Toll Free
877.485.1973 | T: 541.485.1973 | F: 541.683.7543
 | P.O. Box 11248 | Eugene, OR 97440

Facebook footer  Tiwtter footer  LinkedIn footer  YouTube footer  Vimeo footer  Pinterest footer

Literacy and mental health (updated 2018)

Dr Kerry Hempenstall, Senior Industry Fellow, School of Education, RMIT University, Melbourne, Australia.

First published Nov 5 2012, updated 19/8/2016, 12/6/2018

 

All my blogs can be viewed on-line or downloaded as a Word file or PDF at https://www.dropbox.com/sh/olxpifutwcgvg8j/AABU8YNr4ZxiXPXzvHrrirR8a?dl=0


The relationship between mental health and literacy is not easy to disentangle, as studies are usually correlational in design. Certainly, there does appear to be a link - but does illiteracy cause mental health problems, or might mental health problems impede literacy development? Or perhaps a third variable affects both domains. One obvious candidate for a causal link involves extended failure caused or exacerbated by inadequate instruction, particularly in that first big educational hurdle – literacy development.

David Boulton of the Children of the Code fame writes about the unfortunate subjective experience of children with sustained educational low achievement, suggestive of an impact on self-esteem, mental health, and preparedness to persevere. His writings can be found by Googling the heading: Stewarding Healthy Learning.

What does it mean that most of our children are chronically improficient in the skill areas most critically important for success in school?

“What does it feel like - how does it feel, to be chronically, day after day, week after week, month after month, and for a great many children, year after year - not good enough? Not good enough at something that they know is important, that they know is causing them to fall behind, that they can’t seem to get good enough at achieving, and that they can’t hide because their family, friends, and peers know about it too?

What is the effect of chronically feeling ‘not good enough’ about your learning?

There can be a great many reasons why a child is below proficiency in a critical competency area: innate brain issues, impoverished family learning environments (poor developmental learning trajectories), low self-esteem, incompetent preschools, undifferentiated grade school instruction, and many others (including in some cases issue of 'effort'). None of the most common factors, are the child’s fault. Yet, we all conspire, unintentionally yet pervasively, to contribute to the conditions that cause children to experience their improficiencies as if they are their fault – as if they are struggling because they are not good enough, not trying hard enough, not smart enough, not good enough learners.

What do you feel when you blame yourself for not being good enough at something that is important to you and that you do in public? You feel shame.

So what NAEP (and our other educational data aggregations) tell us is that a vast number of our children are experiencing chronic self-blame/shame about not being good enough at learning. Put another way, education is creating the conditions in which a vast number of our children feel chronically ashamed of their minds.

How well do you do at things that cause you to feel ashamed of yourself when you do them? How long can you sustain trying to learn something that frustrates you and causes you to feel stupid? Everyday for a week… for a month… for a year… for years?

If we are honest with ourselves, we have to admit that we are pretty good at doing whatever we have to do to avoid the situations that lead to that dreaded feeling of shame. When we feel ashamed of our looks, our bodies, our singing voices, or our dancing moves, we wear more make-up, we avoid wearing certain kinds of clothes, we stay away from Karaoke bars and dance floors. But what happens when learning challenges evoke shame? What happens to our learning when we feel ashamed of not learning well enough?

Being ashamed of our minds – being ashamed of our ability to learn (“mind-shame”) is learning disabling because we tend to avoid the shame we feel by avoiding the learning challenges that cause us to feel shame”.

David Boulton on Monday, 10 September 2012: See below or at http://www.learningstewards.org/what-does-it-mean-that-most-of-our-children-are-chronically-improficient-in-the-skills-most-critically-important-for-success-in-school/


Below are some quotes collected from papers investigating the literacy - mental health relationship. Both internalising and externalising behaviours are often noted:

