e.g., considerate of other people’s feelings). Each subscale is measured by five items, rated by a 3-point scale ranging from 0 (strongly disagree) and 2 (strongly agree). To obtain the total scores, items are summed. Spanish normative data [54] set at the 90th percentile were used as the clinical cut-off range, except for the prosocial behavior subscale, where we used the 20th percentile. The test has been shown to have criterion validity and good test-retest reliability after four and six months (mean = 0.62). Furthermore, the internal consistency is satisfactory, with a Cronbach’s alpha ranging from 0.57 to 0.88 [52]. The Spanish adaptation [53] showed an internal consistency for total difficulties score of 0.84, ranging from 0.75 to 0.78 for the SDQ subscales. In the current sample, the Cronbach’s alpha was 0.96 for emotional problems, 0.92 for conduct and peer relationship problems, and 0.82 for hyperactivity-inattention and prosocial behavior.

2.3. Data Analysis

Data were analyzed using SPSS version 24. First, descriptive statistics were used in order to describe the characteristics of the participants (see Table 1). Therefore, in the case of continuous variables, the mean and SD are provided, while frequencies and percentages are provided for categorical variables. In order to compare psychological and mental health problems between groups, after verifying that the data fulfilled the criterion of statistical normality, applying the Kolmogorov–Smirnov test, a multivariate analysis of covariance (MANCOVA) was performed with the parents’ occupations as covariates (mothers and fathers) due to the statistically significant differences between groups (see participants section) and the group of origin (DG, D + ADHD-CG, TDCG) as a grouping factor. Next, a between-groups analysis of covariance (ANCOVA) was conducted for each measure with the parents’ occupations as covariates (mothers and fathers). To control for multiple comparisons, a Bonferroni correction (0.05/17 = 0.002) was applied in order to determine the significance levels. We report the effect sizes using the partial eta squared statistic (ηp2) with values between 0.01 and 0.10 considered small effect sizes, values between 0.10 and 0.49 considered medium, and values above 0.50 considered large effect sizes. Subsequently, the Bonferroni post hoc test was applied to check the differences between pairs of groups. Additionally, we computed the percentage of adolescents in each group who obtained scores in the clinically elevated range. To do this, dichotomous variables were created to analyze clinically significant impairments of the participants. Each measure was coded as 0 (below 90th percentile) and 1 (above 90th percentile), except for the SDQ prosocial behavior subscale, where we used the 20th percentile.

