Comorbidity Between Reading Disability and Math Disability: Concurrent Psychopathology, Functional Impairment, and Neuropsychological Functioning
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Reading disability (RD) and math disability (MD) frequently co-occur, but the etiology of this comorbidity is not well understood. Groups with RD only (N = 241), MD only (N = 183), and RD + MD (N = 188) and a control group with neither disorder (N = 411) completed a battery of measures of internalizing and externalizing psychopathology, social and academic functioning, and 10 neuropsychological processes. Groups with RD only, MD only, and RD + MD were significantly impaired versus the control group on nearly all measures, and the group with RD + MD was more impaired than the groups with MD and RD alone on measures of internalizing psychopathology, academic functioning, and 7 of 10 neuropsychological constructs. Multiple regression analyses of the neuropsychological measures indicated that deficits in reading and math were associated with shared weaknesses in working memory, processing speed, and verbal comprehension. In contrast, reading difficulties were uniquely associated with weaknesses in phoneme awareness and naming speed, and math deficits were uniquely associated with weaknesses in set shifting. These results support multiple-deficit neuropsychological models of RD and MD and suggest that RD and MD are distinct but related disorders that co-occur because of shared neuropsychological weaknesses in working memory, processing speed, and verbal comprehension.
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The pattern of results contradicts the idea of an additive effect of the two disorders combined.
“This would contradict the idea of an additive effect of the two disorders combined (Seidman et al., 1995, 2001; Willcutt et al., 2013; Horowitz-Kraus, 2015).”
From Executive Functions in Neurodevelopmental Disorders: Comorbidity Overlaps Between Attention Deficit and Hyperactivity Disorder and Specific Learning Disorders (2021) · cites this paper as Willcutt et al., 2013
In the Discussion section, under “Implications for models of comorbidity between RD and MD,” the paper says that greater impairment in the comorbid group appeared additive in most cases. It reports greater-than-additive impairment on only a handful of measures, so its overall finding does not contradict an additive effect. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredComorbidity amongst math disorder, reading disorder, and ADHD has been associated with low processing speed.
“comorbidity amongst MD, RD, and ADHD has also been associated with low PS, and the relationships between these deficits continue to be explored20,40–44.”
From Diagnostic Associations of Processing Speed in a Transdiagnostic, Pediatric Sample (2020) · cites this paper as [41]
The Results (Neuropsychological measures; page unavailable) associate low processing speed with both reading and math difficulties, including the RD + MD group. The paper also reports higher ADHD rates in those groups, but it does not establish that the three-way comorbidity of MD, RD, and ADHD is associated with low processing speed; ADHD symptoms were controlled for in the processing-speed analysis. (LLM, conf=0.85)
Experimental — accuracy not yet measuredWorking memory impairments might help to explain the co-occurrence of math and reading disorders in 30-70% of individuals diagnosed with SLD.
“These WM impairments might help to explain the co-occurrence of math and reading disorders in 30–70% of individuals diagnosed with SLD (Willcutt et al., 2013).”
From Executive Functions in Neurodevelopmental Disorders: Comorbidity Overlaps Between Attention Deficit and Hyperactivity Disorder and Specific Learning Disorders (2021) · cites this paper as Willcutt et al., 2013
The presence of a SLD significantly predicted PS deficit.
“the presence of a SLD significantly predicted PS deficit.”
From Diagnostic Associations of Processing Speed in a Transdiagnostic, Pediatric Sample (2020) · cites this paper as [41]
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- Authors
- Willcutt, E. G., Petrill, S. A., Wu, S., Boada, R., DeFries, J. C., Olson, R. K., & Pennington, B. F.
- Affiliations
- University of Colorado Boulder (US)
- The Ohio State University (US)
- University of Colorado Anschutz (US)
- University of Denver (US)
- Venue
- Journal of Learning Disabilities
- Publisher
- SAGE Publications
- Published
- 2013-02-28
- Volume
- 46
- Issue
- 6
- Pages
- 500-516
- ISSN
- 0022-2194 (ISSN-L)
- 1538-4780
- PMC
- PMC3749272
- OpenAlex
- W2114081569
- Cited by
- 343
- References
- 86
- Citations by year
- 2026: 21 · 2025: 32 · 2024: 26 · 2023: 34 · 2022: 34 · 2021: 33 · 2020: 32 · 2019: 31 · 2018: 27 · 2017: 28 · 2016: 18 · 2015: 11 · 2014: 9 · 2013: 5 · 2012: 2
- FWCI
- 29.63
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Learning Disabilities (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01 MH 70037, R01MH070037)
- National Institute on Deafness and Other Communication Disorders (R01DC005190, R01 DC 05190)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD068728, R01HD047264, R01 HD 59215, P50-HD27802, R01 HD 68728, R01 HD 69728, R01 HD 47264, R01HD059215, R01HD38526, R24HD075460, R01HD038526, R24 HD 75460, P50HD027802)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Reading and Literacy Development
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Physical Sciences › Mathematics › Statistics and Probability › Cognitive and developmental aspects of mathematical skills
- Keywords
- reading disorders, math disabilities, dyslexia, dyscalculia, comorbidities, working memory, processing speed, verbal comprehension, phoneme awareness, naming speed, set-shifting, internalizing psychopathology, externalizing psychopathology, academic functioning, neuropsychological deficits
- MeSH terms
- Adolescent, Child, Cognition Disorders, Diseases in Twins, Dyslexia, Female, Humans, Male, Neuropsychological Tests, Comorbidity, Dyscalculia
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