“A growing literature indicates that children with reading difficulties are at elevated risk for both internalizing (emotional) and externalizing (behavioural) problems. Longitudinal studies have demonstrated that reading difficulties are prospectively associated with later internalizing (Arnold et al., 2005) and externalizing (Halonen et al., 2006; Snowling et al., 2007) symptoms, suggesting that reading difficulties are a risk factor for the development of later mental health problems. With regard to internalizing symptoms, reading difficulties have been shown to be associated with depression (Arnold et al., 2005; Eissa, 2010; Maughan & Carroll, 2006), anxiety (Arnold et al., 2005; Carroll & Iles, 2006; Carroll et al., 2005; Eissa, 2010; Whitehouse et al., 2009), somatic complaints (Arnold et al., 2005; Eissa, 2010), low mood (Carroll et al., 2005) and general socio-emotional problems (Terras et al., 2009). With regard to externalizing symptoms, reading difficulties have been associated with behavioural problems (Maughan & Carroll, 2006; Snowling et al., 2007; Terras et al., 2009), conduct disorder (Carroll et al., 2005; Thambirajah, 2010), and both anger and aggression (Eissa, 2010; Morgan et al., 2012).” (p. 263)

Boyes, M.E., Leitao, S., Claessen, M., Badcock, N.A., & Nayton, M. (2016). Why are reading difficulties associated with mental health problems? Dyslexia, 22, 263–266.


"A few studies have evaluated whether poor reading performance negatively impacts “distal” feelings and behaviors that are not specific to reading activities. In these studies, poor readers have been reported to be more likely to act out or be aggressive (e.g., Morgan, Farkas, & Wu, 2009; Trzesniewski, Moffitt, Caspi, Taylor, & Maughan, 2006), distractible and inattentive (Goldston et al., 2007; Morgan, Farkas, Tufis, & Sperling, 2008), and anxious and depressed (Arnold et al., 2005; Carroll, Maughan, Goodman, & Meltzer, 2005). Older poor readers have been reported to be more likely to consider or attempt suicide (Daniel et al., 2006)

The increasingly generalized Matthew effects are more likely to occur as children age (Stanovich, 1986) if they begin to avoid reading activities both at home and in school, thereby further constraining growth in their basic reading skills, comprehension, and, eventually, cognitive functioning (Cunningham & Stanovich, 1991; Echols, West, Stanovich, & Zehr, 1996; Griffiths & Snowling, 2002; Guthrie, Schafer, & Huang, 2001; Senechal, LeFevre, Hudson, & Lawson, 1996). The children’s resulting inability to meet their classroom’s academic demands can lead to increasingly frequent feelings of frustration, agitation, withdrawal, and social isolation (e.g., Fleming, Harachi, Cortes, Abbott, & Catalano, 2004; Kellam, Mayer, Rebok, & Hawkins, 1998; Lane, Beebe-Frankenberger, Lambros, & Pierson, 2001; Wehby, Falk, Barton-Arwood, Lane, & Cooley, 2003). These feelings and behaviors may in turn further interfere with children’s learning" (p.361).

"We investigated whether and to what extent being a poor reader increases a child’s likelihood of reporting feeling angry, distractible, sad, lonely, anxious, and unpopular. Poor reading performance has repeatedly been hypothesized to contribute to children’s socioemotional maladjustment (e.g., Stanovich, 1986). Although there is some evidence indicating that poor reading performance results in “proximal” negative Matthew effects (e.g., poorer attitude toward reading, less persistence during reading tasks, less independent reading practice), less is known about the “distal” or more generalized effects on socioemotional maladjustment (e.g., frequently feeling angry, sad, or unpopular). To better estimate these predicted relationships, we statistically controlled for a range of child-, family-, school-, and community-level confounds including the autoregressor. Multilevel logistic regression analyses indicated that poor readers are at substantially greater risk of socioemotional maladjustment. This was the case across multiple self-report measures as well as after extensive statistical control of possible confounding factors" (p.373).

Morgan, P.L., Farkas, G., & Qiong, W. (2012). Do poor readers feel angry, sad, and unpopular? Scientific Studies of Reading, 16(4), 360-381.


“Thus, abnormal amygdalar connectivity may contribute to making the act of reading a slow, effortful, and anxiety-provoking experience for some children with RD. These findings suggest a potential opportunity for the development of novel cognitive-behavioral treatments for RD that could improve reading ability by targeting anxiety symptoms underlying slow and dysfluent reading. … In conclusion, relative to TD peers, children with RD demonstrate increased symptoms of anxiety, as well as abnormal RSFC patterns from amygdala subregions. These amygdalar RSFC abnormalities are similar to those seen in children with anxiety disorder, suggesting that the symptoms of anxiety in pediatric RD are biologically based and, while oftentimes subclinical, interfere with functioning and warrant targeted assessment and treatment.” (p.7, 8)

Davis, K., Margolis, A.E., Thomas, L., Huo, Z., & Marsh, R. (2018). Amygdala sub-regional functional connectivity predicts anxiety in children with reading disorder. Developmental Science, 6-7. Online First.