3. Results

The MANCOVA performed with the parents’ occupations as covariates showed significant main effects by group (Wilks’ Lambda (Λ) = 1197, F(32, 152) = 7.081, p < 0.001, ηp2 = 0.60), with a large effect size.
In relation to mental health problems, results of the ANCOVAs showed significant differences between groups in the majority of variables (see Table 2). Thus, the results showed significant differences between groups in dysphoria, F(2, 90) = 37.604, p < 0.001, ηp2 = 0.45, and in negative self-esteem, F(2, 90) = 21.953, p < 0.001, ηp2 = 0.32, total depression, F(2, 90) = 35.687, p < 0.001, ηp2 = 0.44, and state anxiety, F(2, 90) = 30.101, p < 0.001, ηp2 = 0.40, with a medium effect size. The Bonferroni post hoc showed that in all cases, the DG and D + ADHD-CG groups had more internalizing problems than the other group (TDCG). In addition, there were no significant differences between the DG group and the D + ADHD-CG group. As shown in Table 2, 58.8% in the DG and 60.7% in the D + ADHD-CG groups scored above the clinical cut-off point (above the 90th percentile) in total depression. On the other hand, between 88.2% in DG and 100% of adolescents in the D + ADHD-CG group were identified as clinically impaired in state anxiety (above the 90th percentile). In relation to trait anxiety, the results of the ANCOVAs did not show significant differences between groups. Nevertheless, around 12% of adolescents in the DG and 14% in the D + ADHD-CG groups were identified as clinically impaired in trait anxiety (above 90th percentile), whereas 0% were identified in the TDCG (see Table 3).
In relation to the parents’ ratings of internalizing and externalizing problems, results of the ANCOVAs showed significant differences between groups in the majority of variables (see Table 4). Therefore, the results showed significant differences between groups in emotional symptoms, F(2, 90) = 20.746, p < 0.001, ηp2 = 0.31 and in conduct problems, F(2, 90) = 8.227, p < 0.001, ηp2 = 0.15, with a medium effect size, and in inattention-hyperactivity, F (2, 90) = 62.100, p < 0.001, ηp2 = 0.58 and total difficulties, F(2, 90) = 45.650, p < 0.001, ηp2 = 0.50 with a large effect size. The Bonferroni post hoc showed that in all cases, the D + ADHD-CG group had more emotional and behavioral problems than the other two groups (DG and CG). Additionally, the DG group also showed significantly more emotional and behavioral problems than the CG, with the exception of conduct problems, where there were no differences between the DG and TDCG groups. As indicated in Table 5, the parents reported as clinically impaired in emotional symptoms was 50% of D + ADHD-CG, 24% of DG, and 3% of TDCG; in terms of conduct problems and the total scale, 18% of D + ADHD-CG, 12% of DG, and 0% in TDCG were identified as clinically impaired. Finally, in the inattention-hyperactivity subscale, 96.4% of D + ADHD-CG and 56% of DG were identified by their parents as clinically impaired.
In relation to peer problems and prosocial behaviors, the results of ANCOVAs did not show significant differences between groups. Nevertheless, in peer problems, around 43% of adolescents in the D + ADHD-CG group were identified as clinically elevated by their parents, whereas parents identified around 10% in peer problems in the DG and TDCG (see Table 5). Additionally, the parents reported more adolescents with less prosocial behaviors in the D + ADHD-CG (29%) group than in the others two groups (0% in DG and 6% in TDCG).
With regard to the teachers’ ratings of emotional and behavioral problems, the results of the ANCOVAs showed significant differences between groups (see Table 6) in emotional symptoms, F(2, 90) = 27.176, p < 0.001, ηp2 = 0.38 and in conduct problems, F(2, 90) = 26.347, p < 0.001, ηp2 = 0.37 with a medium effect size, and in inattention-hyperactivity, F(2, 90) = 137.95, p < 0.001, ηp2 = 0.75 and total difficulties, F(2, 90) = 13.642, p < 0.001, ηp2 = 0.65 with a large effect size. The Bonferroni post hoc showed that in all cases, the D + ADHD-CG group had more emotional and behavioral problems than the other two groups (DG and TDCG). Additionally, the DG group also showed significantly more emotional and behavioral problems than the TDCG, with the exception of conduct problems, where there were no differences between the DG and TDCG groups.
As indicated in Table 5, teachers reported 75% of D + ADHD-CG, 40% of DG, and 0% of TDCG as clinically impaired in emotional symptoms. In the conduct problems subscale, 50% of the D + ADHD-CG were identified in the clinical range, while only 3% of DG and 0% of TDCG were classified as clinically impaired. In the total scale, again more than 60% of the D + ADHD-C group was reported by teachers to be clinically impaired compared to 5% of DG and 0% of TDCG. Finally, in the inattention-hyperactivity subscale, 100% of the D + ADHD-CG group were identified by teachers as clinically impaired, whereas only 20% of DG were in the clinical range.
In relation to peer problems and prosocial behaviors, the results of the ANCOVAs did not show any differences between groups. Nevertheless, in peer problems, around 25% of adolescents in the D + ADHD-CG group were identified as clinically elevated by their teachers, whereas the parents identified around 15% in peer problems in the DG and 10% in the TDCG groups (see Table 5). Additionally, the teachers reported slightly more adolescents with less prosocial behaviors in the D + ADHD-CG group (10%) than in the other groups (6% in DG and 0% in TDCG).

