Executive summary

Attention-deficit/hyperactivity disorder (ADHD) and dyslexia can severely impact children's academic performance; both learning disabilities make acquiring curriculum-aligned reading and math skills challenging. Under the Individuals with Disabilities Education Act (IDEA), schools are responsible for identifying children with disabilities, yet screening for dyslexia is only required in 46 states and there is no federal or state screening requirement for ADHD.

This paper proposes a model for standardized ADHD and dyslexia screenings in elementary schools across the United States. Early screening would provide diagnoses and support resources for affected children, empowering them to succeed in school with targeted IEPs or 504 plans.

Overview

The Individuals with Disabilities Education Act (IDEA) mandates that all children with disabilities should be provided a Free Appropriate Public Education (FAPE). In other words, students with disabilities have the same right to K-12 public education as students without disabilities. Additionally, IDEA requires all states who receive federal funding for special education to ensure “identification of children with disabilities, appropriate evaluation, and appropriate educational placement.” Currently, there is no nationwide standardized screening for attention-deficit/hyperactivity disorder (ADHD), and while dyslexia screening is more common, it is still not mandated in all 50 states. 

For elementary school students, reading competency is critical, as “learners access information primarily through reading.” As ADHD and dyslexia impact children's reading comprehension, both learning disabilities affect academic success.Children in second through fifth grades unable to read at grade level find it challenging to understand class curriculum. Early testing allows children to receive support that is consistent with an individualized educational program (IEP). Research has also shown that when ADHD, dyslexia, and other learning disabilities are identified earlier, there is less danger of potential psychological trauma.

Children with ADHD are at a 60% higher risk for having other learning disabilities. For ADHD, although debates persist around overdiagnosis and treatment, the diagnostic criteria has been refined, with the core symptoms of inattention, hyperactivity, and impulsivity well-defined. ADHD diagnosis in the United States requires the involvement of a primary care physician (PCP); however, educators and parents are key in initially screening for key symptoms that are ultimately evaluated by the PCP. This early identification can lead to early action.

Dyslexia, defined as a difficulty in reading and writing, can be detected as early as age six. It affects both academic performance and self-confidence, especially in school aged children. Dyslexia diagnoses are typically made through comprehensive educational evaluations, yet earlier screenings performed by schools allow for more timely interventions that foster better educational outcomes. 

Pointed Summary

• ADHD is often accompanied by a 60% comorbidity rate.
• Children with ADHD and dyslexia are at higher risk for reading and math difficulties.
• Reading proficiency is a fundamental skill for academic success.
• IDEA mandates LEAs to identify and evaluate students with disabilities, yet consistent ADHD and dyslexia screenings are lacking.
• Early diagnosis could lead to effective intervention strategies to support student success.

2. Relevance

The ability to read, acquire vocabulary, and understand texts are critical skills for students. Children who have ADHD or dyslexia encounter challenges in acquiring these skills and often have other significant learning disabilities. 

ADHD is associated with other learning disabilities, the two most common being dyslexia and dyscalculia, which affect about 5% of school aged children. More than 60% of individuals with ADHD also have one or more comorbid disorders such as oppositional defiant disorder, conduct disorder, depression, and tic disorders. ADHD is the second most common psychiatric disorder of childhood. Children with ADHD can be negatively labeled or treated differently at school and at home as they struggle to sit still and to think before they act, which can make learning and functioning in a typical classroom environment challenging. Early screening for ADHD allows for timely intervention and treatment.

Children with dyslexia face not only ongoing challenges with literacy but also various psychological difficulties such as heightened levels of anxiety and aggression. These mental health issues often impact their daily lives and may persist into adulthood. Low self-confidence in their reading abilities can increase the risk of anxiety and depression. Research also suggests that early attention problems contribute to dyslexia, as children with difficulty focusing during the initial stages of learning to read may struggle with developing phonemic awareness. A delayed diagnosis of dyslexia can significantly impact a student’s overall academic journey.

For elementary school children in second through fifth grades, reading competency is critical as “learners access information primarily through reading.” As ADHD and dyslexia impact children's reading comprehension, both learning disabilities can affect academic success.

Early screening for learning disabilities can help in identifying students who are at risk of developing other psychological disorders later in life. Early testing allows children to receive individualized educational programs (IEP), and research has also shown that when ADHD, dyslexia, and other learning disabilities are identified earlier, there is less danger of potential psychological trauma.

3. History

Federal laws designed to ensure students with disabilities have equal access to education tailored to their individual needs have been in place since 1975. Initially known as the Education for all Handicapped Children Act (EHA), this law was amended and renamed The Individuals With Disabilities Education Act (IDEA) in 1990. Prior to the enactment of EHA/IDEA, most children with disabilities were denied access to education. In 1970, schools in the US only educated 20% students with disabilities and students who were blind, deaf, emotionally disturbed or had intellectual disabilities were even barred from going to school (U.S. Department of Education).

Much progress has been made since the passage of EHA/IDEA as today, more than 8 million children with disabilities are able to receive special education at their local neighborhood public schools. Federal grants under IDEA are provided to state educational agencies (SEAs) and local educational agencies (LEAs) to support the provision of special education and related services to children with disabilities to ensure that each child with a disability is provided free appropriate public education. IDEA conditions the receipt of these federal grants to goals that aim to provide certain educational and procedural protections to children with disabilities and their families. Several amendments made to IDEA in 2004 called for (1) early intervening services for children not currently identified as needing special education but who need additional academic and behavioral support to succeed in a general education environment, (2) greater accountability and improved educational outcomes, and (3) raised standards for instructors, who teach special education classes (U.S. Department of Education). Further, federal regulations issued in 2006 required public schools, among other things, to use research-based interventions to assist students with learning disabilities and for determining eligibility for special education.

Although IDEA has significantly contributed to the improvements in ensuring children with disabilities have access to free appropriate education, there is still no national standard for school-based assessments for either ADHD or dyslexia. While screenings for other disabilities such as hearing impairments have been implemented at the national level since the late 1920s, there are no comparable federal screening standards for ADHD and dyslexia even though ADHD and dyslexia have historically been under-recognized in school settings.

Current Stances

Unlike routine vision and hearing screenings, which are standard practice across the U.S., systematic screenings for ADHD and dyslexia are not widely implemented, despite their significant impact on academic performance.

Despite well established diagnostic criteria, there is no standardized screening for ADHD by LEAs in any state. Early diagnosis of dyslexia and ADHD is critical in creating Individualized Education Programs (IEPs) or 504 plans.

There are concerns about ADHD overdiagnosis and overtreatment. Some research suggests that diagnosing milder cases of ADHD may lead to unnecessary medication. There are also claims of overdiagnosis of dyslexia among middle-class children. However, many of these claims are based on outdated information.

Although IDEA mandates that LEAs identify and support all children with disabilities, only 46 out of the 50 US states have passed laws at the state level requiring some type of early dyslexia screening. No state has implemented similar requirements for ADHD screening. The primary goal of screening performed at schools is to identify children who are at risk. Detailed, more thorough evaluations and eventual diagnosis are performed by a child's primary care provider (PCP).

Tried Policy

 There are no federal laws or standards requiring childhood screening for ADHD or dyslexia. Currently, schools only evaluate children for ADHD if the school district believes that a student has a disability and requires the appropriate special education services. An evaluation may also be requested by a student or their family. Following this request, the school district must either (1) investigate the request, (2) provide an explanation for its refusal to evaluate, or (3) inform the family of their ability to challenge that decision using the due process procedures outlined in Section 504 of the Rehabilitation Act of 1973 (U.S. Department of Education).

Recently, a study evaluated the effectiveness of school-wide ADHD screenings and examined whether these screenings prompted parents to reach out to their child's primary care provider (PCP) for an ADHD diagnosis. Although not all students identified as being at risk for ADHD accepted the recommendation to discuss the screening results with the child’s PCP, over 53% of parents did take steps to connect with their PCP for official diagnosis.

Policy Problem

Without systematic ADHD and dyslexia screenings, many students remain undiagnosed, leading to academic struggles. There is a need for consistent policies across all school districts to ensure early detection and support. However, it is also important to balance the potential benefits of early diagnosis through screenings against the potential harmful repercussions of a misdiagnosis of a developmental or mental health disorder.

A false positive can cause parents unnecessary anxiety which may persist even after the diagnosis is confirmed to be false positive. Additionally, an incorrect early diagnosis can also lead to the recommendation of unnecessary, potentially intrusive, and costly therapies, some of which may be untested. On the other hand, a false negative (e.g., no finding of diagnosis even if there is one) also poses a major dilemma: if a diagnosis is made too late, the opportunity for intervention may be missed. The high plasticity of the brain suggests that the interventions made earlier are most effective, emphasizing the importance of early identification.

A. Stakeholders

Key stakeholders include students with ADHD/dyslexia, parents, teachers, LEAs, and policymakers. Diagnosed students benefit from early intervention, while teachers gain insight into managing diverse learning needs in their classrooms.

Students

If students get screened early, then they know that they may have a learning disability and can find ways to study. This gives them more time to test out different work/study strategies and find out what works for them. Getting this “diagnosis” earlier also allows them to get the support and resources they need to succeed in school earlier. Knowing that they have this learning disability may also help them feel less “left out” or discouraged, since they know why they are different from the other kids. Getting diagnosed early can also help reduce the chances/severeness of future mental health risks.

