The Psychiatrist's Role in Dyslexia

What a Reading Diagnosis Doesn't Tell You — and Why the Mind Behind It Matters

By Jose Mantilla-Rivas, MD — Board-Certified Psychiatrist, Child & Adolescent Psychiatrist

Serving South Florida (Pompano Beach & Fort Lauderdale) and cross-border patients in Colombia · English and Spanish

Reading time: ~8 minutes

Quick Facts

• Dyslexia is a learning difference, not a psychiatric illness. It is a specific difficulty with accurate, fluent reading and spelling. Dyslexia has nothing to do with intelligence or effort.

• A psychiatrist does not diagnose dyslexia. That diagnosis comes from a comprehensive psychoeducational or neuropsychological evaluation, which is the foundation for school accommodations.

• But dyslexia rarely travels alone. In studies of children with dyslexia, about half also meet criteria for at least one psychiatric condition — most often ADHD, anxiety, and depression.

• This is where a psychiatrist becomes essential. Untreated ADHD, anxiety, or demoralization can sabotage anyone. Identifying and treating what travels alongside dyslexia is important work.

• The best outcomes come from a team. A psychoeducational evaluator documents the learning profile, while a psychiatrist or therapist addresses the emotional and attentional load. The two roles are different and complement each other to get the best possible outcomes.

A Diagnosis That Stops at the Page

When a family first hears the word dyslexia, the focus — understandably — goes straight to reading. Will my child catch up? What accommodations does the school owe us? Which tutoring program works?

These are the right questions. But in my office, I see what often gets missed: the child behind the reading score. Sometimes, children absorb unconscious stories that often start with “I can’t”.

In my work, I partner with psychologists and other therapists to 1) re-write those scripts (if present) and 2) effectively address common co-occuring issues: anxiety, mood disorders and ADHD.

In other words, while I do not diagnose dyslexia or learning disabilities (this is done by specific testing), I can integrate this layer into a complex clinical picture, to ensure that the best care is being provided.

What "Rides Along" With Dyslexia

Dyslexia is one of the most common learning differences, and one of the most under-recognized truths about it is how often it overlaps with treatable psychiatric conditions.

According to PubMed, a study of primary-school children found that roughly 58% of those with dyslexia also met criteria for at least one psychiatric disorder — most commonly ADHD (about 33%), generalized anxiety (about 22%), and major depression (about 16%) (DOI). Those are not small numbers. They mean that for most children with a reading diagnosis, the reading is only part of the clinical picture.

There is also a deeper, biological reason the overlap is so consistent. According to PubMed, a large genome-wide study confirmed a partly shared genetic basis between dyslexia and ADHD — the two conditions are not just coincidentally common together; they share underlying roots (DOI). This is why so many children carry both, and why treating one without recognizing the other leaves real ground on the table.

Here is what each of these looks like in practice:

• ADHD. When a child can't sustain attention, even the best structured program struggles to work. Reading instruction requires exactly the focus that ADHD undermines. Treating ADHD doesn't cure dyslexia — but it removes a barrier that was blocking the intervention from working.

• Anxiety. Years of unexpected failure often interfere with learning. Many times, children develop anticipatory anxiety around reading aloud, tests, or simply being called on. Left unaddressed, anxiety narrows a child's willingness to take the very risks that learning requires.

None of these are character flaws. They are predictable, and common responses to a brain that learns to read differently. And recognizing them, and addressing them in a meaningful way is my job,

Where a Psychiatrist may fit: Five Concrete Roles

A psychiatrist isn't a substitute for an educational evaluation or for skilled reading instruction. The role is complementary to a multidisciplinary group.

1. Sorting out other possible diagnoses, feelings or situations. When a child struggles in school, the question is rarely "is it only dyslexia?" A careful psychiatric evaluation helps distinguish dyslexia from — or alongside — ADHD, anxiety, mood conditions, and the ordinary discouragement that any human being can feel.

2. Treating the comorbidity, not the reading. If ADHD is present, treating it (with medication, behavioral strategies, or both) can strengthen any structured reading or learning plan. The reading intervention stays with the specialists; the medical management of attention, mood, and anxiety stays with me. In my practice, we communicate to make sure there is seamless integration between these layers.

3. Protecting the child's sense of self. Much of my work with these families is about reframing — for the child and the parents. A child who understands that their brain simply reads differently, and that this says nothing about their worth or intelligence, is a child who can keep showing up. That reframe is therapeutic, honest and important.

4. Coordinating the team. Dyslexia care involves a lot of people: the school, the evaluator, the tutor or reading specialist, sometimes a speech-language pathologist, and the family. A psychiatrist can serve as a steady medical anchor in that group, making sure the pieces talk to each other.

5. Following the long arc. Dyslexia is lifelong. The challenges at age eight look different from those at fifteen or in college. Having a psychiatrist who knows the whole history means the emotional and attentional support evolves as the child does.

The Diagnostic Backbone: Why I Work With Gold Coast Psychoeducational Associates

I'll say plainly what I tell every family: I cannot give your child the dyslexia diagnosis that the school will act on. That requires a comprehensive psychoeducational evaluation, and the quality of that evaluation determines the quality of everything downstream — the accommodations, the interventions, the advocacy.

For families in South Florida, this is why I refer to and collaborate with Gold Coast Psychoeducational Associates, led by Catherine Pinnola, MS, CAGS, NCSP — a Nationally Certified and Florida-licensed School Psychologist based in Boca Raton with nearly two decades of experience.

What makes this partnership work clinically:

• She does the testing I can't. Catherine performs the comprehensive evaluations that identify dyslexia, dyscalculia, dysgraphia, ADHD, and related learning profiles — and, critically, she connects those results to practicalrecommendations rather than handing families a stack of scores.

• She speaks the school's language. As a school psychologist, she knows how IEPs and 504 Plans actually get built and enforced. Her advocacy work — stepping in when families hit an impasse with a school — is something a medical office simply isn't equipped to do.

• We close the loop in both directions. When I see a child whose struggles point toward an undiagnosed learning difference, a thorough evaluation is the right next step. When she identifies a child whose anxiety, attention, or mood is interfering with learning, the medical and psychiatric side is mine. With appropriate permissions, we collaborate so the family isn't left translating between two professionals who never speak.

A psychoeducational evaluation and a psychiatric evaluation answer different questions. Families do best when both questions get asked.

For Bilingual and Cross-Border Families

A note for the families I serve in Spanish, and for those whose lives bridge the United States and Colombia: reading difficulties carry an extra layer of complication across languages and school systems. A child may look "behind" in one language and fine in another, and parents navigating two educational cultures often get conflicting messages about whether anything is wrong.

This is exactly the situation where a clear-eyed evaluation and steady psychiatric support matter most — and where being able to talk through it in your own language, without anything lost in translation, makes a real difference. I practice in both English and Spanish for precisely this reason.

Frequently Asked Questions

Can a psychiatrist diagnose dyslexia? No. Dyslexia is diagnosed through a comprehensive psychoeducational or neuropsychological evaluation. A psychiatrist's role is to evaluate and treat the conditions that frequently accompany dyslexia — such as ADHD, anxiety, and depression — and to support the child's overall mental health and development.

Why would my child with a reading problem need to see a psychiatrist? Because dyslexia rarely occurs in isolation. More than half of children with dyslexia also have a treatable psychiatric condition. Untreated ADHD or anxiety can prevent even excellent reading interventions from working, and the emotional toll of years of struggle is itself worth addressing.

Will medication help my child read better? Medication does not treat dyslexia. But if your child also has ADHD, treating the attention difficulty can make reading instruction far more effective by removing a barrier that was blocking progress. Any decision about medication is individualized and made carefully.

What's the difference between a school psychologist and a psychiatrist here? A school psychologist (like Catherine Pinnola at Gold Coast Psychoeducational Associates) performs the evaluation that identifies dyslexia and connects it to school services. A psychiatrist is a medical doctor who diagnoses and treats the psychiatric conditions that travel alongside it. The roles are complementary.

Do you offer services in Spanish? Yes. I provide care in both English and Spanish, including for families connected to both the United States and Colombia.

Work With Us

If your child is struggling with reading and you're not sure where the difficulty really lies — the page, the attention, the mood, or some combination — that's exactly the conversation worth having.

For a comprehensive psychoeducational evaluation in South Florida, I recommend Gold Coast Psychoeducational Associates (Boca Raton). For the psychiatric side — evaluating and treating the ADHD, anxiety, or mood difficulties that so often accompany dyslexia — reach out to my practice. Care available in English and Spanish, in person in the Pompano Beach / Fort Lauderdale area and across the U.S.–Colombia connection.

This article is for educational purposes and is not a substitute for individualized medical advice. Research on psychiatric comorbidity in dyslexia is drawn from PubMed-indexed studies, including El Sheikh et al., Child and Adolescent Mental Health (DOI) and Gialluisi et al., Translational Psychiatry (DOI).