This post is a reworking of an article I wrote for School House Magazine a number of years ago. I felt it was time to dust it off and update it as it is clear to me that the issue of under-detection of dyslexia in girls is sadly still alive and kicking.
Back when I was working as a dyslexia assessor I witnessed a troubling but undeniable trend. With unfortunate consistency, I began to notice that girls were brought to see me on average three to four years later than boys. Upon assessment, I often wondered how these girls managed to navigate with the same difficulties as their male peers, often with the same clear history of underperformance, yet the systems around them failed to raise flags. I also noted that the vast majority of girls were brought by a worried parent often against the advice of the school. Having been told their child was doing 'well enough' and to 'give it time', at a loss to understand the clear depth of their daughter's struggle, they chose to take matters into their own hands.
I am not seeking to demonise schools here. I understand there are numerous considerations schools must carefully balance before taking action.
As someone who spent many years in education as a teacher, a Vice Principal and a Special Educational Needs Coordinator, I am very aware that in schools perceptions dictate responses. On many occasions I saw the academic struggles of girls were noticed, but often attributed to 'friendship issues' or high levels of anxiety due to school pressures (frequently with the unspoken assumption that this was driven by 'pushy parents'). Essentially, I found due to gendered thinking around social expectations, there were assumptions regarding how girls navigate their relational landscapes; driven by a belief that it was low self-esteem that was impacting academic performance. Unfortunately, this thinking could quickly eclipse the inverse possibility; that it was actually the struggle to function academically driving insecurities that were then manifesting socially.
I can attest to this from my personal experience of school as a dyslexic child and teen - although that was a long time ago.
The real question is, with the level of dyslexia awareness being what it is today, how can this still be the case? Like so many other situations where neurodiversity is concerned, I believe the answer lies in our deeply embedded, often unconscious, expectations of how dyslexia presents in our children (both boys and girls). Meaning the difficulty with recognition is due to misperceptions and misinterpretation of what we see as opposed to a lack of concern.
The shocking thing is, clinicians were already questioning this assertion of male prevalence in dyslexia back in 1973.
As was often the case when I was working as a dyslexia specialist, I would look to The Yale Center for Dyslexia & Creativity and the work of its founders, Doctors Sally and Bennett Shaywitz. I was astonished to discover that by 1983 Sally Shaywitz had already completed a 10 year longitudinal study investigating whether or not dyslexia was more common in boys. In her landmark study of Connecticut schools, Shaywitz found no significant difference in the prevalence of reading difficulties between sexes, yet there was a clear pattern of schools referring far more boys for assessment. In a startling and revealing example of referral bias, Shaywitz illustrated that the issue lay with who was identifying the issue and how they were recognising need. In a sample of more than 300 second graders (aged 7-8 years), Shaywitz's researchers identified 8.7% of boys and 6.9% of girls as having diagnosable reading difficulties; compared to 13.6% of boys and only 3.2% of girls identified by the schools. In analysing this discrepancy, Shaywitz found one clear issue consistently arose. Whereas Shaywitz's researchers where testing all children, the school was choosing to test based on a set of referral criteria which inevitably included disruptive classroom behaviour.
Needless to say, this is problematic ...
When looking at wider research into child development, we see that, due to many factors including social expectations and conditioning, girls under stress are less likely to 'act out' than boys. Even in more recent studies the myth of dyslexia effecting more boys than girls persists because their findings are not contextualised through this wider developmental and social lens. Where this leaves us, even in this time of heightened awareness and increasing access to support, is with girls still more likely to suffer in silence and, therefore, slip through the referral net.
It is this kind of flawed thinking, based on our preconceived ideas of what dyslexia 'should' look like, which is still at the root of the issue even after all these years. We know this is not just the case with dyslexia, but is also a rampant problem for girls with ADHD and autism.
Historically, as a society, we hold to the idea that girls mature more quickly than boys. Unfortunately, this is a reflection of societal expectations rather than the intrinsic nature of girls. Whilst my intention here is not to speak in absolutes, all too often social mores still encourage young girls to adapt themselves to conventional gender roles and outdated behavioural expectations at school, which stands in contrast to the (very) slowly changing perceptions of women in the workplace. Due to this, girls are, sadly, still less likely to demonstrate outwardly in the classroom when they are angry or frustrated. It is for this reason our girls are far more likely to suffer with mental health issues like anxiety or depression, or engage in self-harming acts and eating disorders. I know this to be the case as my colleagues and I see this in our work every day. In essence, if we read between the lines, what these studies have actually shown time and again is when pushed to frustration and/or anger our girls are statistically more likely to internalise their distress. Therefore, the real clarion call here is less about statistics and more about how we can better safeguard the mental wellbeing of our dyslexic (and other neurodivergent) girls.
So where do we go from here?
We can start by listening to what dyslexia advocates have been saying for years
Along with the more commonly accepted red flags such as issues with reading, writing, organisational difficulties or school work refusal, many girls may overcompensate in their desire to please the adults around them. Hence, we must also be vigilant of:
Perfectionism: Labouring over school work to make it look beautiful. A lovely looking piece of homework the teacher thinks took 30-minutes was painstakingly laboured over all evening.
Inconsistency: Presentation may not reflect content quality. Despite looking perfect, work content seems weak or disjointed; likely due to over focus on tidy handwriting and spelling
Hyper-organisation: Overcompensation for internal chaos by over-organising. Self-inflicted pressures create heightened anxiety while consuming unseen, exhausting hours of work
Physical and emotional symptoms brought on by anxiety/stress (also called somatisation): When stress and anxiety that can come with dyslexic struggles manifest as emotional/physical issues. Statistically, dyslexic girls are more likely to struggle with depression and/or anxiety as well as stomach aches, headaches, heart palpitations, and other physical symptoms that have no medical cause. These symptoms are often an unspoken call for help.
Whilst, thankfully, there is slowly growing awareness of how girls with Autism and ADHD can be effected by their life struggles, it is also important that our dyslexic girls do not drop off our radar.
If in doubt, seek assessment
Once upon a time, it was assumed that a Psychologist qualified in educational testing or an Educational Psychologist (in the UK also known as Ed Psych) was necessary for a dyslexia assessment. However, this is not the case. Over the years there has been a growing awareness that dyslexia Specialist Assessors can offer outstanding assessment services and provide additional insight into meaningful pathways to intervention and support. In the UK the SpLD Assessment Standards Committee (SASC) and PATOSS offer open access to their listings of qualified Specialist Assessors across the country.
Lastly, an important aim in starting this blog has been to offer resources to readers. As my focus more recently has been on autism and ADHD, I took some time to reacquaint myself with what is available out there for dyslexic girls. Whilst there was a treasure trove of online information and guidance for dyslexia generally, and a growing body of material for autistic and ADHD girls, I was disappointed to discover that there was precious little for dyslexic girls specifically.
Ironically, it was my old, outdated article that kept coming up.
This needs to change...
Resources:
What is dyslexia?
Note from the blog post author: As this video was created 10 years ago, I have edited out content that does not reflect more current thinking around hemispheric brain function.
References:
Shaywitz, S., Shaywitz, B.A., Fletcher, J.M., & Escobar, M. (1990). Prevalence of reading disability in boys and girls. Results of the Connecticut Longitudinal Study. JAMA, 264 8, 998-1002.
Dyslexia Specialist Assessment and Support: