*Co-Occurrence and Causality Among ADHD, Dyslexia, and Dyscalculia

ADHD, dyslexia, and dyscalculia often co-occur, and the underlying continuous traits are correlated (ADHD symptoms, reading, spelling, and math skills). This may be explained by trait-to-trait causal effects, shared genetic and environmental factors, or both. We studied a sample of ≤ 19,125 twin children and 2,150 siblings from the Netherlands Twin Register, assessed at ages 7 and 10. Children with a condition, compared to those without that condition, were 2.1 to 3.1 times more likely to have a second condition. Still, most children (77.3%) with ADHD, dyslexia, or dyscalculia had just one condition. Cross-lagged modeling suggested that reading causally influences spelling (β = 0.44). For all other trait combinations, cross-lagged modeling suggested that the trait correlations are attributable to genetic influences common to all traits, rather than causal influences. Thus, ADHD, dyslexia, and dyscalculia seem to co-occur because of correlated genetic risks, rather than causality.