4. Discussion

To our knowledge, this study is the first to examine internalizing and externalizing problems in Spanish adolescents with dyslexia, with and without ADHD, using different sources of information such as self-reports and the ratings from the parents and teachers.
In general, both the self-reports from the adolescents themselves and the parents and teachers reported that Spanish adolescents in the two groups with reading difficulties (DG and D + ADHD-CG) obtained higher mean values of internalizing (e.g., state anxiety, depression, emotional problems), externalizing (e.g., conduct problems, inattention-hyperactivity), and total problems than the comparison group, with a higher number of adolescents above the clinical cut-off. In addition, we confirmed that the sample size was adequate and that the power of the significant results was adequate (range 0.80 to 0.83) by using G*Power 3 [55]. Our results are consistent with those in previous studies showing dyslexia as a risk condition for internalizing and externalizing problems [11,13,14,15,16,18,19,21,22,24,25,34,35,36,37,38,39,40], especially during adolescence [31,32].
One aspect that deserves to be highlighted from our findings is that adolescents in the D + ADHD-CG group presented the greatest internalizing and externalizing problems according to the ratings of the parents and teachers, since, as concluded in the review of previous studies, comorbidity with ADHD is one of the main risk factors [31]. However, our findings with the adolescent self-reporting measures failed to show differences between the two groups with reading difficulties, with and without associated ADHD (GD and D + ADHD-CG). This lack of differences between the two groups is possibly due to strong evidence that a substantial proportion of students with attention-deficit hyperactivity disorder (ADHD) tend to make more positive assessments of their own abilities relative to other external assessments. That is, children and adolescents with ADHD appear to exhibit a self-enhancement bias, being unaware of their thinking patterns, feelings, and behaviors, so their self-reports are often at variance with the assessment of their parents and teachers of them, even with objective evaluations. This positive self-assessment may persist into adulthood [56,57,58]. Although these discrepancies between self-reports and parent and teacher ratings may be considered as measurement errors or informant bias [59], they may also reflect the true differences related to the environment (e.g., home and school) and/or differences in the informant’s knowledge and experiences [60,61,62,63,64].
Our results should be interpreted in light of some of the limitations of the present study. A first limitation concerns the age range of the participants. Our sample was limited to early adolescence (13–15 years), so further research should investigate in depth the development of mental health problems in older adolescents. Longitudinal studies would allow for the detection of early signs of emotional and behavioral problems as well as the possible risk and protective factors for these problems and their progression through the life cycle. A second limitation was the absence of an ADHD group without a reading disability. Comparing this group with an ADHD group without dyslexia would allow us to better understand the impact of ADHD on internalizing and externalizing symptoms.
There are several implications for the practice of our findings. Our results confirm that the presence of dyslexia increases the risk of experiencing mental health problems (anxiety and depression) as well as the presence of internalizing and externalizing problems. Some researchers [12,13] have highlighted that most interventions tend to focus on academic domains, not paying attention to internalizing and externalizing problems. Given that academic progress, emotional well-being, and mental health are intimately related [12,19,65], the presence of mental health problems should be promptly recognized and treated in combination with academic problems, especially in school contexts [66,67] due to several reasons: (a) adolescents spend a large number of hours per day in schools; (b) mental health problems can be normalized to a greater extent due to the number of students; and (c) they allow for easy access to teachers and families who can participate in the implementation of interventions. Recent reviews [65,66,67] have confirmed the effectiveness that different psychoeducational interventions, many of which employ cognitive-behavioral techniques, have in reducing the risk and/or symptomatology of anxiety and depression in adolescents. For example, the solution focused behavior therapy program [68,69] focuses on enhancing the behavioral and social-emotional functioning of students with reading difficulties and/or ADHD as well as their academic achievement. In the same vein, other studies [70,71] have confirmed the effectiveness of combined programs on reading and anxiety, both in terms of improving reading difficulties and comprehension as well as reducing anxiety symptoms.

5. Conclusions

In summary, interventions aimed at students with learning difficulties such as dyslexia should address both academic problems and their mental health and/or socio-emotional and behavioral problems, in order to provide them with an educational response more appropriate to their needs. Moreover, if these combined interventions are developed in the early grades, they could further reduce both the academic difficulties and internalizing and externalizing problems of adolescents.

Author Contributions

Conceptualization, M.-R.M.-S. and M.S.-F.; Methodology, M.-R.M.-S. and M.S.-F.; Formal analysis, M.-R.M.-S. and M.S.-F.; Investigation, M.-R.M.-S. and M.S.-F.; Resources, M.-R.M.-S. and M.S.-F.; Data curation, M.-R.M.-S. and M.S.-F.; Writing—original draft preparation, M.-R.M.-S. and M.S.-F.; Writing—review and editing, M.-R.M.-S. and M.S.-F.; Visualization, M.S.-F.; Supervision, M.S.-F.; Project administration, M.S.-F.; Funding acquisition, M.S.-F. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of University of Valencia (protocol code H1518525013984, date of approval 2 March 2018).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Data are available on reasonable request from the corresponding author.

