Ninety-Eight Studies, No Single Number

What the research found

In 2023, Adrienne Wilmot and four colleagues at Curtin University published a review of the research on mental health in children with dyslexia. They gathered 98 studies in total: 86 peer-reviewed papers and 12 doctoral theses. Every study concerned children aged eighteen or under who had developmental dyslexia or word-reading difficulties. This is one of the widest surveys of the field to date.

The headline is not surprising, but it is worth stating plainly. Children with dyslexia show higher rates of both internalising and externalising difficulties than their peers. Internalising means the troubles a child carries inwardly: anxiety, low mood, worry. Externalising means the troubles that show outwardly: frustration, aggression, disruptive behaviour. Of the 98 studies, 62 looked at both kinds together, 25 looked only at internalising symptoms, and just one looked at externalising symptoms alone. The weight of attention falls, rightly, on the quiet inward struggles.

The review then asks a more useful question than “is there a risk?” It asks “what sits between the reading difficulty and the distress?” The authors organised the evidence into factors at three levels: the individual, the family, and the wider community. Individual-level factors drew the most study, appearing in 70 of the 98 papers. Family-level factors appeared in 39, and community-level factors in 54. Among individual factors, self-esteem was one of the most examined, addressed in 30 studies. This includes closely related ideas such as self-concept, self-worth, and self-efficacy, a child’s belief in their own ability to manage a task.

Self-esteem matters here because it may be part of the pathway, not merely a side effect. One study within the review suggested that poor reading self-concept, a child’s sense that they are “bad at reading”, could itself be a risk factor for later anxiety and depression. That is a meaningful idea. But it is an idea the review can point to, not prove. Community-level evidence pointed in a similar direction, with a consistent link between bullying and mental health difficulty.

Two things this review is not. It is not a meta-analysis. The authors chose a scoping review deliberately, because the field was too varied to pool into a single number. So there is no combined effect size, no tidy percentage of dyslexic children who become anxious. And it is not proof of cause. Most of the underlying studies measured children at a single moment, which can show that reading difficulty and distress travel together, but cannot show which one leads to the other, or whether a third thing drives both.

What it means for you and your child

The practical message is a calm one. A reading difficulty is not only a reading difficulty. For many children it carries an emotional weight, and that weight deserves attention in its own right, not as an afterthought once the decoding is sorted. If your child struggles to read and also seems anxious, withdrawn, or unusually quick to anger, these are not two unrelated problems. The research suggests they often travel as a pair.

Notice, though, what the review does not license you to do. It does not let anyone tell you your child is destined for poor mental health. A raised risk across a population is not a forecast for one child. Many children with dyslexia are content, confident, and well. The figures describe a tendency in a group, and your child is a person, not a group.

The finding about self-esteem is the one worth carrying with you. A child’s belief that they are “no good at reading” may do real harm, possibly more harm than the reading difficulty itself. This points to something you can influence at home. Praise effort and strategy rather than speed. Separate a child’s worth from a child’s reading age in your own language, because children absorb that distinction quickly. Protect the sense that they are capable, even on the days the page defeats them.

Be alert to bullying, which the review links repeatedly to distress. Children who read differently are sometimes singled out, and the damage lands on their confidence as much as their spelling. A quiet word with a teacher is not fussing. It is addressing a factor the evidence takes seriously.

Finally, a note of honest proportion. This is a map of the research, not a manual. It tells us where to look and what tends to co-occur; it does not hand us a proven cure or a guaranteed cause. The authors themselves flag that too much of the evidence relies on parents and teachers rather than on children’s own accounts, and that adolescents have been studied far less than younger children. So trust your own observation of your teenager, and treat any single confident claim about dyslexia and mental health with mild suspicion. What we can say with reasonable confidence is modest and useful: the emotional side is real, it is worth tending early, and a child’s sense of their own capability is one of the levers most within your reach.