“Children with reading and spelling disorder are often seen in outpatient healthcare services—for example, in pediatric practices or public health services—for psychosomatic symptoms, such as headaches or stomach aches, nausea, and lack of motivation/drive. If children or adolescents repeatedly experience failures at school, the may develop severe fear of failure and negative self-conception of their own ability. The comorbidity with externalizing and internalizing disorders is correspondingly high (6). Some 20% of children and adolescents with a reading disorder develop an anxiety disorder, but depression and conduct disorders are also common (7–10). Untreated and without specific support, reading and spelling disorder often results in failure at, or absenteeism from school, with grave consequences for professional education and training and for psychological wellbeing in adulthood (11–13).” (p. 279)

Galuschka, K., & Schulte-Korne, G. (2016). The diagnosis and treatment of reading and/or spelling disorders in children and adolescents. Deutsches Ärzteblatt International, 113(16), 279-286.


“Many children with difficulty in learning to read develop a negative self-concept within their first two years of schooling”.

Chapman, J.W., Tunmer, W.E., & Prochnow, J.E. (2000). Early reading-related skills and performance, reading self-concept, and the development of academic self-concept: A longitudinal study. Journal of Educational Psychology, 92, 4, 703–708.


“Young boys with reading problems were three times more likely to report high levels of depressed mood than their peers. The reading problems influenced boys' risk of depressed mood”.

Maugban, B. (2003). Reading problems and depressed mood. Journal of Abnormal Child Psychology, 31, 210-229.


“ … evidence that internalizing symptoms (Sideridis, 2007; Valâs, 2001) and dysfunctional cognitive-emotional processes (Bauminger & Kimhi-Kind, 2008; Conradi, Jang, & McKenna, 2014; Katzir, Lesaux, & Kim, 2009) are common among students experiencing academic difficulties, regardless of the nature of their core academic deficit. Although research linking cognitive and emotional regulation processes is still in its infancy and the current study was not designed to address this topic, our results are generally consistent with a generic shutdown of the system that controls reading performance, caused by the additive effects of limited cognitive resources and print-related skills and compounded by cognitive and emotion self-regulation difficulty. … a student’s motivational/emotional sphere does not function in a linear way and that the accumulated effects of failure and frustration may lead to dramatic changes in students’ behaviors, such as choosing to withdraw from a task, competency, or skill area overall. Educators need to be sensitive to changes in students’ emotionality and mood to prevent such episodes and to help students maintain a level of integrity and achievement that is necessary for them to maintain proper levels of engagement.” (p.9)

Sideridis, G.D., Simos, P., Mouzaki, A., Stamovlasis, D., & Georgiou, G.K. (2018). Can the relationship between rapid automatized naming and word reading be explained by a catastrophe? Empirical evidence from students with and without reading difficulties. Journal of Learning Disabilities, 1–12.


"Reading difficulties have been linked to externalizing behaviors, including classroom discipline problems, bullying, and aggression, as well as internalizing behaviors, including depression and anxiety (Catalano et al., 2003; Kellam, Mayer, Rebok, & Hawkins, 1998; Miller & Shinn, 2005). In severe cases, a child may perceive reading failure as a personal threat with harmful consequences (Herman & Ostrander, 2007). … language minority status does not appear to render young poor readers in urban elementary schools more vulnerable to academic, behavioral, or emotional problems beyond the vulnerability associated with being poor readers in urban schools.” (p.183-4, 197)

Pierce, M.E., Wechsler-Zimring, A., Noam, G., Wolf, M., & Katzir, T. (2013). Behavioral problems and reading difficulties among language minority and monolingual urban elementary school students. Reading Psychology, 34(2), 182-205. 


“The role of comorbidities for the effectiveness of therapeutic methods in the setting of reading and spelling disorder has thus far been underestimated. These comorbidities often include anxiety disorders, depressive symptoms, hyperkinetic disorder or attention deficit/ hyperactivity disorder (ADHD) and absenteeism from school, and conduct disorders in adolescents. ADHD is four times more common in children and adolescents with reading and spelling disorder, and the prevalence in children whose reading and spelling disorder has already been diagnosed is 8–18% (7, 9, 32). Furthermore, a notably increased prevalence of anxiety disorders (20%) and depressive disorders (14.5%) was found in young persons with reading and spelling disorder. The risk for being found to have an anxiety disorder in existing reading and spelling disorder is quadrupled. For social phobia, there are indications that the risk increases sixfold (7, 9, 10). The comorbid occurrence of reading and spelling disorder and specific disorder of arithmetical skills is significantly increased. The prevalence rate was between 20% and 40% in children who had already been diagnosed with reading and spelling disorder. The risk of a disorder of arithmetical skills is increased by four to five times (33). The prevalence of both disorders in the total population is 3–8% (33–37).” (p.283)

Galuschka, K., & Schulte-Korne, G. (2016). The diagnosis and treatment of reading and/or spelling disorders in children and adolescents. Deutsches Ärzteblatt International, 113(16), 279-286.


“ … failure in achievement tasks may constitute a stress factor that can trigger a depression episode, particularly for students with learning disabilities (LD), and a particular motivational pattern may constitute a cognitive diathesis for depression”.

Sideridis, G.D. (2007). Why are students with LD depressed? A goal orientation model of depression vulnerability. Journal of Learning Disabilities, 40(6), 526-539.


“A pathway from reading difficulties to anxiety or depression may be mediated by poor readers' well-established vulnerability to problems in academic (and possibly more global) self-esteem.”

Chapman, J. W. (1988). Cognitive-motivational characteristics and academic-achievement of learning-disabled children-A longitudinal-study. Journal of Educational Psychology, 80, 357-365.


“This longitudinal study of 105 economically disadvantaged children examined the relation between reading problems and internalizing behavior in 3rd- and 5th-grade assessments (8- to 12-year olds). The variable-centered results showed that reading problems predicted change in internalizing behavior in the context of child and family predictors. The person-centered results showed that children with reading problems in both grades had higher internalizing scores in 5th grade but not in 3rd grade than children with reading problems in 3rd grade or no problems. Child-reported negative emotion experiences varied similarly across grade. The results tie reading problems to emotional distress in school and support conclusions about the direction of effects and the internalization of academic difficulty for disadvantaged children.”

Ackerman, B. P., Izard, C. E., Kobak, R., Brown, E. D., & Smith, C. (2007). Relation between reading problems and internalizing behavior in school for preadolescent children from economically disadvantaged families. Child Development, 78, 581-596.


“This article presents the results of a meta-analysis of the empirical literature on anxious symptomatology among school-aged students with learning disabilities (LD) in comparison to their non-LD peers. Fifty-eight studies met inclusion criteria. Results indicate that students with LD had higher mean scores on measures of anxiety than did non-LD students. The overall effect size was statistically significant and medium in magnitude (d = .61) although substantial heterogeneity of results was found. Moderator effects were examined for informant type, gender, grade, publication status, and identification source. Informant type (i.e., self-, parent, or teacher report) explained a significant amount of variability in the sample of studies, and identification source (i.e., school identified or special school and clinic/hospital identified) approached statistical significance. Implications for assessment and intervention are discussed” (p.3).

Nelson, J.M., & Harwood, H. (2011). Learning disabilities and anxiety: A meta-analysis. Journal of Learning Disabilities, 44(1), 3-17.


“The twin study indicated that increased rates of internalizing symptomatology among poor readers were attributable to reading problems rather than to shared family factors.”

Willcutt, E. G., & Pennington, B. F. (2000). Psychiatric comorbidity in children and adolescents with reading disability. Journal of Child Psychology and Psychiatry, 41, 1039-1048.


”By the secondary grades, struggling readers have little confidence in their ability to succeed in reading and little sense of themselves as readers (Collins, 1996). Guthrie, Alao, and Rinehart (1997) noted an "eroding sense of confidence" in these students. They are acutely aware of their reading problems (Wigfield & Eccles, 1994) and likely to suffer serious psychological consequences, including anxiety, low motivation for learning, and lack of self-efficacy. … We have not found evidence that boosting self-esteem (by therapeutic interventions or school programs) causes benefits. Our findings do not support continued widespread efforts to boost self-esteem in the hope that it will by itself foster improved outcomes. In view of the heterogeneity of high self-esteem, indiscriminate praise might just as easily promote narcissism, with its less desirable consequences. Instead, we recommend using praise to boost self-esteem as a reward for socially desirable behavior and self-improvement.”

Baumeister, R. F., Campbell, J. D., Krueger, J. I., & Vohs, K. D. (2003). Does high self-esteem cause better performance, interpersonal success, happiness, or healthier lifestyles? Psychological Science in the Public Interest, 4(1), 1-44. http://www.psychologicalscience.org/journals/pspi/4_1.html


“We almost need a trauma centre to take care of this problem, it’s that serious for kids that can’t read.”

Manzo, K.K. (2004). Reading programs bear similarities across states. Education Week, 23, 1-5.


 “Many factors contribute to individual differences in adolescent reading ability. For example, there is a correlation between behavioural and emotional difficulties and reading ability in adolescents (Arnold et al., 2005). … Poor reading ability amongst adolescents has negative implications for psycho-social and educational development. A study by Daniel et al. (2006) showed that fifteen-year old adolescents with poor reading ability were more likely to experience suicidal ideas or attempts, and dropout of school than typical readers, suggesting that adolescents with poor reading ability can be labelled as being at social risk.” (p. 116)

Paul, S-A.S, & Clarke, P.J. (2016). A systematic review of reading interventions for secondary school students. International Journal of Educational Research, 79, 116–127.


More suffer life-harm from illiteracy than from parental abuse, accidents, and all other childhood diseases and disorders combined.”

Whitehurst, G. (2003). Children of the Code interview: Evidence based education, science and the challenge of learning to read. Retrieved January 11, 2004, from http://www.childrenofthecode.org/cotcintro.htm


“These children thus have an increased lifetime risk for a broad range of psychiatric disorders (Esser, Schmidt, & Woerner, 1990), and particularly depressive disorders and Posttraumatic Stress Disorder (McNulty, 2003). For example, when compared to other pupils, college students with learning disabilities were found to be nearly three times more likely to have depressive illness, and have more problems with their grades and quality of their coping skills (Arnold, 2000). Even when the consequences of learning disabilities such as harsh self-appraisal do not merit psychiatric diagnoses, children and adults with learning disabilities can still experience diminished confidence in the efficacy of their own academic, cognitive, and occupational efforts, having internalized repeated exposure to frustration (Cummings, Maddux, & Casey, 2000). As members of the adult workforce, those with learning disabilities are more likely to experience unemployment, or underemployment, and to earn less than non-disabled adults (Cummings et al., 2000). Even among adults who possess college degrees, routine workplace demands can prove more difficult for employees with learning disabilities than for their coworkers, diminishing their productivity and value to employers (Dickenson & Verbeek, 2002).”

Lange, S.M., & Thompson, B. (2006). Early identification and interventions for children at risk for learning disabilities. International Journal of Special Education, 21(3), 108-119. Retrieved October 19, from http://www.internationalsped.com/documents/92%20Lange.doc


 “It is well recognized that children with disabilities exhibit learning and behavioral problems at an early age” (Kamps et al., 2003 p. 212).

Kamps, D.M., Wills, H. P., Greenwood, C. R., Thorne, S., Lazo, J. F., Crockett, J. L., Akers, J. M., & Swaggart, B. L. (2003). Curriculum influences on growth in early reading fluency for students with academic and behavioral risks: A descriptive study. Journal of Emotional and Behavioral Disorders, 11, 211-224.


“Behaviour problems among children with learning disorders are about 3 times than the norm by 8 years of age” (p.295).

Mash, E.J., & Wolfe, D.A. (2002). Abnormal child psychology. Belmont, CA: Wadsworth Thomson Learning.


“To investigate the hypothesis that learning disabilities (LD) play a part in adolescent suicide, all available suicide notes (n = 27) from 267 consecutive adolescent suicides were analyzed for spelling and handwriting errors. The suicide notes were dictated to adolescents with LD and adolescent non-LD controls. The results showed that 89% of the 27 adolescents who committed suicide had significant deficits in spelling and handwriting that were similar to those of the adolescents with LD, and they were significantly more impaired than the non-LD adolescents and older adults (65 and older) who had committed suicide in the same time period and in the same geographical area”.

McBride, H.E.A, & Siegel, L.S. (1997). Learning disabilities and adolescent suicide. Journal of Learning Disabilities, 30(6), 652-659.


“Nonhandicapped students with greater depressive characteristics were more likely to be hyperactive and less likely to be accepted by their peers. They were also less likely to achieve adequately in reading recognition, reading comprehension, arithmetic, and writing” (Cullinan, Schloss, & Epstein, 1987, p. 96).

Cullinan, D., Schloss, P. J., & Epstein, M. H. (1987). Relative prevalence and correlates of depressive characteristics among seriously emotionally disturbed and nonhandicapped students. Behavioral Disorders, 12, 90-98.


“…the poorer the academic performance, the higher the delinquency” (Manguin & Loeber, 1996, p. 246).

Manguin, E., & Loeber, R. (1996). Academic performance and delinquency. In M. Tonry (Ed.), Crime and justice: An annual review of research: Vol. 20 (p. 145-264). Chicago: University of Chicago Press.


 “Early learning problems and aggressive behavior have problematic consequences extending far into the life course, and they have been found to be correlated early in children’s schooling” (Kellam, Mayer, Rebok, & Hawkins, 1998, p. 486).

Kellam, S. G., Mayer, L. S., Rebok, G. W., & Hawkins, W. E. (1998). Effects of improving achievement on aggressive behavior and of improving aggressive behavior on achievement through two preventive interventions: An investigation of casual paths. In B. P. Dohrenwend (Ed.), Adversity, stress, and psychopathology (pp. 486-505). New York: Oxford University Press.



“The concomitant relationship between academic underachievement and emotional and behavioral disorders (EBD) is one that has been repeatedly established in research literature” (Wehby, Falk, Barton-Arwood, Lane, & Cooley, 2003, p. 225).

Wehby, J. H., Falk, K.B., Barton-Arwood, S., Lane, K. L., & Cooley, C. (2003). The impact of comprehensive reading instruction on the academic and social behavior of students with emotional and behavioral disorders. Journal of Emotional and Behavioral Disorders, 11, 225-238.


“Reading difficulties are highly comorbid with attention-deficit/hyperactivity disorder (ADHD; Willcutt & Pennington, 2000a), with as many as 15–40% of children with reading difficulties also meeting criteria for ADHD (Maughan & Carroll, 2006; Willcutt & Pennington, 2000a). However, the relationship between reading ability and ADHD appears to be specific to attentional problems with less evidence of a link between reading ability and hyperactivity (Carroll et al., 2005).” (p. 126)

Boyes, M.E., Tebbutt, B., Preece, K.A., & Badcock, N.A. (2018). Relationships between reading ability and child mental health: moderating effects of self‐esteem. Australian Psychologist 53(2), 125–133.


So, the results are serious. What about interventions?

Apart from the risk of low reading progress causing anxiety, it’s also possible that this anxiety acts as an impediment to progress when reading interventions are implemented with the struggling readers. It’s possible too that pre-existing anxiety may interfere with students’ learning from the outset. Either way, there is beginning to be a recognition that addressing the anxiety issue in company with exemplary instruction may enhance the instructional effectiveness, but also important for the students’ continued academic and socio-emotional progress.

“ … researchers should begin to more broadly investigate the contribution of additional socioemotional domains, including anxiety, into existing intervention programs for children at-risk for reading difficulties. It may be that the inclusion of such anxiety/stress management programs provides children with additional skills that can enhance their ability to learn and/or implement learned academic material…. the findings add to the emerging database on characteristics of inadequate responders to instruction, suggesting that anxiety may be a prominent non-cognitive characteristic of some inadequate responders.”

Grills-Taquechel, A. E., Fletcher, J. M., Vaughn, S. R., Barth, A.E., Denton, C.A., & Stuebing, K. K. (2014). Anxiety and response to reading intervention among first grade students. Child and Youth Care Forum, 43(4), 417-431.


“It may be the case that mental health problems arise as a direct consequence of reading difficulties. If this is the case, then remediation of reading skills should also improve child self-esteem and mental health. Many child mental health measures (such as the Strengths and Difficulties Questionnaire; Goodman, 1997) are short, easy to administer, and can be completed by children, parents, or teachers. These measures could be included as secondary outcomes in trials of interventions to remediate reading. Of particular interest would be investigating whether reading intervention improves reading/academic-related self esteem, and whether this is linked with improvements in mental health.” (p. 265)

Boyes, M.E., Leitao, S., Claessen, M., Badcock, N.A., & Nayton, M. (2016). Why are reading difficulties associated with mental health problems? Dyslexia, 22, 263–266.


“A recent synthesis examining the effects of intervention research on the self-concept of students with LD indicates at the elementary level that academic interventions are the most effective means of improving self-concept (Elbaum & Vaughn, 1999).”