Acknowledgments

We would like to thank the Spanish Government for its support through Plan Nacional I + D + i (Ministry of Economy and Competitiveness), number EDU2012-35786. We would also like to thank all of the adolescents, their parents, and teachers for their participation in the study.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Cree, A.; Kay, A.; Steward, J. The Economic and Social Cost of Illiteracy: A Snapshot of Illiteracy in a Global Context; World Literacy Foundation: Melbourne, Australia, 2012. [Google Scholar]
  2. Irwin, L.G.; Siddiqi, A.; Hertzman, C.; World Health Organization. Early Child Development: A Powerful Equalizer: Final Report for the World Health Organization’s Commission on the Social Determinants of Health; Human Early Learning Partnership: Vancouver, BC, Canada, 2007. [Google Scholar]
  3. Johnston, R.B., Jr. Poor Education Predicts Poor Health—A Challenge Unmet by American Medicine; National Academy of Medicine: Washington, DC, USA, 2019. [Google Scholar]
  4. American Psychiatric Association [APA]. Manual Diagnóstico y Estadístico de Los Trastornos Mentales. Texto Revisado. DSM-5-TR, [Diagnostic and Statistical Manual of Mental Disorders, Text Revised], 5th ed.; E. Médica Panamericana: Madrid, Spain, 2023. [Google Scholar]
  5. Fletcher, J.M.; Lyon, G.R.; Fuchs, L.S.; Barnes, M.A. Learning Disabilities: From Identification to Intervention, 2nd ed.; Guilford Press: New York, NY, USA, 2018. [Google Scholar]
  6. Shaywitz, S.E. Dyslexia. N. Engl. J. Med. 1998, 338, 307–312. [Google Scholar] [CrossRef] [PubMed]
  7. Yang, L.; Li, C.; Li, X.; Zhai, M.; An, Q.; Zhang, Y.; Zhao, J.; Weng, X. Prevalence of Developmental Dyslexia in Primary School Children: A Systematic Review and Meta-Analysis. Brain Sci. 2022, 12, 240. [Google Scholar] [CrossRef] [PubMed]
  8. Cubilla-Bonnetier, D. Prevalencia de la dislèxia del desarrollo en espanyol: Un metaanàlisis [Prevalence of developmental dyslexia in Spanish: A meta-analysis]. Rev. Argent. Cienc. Comport. 2024, 16, 1–13. [Google Scholar]
  9. Jiménez, J.E.; Gúzman, R.; Rodríguez, C.; Artiles, C. Prevalencia de las dificultades específicas de aprendizaje: La dislexia en español [Prevalence of specific learning disabilities: Dyslexia in Spanish]. An. Psicol. 2009, 25, 78–85. [Google Scholar]
  10. González, D.; Jiménez, J.E.; García, E.; Díaz, A.; Rodríguez, C.; Crespo, P.; Artiles, C. Prevalencia de las dificultades específicas de aprendizaje en la Enseñanza Secundaria Obligatoria [Prevalence of specific learning disabilities in Compulsory Secundary Education. Eur. J. Educ. Psychol. 2010, 3, 317–327. [Google Scholar]
  11. Carroll, J.M.; Maughan, B.; Goodman, R.; Meltzer, H. Literacy difficulties and psychiatric disorders: Evidence for comorbidity. J. Child Psychol. Psychiatry 2005, 46, 524–532. [Google Scholar] [CrossRef]
  12. Swanson, E.; Vaughn, S. Learning Disabilities: Academic and Mental Health Needs. In Critical Issues in School-Based Mental Health; Holt, M.K., Grills, A.E., Eds.; Routledge: New York, NY, USA, 2016; pp. 30–41. [Google Scholar]
  13. Hendren, R.L.; Halt, S.L.; Black, J.M.; White, N.C.; Hoelt, F. Recognizing psychiatric comorbidity with reading disorders. Front. Psychiatry 2018, 9, 101. [Google Scholar] [CrossRef]
  14. Lee, E.J.; Bukouski, W.M. Co-development of internalizing and externalizing problem behaviors: Causal direction and common vulnerability. J. Adolesc. 2012, 35, 713–729. [Google Scholar] [CrossRef]
  15. Panicker, A.S.; Chelliah, A. Resilience and Stress in children and adolescents with specific learning disability. J. Can. Acad. Child Adolesc. Psych. 2016, 25, 17–23. [Google Scholar]
  16. Willcutt, E.G.; Pennington, B.F. Psychiatric comorbidity in children and adolescents with reading disabilities. J. Child Psychol. Psychiatry 2000, 41, 1039–1048. [Google Scholar] [CrossRef]