Parents

For parents, knowing their child/children may have a learning disability can help them decide what next steps to take. They can learn how to support their kid and how to help them succeed in school and in life through trial and error and/or through research. This unofficial diagnosis also lets a parent know that they can get a real diagnosis if they wish to and possibly get an IEP or a 504 plan for their child, if they previously believed that their child/children didn’t have a learning disability.

Teachers

This early screening helps teachers to know that one or more of their students has a learning disability and helps them find resources to support those students. With this information, they can schedule parent-teacher meetings, if needed (and if possible), to maybe get additional resources (such as an IEP or a 504) for those students. With these diagnoses, teachers can help support students in any way they feel the need to.

LEAs/Schools

When screening for possible learning disabilities in students, LEAs can let the school know which students are more at risk for having learning disabilities. Then, the school can make the appropriate arrangements for those students (transferring them to a class for kids with similar learning disabilities, contacting parents to see if they want an IEP or a 504 plan for their children, etc.).

B. Risks of Indifference

Without standardizing ADHD and dyslexia screenings, many children may be left undiagnosed and suffer from learning challenges. This oversight risks not only academic underachievement but also other mental health and psychological disorders.

There is a strong correlation between the severity of learning disorders and a lower quality of life. Children with dyslexia have negative self-image, relationships with their friends and family, and social interactions. Higher anxiety and depression levels were also more prevalent in children with dyslexia as well as elevated suicide rates, and increases in antisocial behaviors. These issues may complicate student-teacher relationships. Due to the lack of understanding from peers, teachers, parents, and classmates, children with dyslexia often have lower academic scores, unstable emotions, and feelings of inferiority. A study reported that 50% of children with dyslexia were frequently teased, tormented, or even rejected by their peers due to their poor reading skills and poor academic achievement.

Children for whom ADHD remains undiagnosed and untreated also face mental health risks. Adults who failed to receive treatment for ADHD suffer from low esteem, anxiety and depression; they are unlikely to graduate from college or high school and suffer from job instability and unstable income compared to those without ADHD. Adults with untreated ADHD also have more difficulty controlling their emotions and impulses which can negatively impact personal relationships.

Screening for ADHD and dyslexia enables at-risk families to pursue early interventions that can help lessen both learning and psychological challenges.

C. Nonpartisan Reasoning

Systematic screenings for ADHD and dyslexia help schools meet the federal IDEA standards by facilitating early interventions tailored to students' needs. By identifying learning disabilities promptly, schools can provide targeted support, fulfilling their federal responsibilities while promoting equitable educational opportunities.

Policy Options

The proposed policy would introduce standardized ADHD and dyslexia screening in all public elementary schools across the U.S., as part of a comprehensive annual health check that currently includes vision and hearing exams. Each year during student registration, parents would complete a questionnaire to flag potential concerns related to ADHD and dyslexia. With parental consent, teachers and LEAs would conduct initial classroom observations and screenings based on these responses.

Once students have settled into the academic year, targeted testing days would be held in schools to formally assess flagged students for ADHD or dyslexia. These screenings would be handled by LEA-funded professionals trained to recognize and evaluate these learning challenges. Parents of diagnosed students would be invited to school meetings to discuss potential IEP or 504 plans, tailored to address their child’s specific needs.

This policy would ensure all children, particularly those in underserved or rural districts, have access to early identification and support for learning disabilities. By incorporating ADHD and dyslexia screenings into standard school procedures, LEAs can proactively address learning challenges, ensuring children develop critical reading and comprehension skills. The policy emphasizes IDEA’s goal of providing a Free Appropriate Public Education to all, allowing students to thrive in school environments that cater to their diverse learning needs.

Conclusions

Implementing standardized, nationwide screenings for ADHD and dyslexia in elementary schools would fulfill the mandates of the Individuals with Disabilities Education Act, ensuring that all students receive the early support they need to thrive academically.

The current lack of systematic screening not only delays necessary interventions but also exacerbates academic and psychological challenges that can persist into adulthood. By integrating ADHD and dyslexia screenings into the existing health check protocols conducted in schools, we can identify at-risk students early on and create tailored Individualized Education Programs (IEPs) or 504 plans to address their unique needs.

A nationwide policy mandating these screenings would not only enhance educational equity but also reduce the long-term mental health risks associated with undiagnosed learning disabilities.

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Acknowledgment

The Institute for Youth in Policy wishes to acknowledge Gwen Singer, Mason Carlisle, Lilly Kurtz, Paul Kramer. and other contributors for developing and maintaining the Fellowship Program within the Institute.

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