Elbaum, B. E., & Vaughn, S. (1999, May). A meta-analysis of intervention studies for students with LD and their effects on self-concept. Paper presented at the National Council for Learning Disabilities Summit, Washington, DC.


“ … all measures indicated less favorable outcomes among the LD group than among the control group, suggesting that a notable share of individuals with LD have problems with mental health, are unable or delayed in attaining degrees after compulsory education, and have difficulties gaining (or keeping) employment. Second, LD subgroup differences were found: MD was more strongly associated with antidepressant use and unemployment than RD. Moreover, gender-related subgroup differences emerged, indicating that RD was a more prominent risk for males, while for females, MD with or without RD resulted more often than RD in the use of antidepressants and the lack of a secondary degree. … All our indicators of mental health problems, that is, having received sickness allowances or disability pensions on the basis of psychiatric diagnoses and having received reimbursements for psychoactive medication expenses, indicated more problems among the group with childhood LD diagnosis than among the population-based reference group. The higher percentage of individuals receiving sickness allowances or disability pensions indicates that mental health problems were a more common reason for incapacity to work among the LD group than the controls.” (p. 9)

“The findings suggest that strategies and personal attributes aimed at circumventing difficulties should be a priority in special education early on, and they should be given at least equal attention as efforts to enhance academic skills. Earlier research suggests that certain interpersonal factors, such as community and social support (e.g., Miller, 2002; Panicker & Chelliah, 2016; Raskind et al., 1999), and intrapersonal factors—such as self-awareness, proactivity, self-esteem, perseverance, and effective coping strategies (e.g., Gardynik & McDonald, 2005; Idan & Margalit, 2014; Miller, 2002; Raskind et al., 1999; Spekman, Goldberg, & Herman, 1992; Werner, 1993)—are relevant predictors of coping with LD, and they predict success better than variables like IQ, academic achievement, life stressors, age, gender, socioeconomic status, and ethnicity (Raskind et al., 1999). When these “success attributes” are understood as a set of skills that can be rehearsed and learned, rather than specific or stable individual characteristics, it opens new horizons and prospects for developing supportive programs or therapeutic approaches to enhance psychological well-being in, for example, special education settings or psychotherapeutic relationships.” (p. 11)

Aro, T., Eklund, K., Eloranta, A-K., Närhi, V., Korhonen, E., & Ahonen, T.  (2018). Associations between childhood learning disabilities and adult-age mental health problems, lack of education, and unemployment. Journal of Learning Disabilities, 1–13.


  “Taken together, these results provide evidence for the role of mastery of reading achievement in aggressive behavior, particularly in boys, and in depression, particularly in girls. The preventive trials provide evidence of the direction of effects, and the reversibility of the aggressive behavior and depressive symptoms in some children by raising the level of reading achievement.”

Kellam, S.G. (1999). Developmental epidemiologically-based prevention research: From efficacy to effectiveness. National Institute of Mental Health Fifth Annual National Conference on Prevention Research. http://www.oslc.org/spr/ecpn/nckellam.html


... a successful learning experience is itself a major contribution to mental health” (p.153).

Steinberg, Z., & Knitzer, J. (1992). Classrooms for emotionally and behaviorally disturbed students: Facing the challenge. Behavioral Disorders, 17, 145-156.


“In a first-grade intervention study, boys whose reading skills improved from fall to spring showed a much reduced depressive symptomatology than their peers who continued to show problems in reading.”

Kellam, S. G., Rebok, G. W., Mayer, L. S., Iaolongo, N., & Kalodner, C. R. (1994). Depressive symptoms over 1st-grade and their response to a developmental epidemiologically based preventive trial aimed at improving achievement. Development and Psychopathology, 6, 463-481.


“A critical step in prevention and reduction of behavior problems is helping students with behavior disorders develop academic competence. Unless academic deficits are remediated and these students are successful in their efforts, they will continue to become frustrated, will develop a negative perception of school, and will most likely act out” (Bowen, Jenson, & Clark, 2004; p. 132).

Bowen, J., Jenson, W.R., & Clark, E. (2004). School-based interventions for students with behavior problems. New York: Kluwer Academic.


 “…U.S. and international literacy campaigns routinely invoke the positive effects of literacy and schooling upon child development, public health, and crime prevention” (Vanderstaay, 2006, p. 331).

Vanderstaay, S. L. (2006). Learning from longitudinal research in criminology and the health sciences. Reading Research Quarterly, 41, 328-350.


What about direct mental health interventions? 

“If embedded into the curriculum and delivered by school staff, school-based prevention and intervention programs are cost-effective and can reduce risks for later mental health problems in primary school children generally (Neil & Christensen, 2009). However, universal mental health or prevention programs typically yield small effect sizes (Durlak et al., 2011). Given that the majority of children will not develop a mental health problem, it would be helpful to see if such programs are particularly effective for potentially vulnerable subgroups such as children with reading difficulties. If this is the case, the skills targeted by these interventions may be salient risk and resilience-promoting factors moderating and/or mediating associations between reading difficulties and mental health.” (p.265)

Boyes, M.E., Leitao, S., Claessen, M., Badcock, N.A., & Nayton, M. (2016). Why are reading difficulties associated with mental health problems? Dyslexia, 22, 263–266.


Does self-esteem come into it? Maybe.

“A number of studies have examined relationships between reading ability and global self-esteem, as well as self-esteem in specific domains (McArthur, Francis, Caruana, Boyes, & Badcock, 2016). With regard to general self-esteem, the findings are mixed. A number of studies have reported poor general self-esteem, general self-concept, or general self-worth in children with reading difficulties (Alexander-Passe, 2006; Humphrey & Mullins, 2002); however, other studies have reported no deficits in general self-esteem (Frederickson & Jacobs, 2001; Terras et al., 2009). There are also mixed findings regarding relationships between reading ability and social (Alexander- Passe, 2006; Boetsch et al., 1996; Terras et al., 2009), parent home (Alexander-Passe, 2006; Humphrey & Mullins, 2002), and physical self-esteem (Boetsch et al., 1996; Humphrey & Mullins, 2002; Terras et al., 2009). In contrast, findings regarding academic self-esteem are more equivocal with the majority Reading, self-esteem, and child mental health ME Boyes et al. of studies reporting that reading difficulties are associated with poorer academic self-esteem (Alexander-Passe, 2006; Boetsch et al., 1996; Casey, Levy, Brown, & Brooks-Gunn, 1992; Frederickson & Jacobs, 2001; Humphrey & Mullins, 2002; McArthur, Castles, Kohnen, & Banales, 2016; Snowling, Muter, & Carroll, 2007; Terras et al., 2009). … the current study demonstrates that reading ability is associated with internalising symptoms and that self-esteem moderates the impact of reading ability on externalising symptoms and total difficulty scores. This is an important and novel finding, which suggests that children’s self-esteem can help buffer against the negative mental health impacts of poor reading ability.” (p. 126-7, 131)   

Boyes, M.E., Tebbutt, B., Preece, K.A., & Badcock, N.A. (2018). Relationships between reading ability and child mental health: moderating effects of self‐esteem. Australian Psychologist 53(2), 125–133.


So, what's the takeaway?

Be aware of the potential impact of a student's difficulty in learning to read on his whole life. Screen early for literacy progress, and act accordingly with evidence-based programs. Be alert for those low-progress readers whose demeanour is not quite right. Red flag such children, and redouble efforts to alter his literacy trajectory, using Response to Intervention techniques. Refer for mental health assessment if, despite the school's efforts, the student continues to show signs of emotional distress.

Further references:

Algozzine, B., Wang, C., & Violette, A. S. (2010). Reexamining the relationship between academic achievement and social behavior. Journal of Positive Behavior Interventions, 13, 3-16.

Martin, A. J. (2011). Courage in the classroom: Exploring a new framework predicting academic performance and engagement. School Psychology Review, 26, 145-160.

Trzesniewski, K. H., Moffitt, T. E., Caspi, A., Taylor, A., & Maughan, B. (2006). Revisiting the association between reading achievement and antisocial behavior: New evidence of an environmental explanation from a twin study. Child Development, 77, 72-88.

Wang, M-T. (2009). School climate support for behavioral and psychological adjustment: Testing the mediating effect of social competence. School Psychology Quarterly, 24, 240-251.

Module-Bottom-Button-A rev

Module-Bottom-Button-B rev

Module-Bottom-Button-C rev2

Online Fundraising
Use Giving Assistant to save money and support National Institute for Direct Instruction

Shop til you drop at NIFDI and sign up for Giving Assistant to benefit National Institute for Direct Instruction.