  17. Heiman, T.; Olenik-Shemesh, D. Socio-emotional profile of children with and without learning disabilities: The relationships with perceived loneliness, self-efficacy and well-being. Intern. J. Environ. Res. Public Health 2020, 17, 7358. [Google Scholar] [CrossRef] [PubMed]
  18. Achenbach, T.M.; Rescorla, A. Manual for the ASEBA School-Age Forms & Profiles; Research Center for Children, Youth & Families, University of Vermont: Burlington, VT, USA, 2001. [Google Scholar]
  19. Boyes, M.E.; Leitao, S.; Claessen, M.; Badcock, N.A.; Nayton, M. Why are reading difficulties associated with mental health problems? Dyslexia 2016, 22, 263–266. [Google Scholar] [CrossRef]
  20. Zuppardo, L.; Serrano, F.; Pirrone, C.; Rodriguez-Fuentes, A. More Than Words: Anxiety, Self-Esteem, and Behavioral Problems in Children and Adolescents with Dyslexia. Learn. Disabil. Q. 2023, 46, 77–91. [Google Scholar] [CrossRef]
  21. Nelson, J.M.; Harwood, H. Learning disabilities and anxiety: A meta-analysis. J. Learn. Disabil. 2011, 44, 3–17. [Google Scholar] [CrossRef]
  22. Nelson, J.M.; Harwood, H. A meta-analysis of parent and teacher reports of depression among students with learning disabilities: Evidence for the importance of multi-informant assessment. Psychol. Sch. 2011, 48, 371–384. [Google Scholar] [CrossRef]
  23. Vieira, A.P.A.; Peng, P.; Antoniuk, A.; DeVries, J.; Rothou, K.; Parrila, R.; Georgiou, G. Internalizing problems in individuals with reading, mathematics and unspecified learning difficulties: A systematic review and meta-analysis. Ann. Dyslexia 2024, 74, 4–26. [Google Scholar] [CrossRef]
  24. Francis, D.A.; Caruana, N.; Hudson, J.L.; McArthur, G.M. The association between poor reading and internalizing problems: A systematic review and meta-analysis. Clin. Psychol. Rev. 2019, 67, 45–60. [Google Scholar] [CrossRef]
  25. Mammarella, I.C.; Ghisi, M.; Bomba, M.; Botessi, G.; Caviola, S.; Broggi, F.; Nocinovich, R. Anxiety and depression in children with nonverbal learning disabilities, reading disabilities, or typical development. J. Learn. Disabil. 2016, 49, 130–139. [Google Scholar] [CrossRef] [PubMed]
  26. Li, M.; Zhao, W.; Liu, M.; Zhang, L.; Li, G. Mental health among children with and without reading difficulties. Ann. Dyslexia 2024, 74, 27–46. [Google Scholar] [CrossRef]
  27. Arnold, E.M.; Goldston, D.B.; Walsh, A.K.; Reboussin, B.A.; Daniel, S.S.; Hickman, E.; Wood, F.B. Severity of emotional and behavioral problems among poor and typical readers. J. Abnorm. Child Psychol. 2005, 33, 205–217. [Google Scholar] [CrossRef]
  28. Maag, J.W.; Reid, R. Depression among students with learning disabilities: Assessing the risk. J. Learn. Disabil. 2006, 39, 3–10. [Google Scholar] [CrossRef] [PubMed]
  29. Miller, C.J.; Hynd, G.W.; Miller, S.R. Children and dyslexia: Not necessarily at risk for elevated internalizing symptoms. Read. Writ. 2005, 18, 425–436. [Google Scholar] [CrossRef]
  30. Grills, C.J.; Fletcher, J.M.; Vaughn, S.; Barth, A.; Denton, C.A.; Stuebering, K.K. Anxiety and response to reading intervention among first grade students. Child Youth Care Forum 2014, 43, 417–431. [Google Scholar] [CrossRef] [PubMed]
  31. Mugnaini, D.; Lassi, S.; La Malfa, G.; Albertini, G. Internalizing correlates of dyslexia. World J. Pediatrics 2009, 5, 255–264. [Google Scholar] [CrossRef]
  32. Avenevoli, S.; Knight, E.; Kessler, R.C.; Merikangas, K.R. Epidemiology of depression in children and adolescents. In Handbook of Depression in Children and Adolescents; Abela, J.R.Z., Hankin, B.L., Eds.; The Guildford Press: New York, NY, USA, 2008; pp. 6–32. [Google Scholar]
  33. Giovagnoli, S.; Mandolesi, L.; Magri, S.; Gualtieri, L.; Fabbri, D.; Tossani, E.; Benassi, M. Internalizing symptoms in developmental dyslexia: A comparison between primary and secondary school. Front. Psychol. 2020, 11, 461. [Google Scholar] [CrossRef]
  34. Halonen, A.; Aunola, K.; Ahonen, T.; Nurmi, J.E. The role of learning to read in the development of problem behavior: A cross-lagged longitudinal study. Br. J. Educ. Psychol. 2006, 76, 517–534. [Google Scholar] [CrossRef]
  35. McIntosh, k.; Sadler, C.; Brown, J.A. Kindergarten reading skill level and change as a risk factors for chronic problem behavior. J. Posit. Behav. Interv. 2012, 14, 17–28. [Google Scholar] [CrossRef]
  36. Morgan, P.L.; Farkas, G.; Tufis, P.A.; Sperling, R.A. Are reading and behavior problems risk factors for each other? J. Learn. Disabil. 2008, 41, 417–436. [Google Scholar] [CrossRef]
  37. Lim, H.J.; Kim, J. A longitudinal study of children’s social behaviors and their causal relationship to reading growth. Asia Pac. Educ. Rev. 2011, 12, 197–213. [Google Scholar] [CrossRef]
  38. Heiervang, E.; Lund, A.; Jim, S. Behavior problems in children with dyslexia. Nord. J. Psychiatry 2001, 55, 251–256. [Google Scholar] [CrossRef]
  39. Knivsberg, A.M.; Andreassen, A.B. Behavior, attention and cognition in severe dyslexia. Nord. J. Psychiatry 2008, 62, 59–65. [Google Scholar] [CrossRef] [PubMed]
  40. Dahle, A.E.; Knivsberg, A.M. Internalizing, externalizing and attention problems in dyslexia. Scand. J. Disabil. Res. 2014, 16, 179–193. [Google Scholar] [CrossRef]
  41. Darweesh, A.M.; Elserogy, Y.M.; Khalifa, H.; Gabra, R.H.; El-Ghafour, M. Psychiatric comorbidity among children and adolescents with dyslexia. Middle East. Curr. Psychiatry 2020, 27, 28. [Google Scholar] [CrossRef]
  42. Miranda, A.; Garcia, R.; Soriano-Ferrer, M. Habilidad narrativa de estudiantes con Trastorno de Déficit de Atención con Hiperactividad [Narrative ability of students with Attention Deficit Hyperactivity Disorder]. Psicothema 2005, 17, 227–232. [Google Scholar]
  43. Miranda, A.; Soriano-Ferrer, M.; Baixauli, I. Written composition performance of students with attention-deficit hyperactivity disorder. Appl. Psycholing 2013, 34, 443–460. [Google Scholar] [CrossRef]
  44. Miranda, A.; Soriano-Ferrer, M.; Fernández, I.; Meliá, A. Emotional and behavioral problems in children with Attention Deficit Hyperactivity Disorder: Impact of age and learning disabilities. Learn. Disabil. Q. 2008, 34, 171–185. [Google Scholar] [CrossRef]
  45. Lau, T.W.I.; Lim, C.G.; Accharryya, S.; Lim-Ashwoth, N.; Tan, Y.R.; Fung, S.S.D. Gender differences in externalizing and internalizing problems in Singaporean children and adolescents with attention-deficit/ hyperactivity disorder. Child Adolesc. Psychiatry Ment. Health 2021, 15, 1–11. [Google Scholar] [CrossRef]
  46. Nelson, J.M.; Liebel, S.W. Anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD): Cross-informant, sex, and subtype differences. J. Am. Coll. Health 2018, 66, 123–132. [Google Scholar] [CrossRef]
  47. Cattell, R.B.; Cattell, A.K.S.; Weiss, R.H. Factor g-R. Test de Inteligencia no Verbal-Revisado [Factor g-R Test. Non-Verbal Intelligence Test-Revised]; TEA: Madrid, Spain, 2017. [Google Scholar]
  48. Cuetos, F.; Arribas, D.; Ramos, J.L. Batería de Evaluación de los Procesos Lectores en Secundaria y Bachillerato. PROLEC-SE-R. [Battery of Evaluation of the Reading Processes in Secondary and Baccalaureate. PROLEC-SE-R]; TEA: Madrid, Spain, 2016. [Google Scholar]
  49. International Labour Organization [ILO]. International Standard Classiffication of Occupations. ISCO-08; International Labour office: Geneva, Switzerland, 2012. [Google Scholar]
  50. Spielberger, C.D. STAIC. Cuestionario de Ansiedad Estado-Rasgo en Niños [State-Trait Anxiety Inventory for Children]; TEA: Madrid, Spain, 2014. [Google Scholar]
  51. Kovacs, M. Inventario de Depresión Infantil [Children’s Depression Inventory]; TEA: Madrid, Spain, 2004. [Google Scholar]
  52. Goodman, R. Psychometric properties of the strengths and difficulties questionnaire. J. Am. Acad. Child Adolesc. Psychiatry 2001, 40, 1337–1345. [Google Scholar] [CrossRef]
  53. Ortuño-Sierra, J.; Aritio-Solana, R.; Fonseca-Pedrero, E. Mental health difficulties in children and adolescents: The study of the SDQ in the Spanish National Health Survey 2011–2012. Psychiatry Res. 2017, 259, 236–242. [Google Scholar] [CrossRef]
  54. Español-Martín, G.; Pagerols, M.; Prat, R.; Rivas, C.; Sixto, L.; Valero, S.; Soler, M.; Ribasés, M.; Ramos-Quiroga, J.A.; Casas, M.; et al. Strenghts and Difficulties Questionnaire: Psychometric properties and Normative data for Spanish 5 to 17 year olds. Assessment 2020, 5, 1445–1458. [Google Scholar] [CrossRef]
  55. Faul, F.; Erdfelder, E.; Lang, A.-G.; Buchner, A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav. Res. Methods 2007, 39, 175–191. [Google Scholar] [CrossRef] [PubMed]
  56. Chan, T.; Martinussen, R. Positive Illusions? The Accuracy of Academic Self-Appraisals in Adolescents with ADHD. J. Pediatr. Psychol. 2016, 41, 799–809. [Google Scholar] [CrossRef] [PubMed]
  57. Colomer, C.; Martinussen, R.; Wiener, J. The self-enhancement bias in attention deficit/hyperactivity disorder: Origin, nature, and consequences. Curr. Dev. Disord. Rep. 2016, 3, 1–6. [Google Scholar] [CrossRef]
  58. Colomer, C.; Wiener, J.; Varma, A. Do Adolescents with ADHD Have a Self-Perception Bias for Their ADHD Symptoms and Impairment? Can. J. Sch. Psychol. 2020, 35, 238–251. [Google Scholar] [CrossRef]
  59. De Los Reyes, A.; Thomas, S.A.; Goodman, K.L.; Kundey, S.M. Principles underlying the use of multiple infor mants’ reports. Annu. Rev. Clin. Psychol. 2013, 9, 123–149. [Google Scholar] [CrossRef]
  60. Achenbach, T.M. Commentary: Definitely more than measurement error: But how should we understand and deal with informant discrepancies? J. Clin. Child Adolesc. Psychol. 2011, 40, 80–86. [Google Scholar] [CrossRef]
  61. Achenbach, T.M. Future directions for clinical research, services, and training: Evidence-based assessment across informants, cultures, and dimensional hierarchies. J. Clin. Child Adolesc. Psychol. 2017, 46, 159–169. [Google Scholar] [CrossRef]
  62. De Los Reyes, A.; Kazdin, A. Measuring informant discrepancies in clinical child research. Psychol. Assess. 2004, 16, 330–334. [Google Scholar] [CrossRef]
  63. De Los Reyes, A.; Kazdin, A. Informant discrepancies in assessment of childhood psychopathology: A critical review. Psychol. Bull. 2005, 131, 483–509. [Google Scholar] [CrossRef]
  64. Morte-Soriano, M.R.; Begeny, J.; Soriano-Ferrer, M. Parent and teacher ratings of behavioral executive functioning for students with dyslexia. J. Learn. Disabil. 2021, 54, 373–387. [Google Scholar] [CrossRef]
  65. Gyereh, J.; Shukla, M. Risk factors of and interventions for mental health problems in learning disabilities: A systematic review of psychological therapies for parents and children. Curr. Psychol. 2024, 43, 3956–3972. [Google Scholar] [CrossRef]
  66. Garcia-Lopez, L.J.; Jimenez-Vazquez, D.; Muela-Martinez, J.A.; Piqueras, J.A.; Espinosa-Fernandez, L.; Canals-Sans, J.; Vivas-Fernandez, M.; Morales-Hidalgo, P.; Diaz-Castela, M.-M.; Rivera, M.; et al. Effectiveness of a transdiagnostic indicated preventive intervention for adolescents at high risk for anxiety and depressive disorders. Curr. Psychol. 2024, 43, 15484–15498. [Google Scholar] [CrossRef]
  67. López-Villegas, A.; Sánchez-Sandoval, Y. Intervenciones psicoeducativas sobre salud mental con adolescentes en contextos escolares: Una revisión sistemática [Psychoeducational interventions on mental health with adolescents in scholar contexts: A systematic review]. Rev. Psicol. Clin. Con Ninos Adolesc. 2024, 11, 33–41. [Google Scholar] [CrossRef]
  68. Daki, J.; Savage, R. Solution-Focused Brief Therapy: Impacts on Academic and Emotional Difficulties. J. Educ. Res. 2010, 103, 309–326. [Google Scholar] [CrossRef]
  69. Woods, K.; Bond, C.; Humphrey, N.; Symes, W.; Green, L. Systematic Review of Solution Focused Brief Therapy (SFBT) with Children and Families; Research Report DFE-RR179; Department for Education: London, UK, 2011.
  70. Francis, D.; Hudson, J.L.; Kohnen, S.; Mobach, L.; McArthur, G.M. The effect of an integrated reading and anxiety intervention for poor readers with anxiety. PeerJ 2021, 9, e10987. [Google Scholar] [CrossRef]
  71. Vaughn, S.; Grills, A.E.; Capin, P.; Roberts, G.; Fall, A.M.; Daniel, J. Examining the Effects of Integrating Anxiety Management Instruction within a Reading Intervention for Upper Elementary Students with Reading Difficulties. J. Learn. Disabil. 2022, 55, 408–426. [Google Scholar] [CrossRef]
Table 2. Comparison of mental health (depression and anxiety) problems.
Table 2. Comparison of mental health (depression and anxiety) problems.
DG (N = 34)D + ADHD-CG (N = 28)TDCG (N = 33)F(2, 90)pηp2
MSDMSDMSD
CDI—Dysphoria6.622.367.392.372.452.3037.6040.0010.45
CDI—Negative Self-Esteem10.622.7211.042.706.82321.9530.0010.32
CDI—Total Depression Score17.244.2018.464.709.274.9535.6870.0010.44
STAIC—Trait Anxiety36.217.4536.077.6932.215.044.6370.0120.09
STAIC—State Anxiety47.8510.0253.215.23368.0430.1010.0010.40
Table 3. N and percentage of adolescents above a clinically elevated score.
Table 3. N and percentage of adolescents above a clinically elevated score.
DG (N = 34)D + ADHD-CG (N = 28)TDCG (N = 33)
n (%) n (%) n (%)
CDI—Total Depression Score20 (58.8)17 (60.7)2 (6.1)
STAIC—Trait Anxiety4 (11.8)4 (14.3)0 (0)
STAIC—State Anxiety30 (88.2)28 (100)3 (9.1)
Table 4. Comparison of the parents’ ratings on emotional and behavioral problems.
Table 4. Comparison of the parents’ ratings on emotional and behavioral problems.
DG
(N = 34)		D + ADHD-CG (N = 28)TDCG
(N = 33)		F(2, 90)pηp2
SDQMSDMSDMSD
Emotional Symptoms2.682.54.42.20.881.0820.7460.0010.31
Conduct Problems1.321.471.541.50.520.568.2270.0010.15
Inattention-Hyperact.4.622.471.331.581.662.1000.0010.58
Peer Problems1.822.42.292.10.941.42.6730.0740.05
Prosocial Behaviors8.443.18.41.38.701.40.1920.8250.00
Total Difficulties9.855.5115.114.43.913.545.6500.0010.50
Table 5. N and percentage of the ratings of the parents and teachers above a clinically elevated score in each group.
Table 5. N and percentage of the ratings of the parents and teachers above a clinically elevated score in each group.
DG
(N = 34)		D + ADHD
-CG (N = 28)		TDCG
(N = 33)
ParentTeacherParentTeacherParentTeacher
n (%) n (%) n (%) n (%) n (%) n (%)
Emotional Symptoms8 (23.5)14 (41.2)14 (50)21 (75)1 (3)0 (0)
Conduct Problems4 (11.8)1 (2.9)5 (17.9)14 (50)0 (0)0 (0)
Inattention-Hyperact.19 (55.9)7 (20.6)27 (96.4)28 (100)1 (3)0 (0)
Peer Problems4 (11.8)5 (14.7)12 (42.9)7 (25)3 (9.1)3 (9.1)
Prosocial Behaviors0 (0)2 (5.8)8 (28.6)3 (10.3)2 (6.1)0 (0)
Total Difficulties4 (11.8)2 (5.2)5 (17.9)18 (64.3)0 (0)0 (0)
Table 6. Comparison of the teachers’ ratings on emotional and behavioral problems.
Table 6. Comparison of the teachers’ ratings on emotional and behavioral problems.
DG
(N = 34)		D + ADHD-CG (N = 28)TDCG
(N = 33)		F(2, 90)pηp2
MSDMSDMSD
Emotional Symptoms2.12.14.041.90.76127.1760.0010.38
Conduct Problems0.650.883.933.10.210.5526.3470.0010.37
Inattention-Hyperact.3.61.436.90.471.151.5137.9570.0010.75
Peer Problems0.711.32.12.20.611.294.4760.010.09
Prosocial Behaviors7.412.656.961.758.451.92.8600.0620.06
Total Difficulties7.13.416.95.22.732.9413.6420.0010.65
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Morte-Soriano, M.-R.; Soriano-Ferrer, M. Beyond Reading: Psychological and Mental Health Needs in Adolescents with Dyslexia. Pediatr. Rep. 2024, 16, 880-891. https://doi.org/10.3390/pediatric16040075

AMA Style

Morte-Soriano M-R, Soriano-Ferrer M. Beyond Reading: Psychological and Mental Health Needs in Adolescents with Dyslexia. Pediatric Reports. 2024; 16(4):880-891. https://doi.org/10.3390/pediatric16040075

Chicago/Turabian Style

Morte-Soriano, Manuel-Ramón, and Manuel Soriano-Ferrer. 2024. "Beyond Reading: Psychological and Mental Health Needs in Adolescents with Dyslexia" Pediatric Reports 16, no. 4: 880-891. https://doi.org/10.3390/pediatric16040075

APA Style

Morte-Soriano, M. -R., & Soriano-Ferrer, M. (2024). Beyond Reading: Psychological and Mental Health Needs in Adolescents with Dyslexia. Pediatric Reports, 16(4), 880-891. https://doi.org/10.3390/pediatric16040075

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