**3. Method**

The study applies an explanatory mixed methods design, which consists of collecting quantitative data and then collecting qualitative data to help explain the relationships or trends found in the quantitative data [28]. In the following section, quantitative results will be at the forefront, revealing differences in educational attainment and anxiety between dyslexic and non-dyslexic youth. Qualitative interviews with young dyslexic people then give the possibility to develop a more in-depth understanding of the reasons for anxiety and drop-out from education and experiencing anxiety.

For the survey, a random sample of 4000 individuals, aged 18–24, was drawn from the Icelandic National Register. An introductory letter was sent to the legal residence of the young people in the sample, in which the purpose of the study was described. The letter also contained the URL to complete the survey online. Later, sampled members who had a phone number listed in the telephone directory were called, reminded of the survey, and invited to provide their email address to receive the survey by email. Since the response rate was poor, a decision was later made to visit the sampled individuals' legal residence and conduct the survey face-to-face. Data collection took place from August 2022 to March 2023. The total number of participants in the survey was 1036 resulting in a 26% response rate.

The questionnaire was designed by one of the researchers, in cooperation with staff at the Social Science Research Institute at the University of Iceland. Most questions were created specifically for the study, but the questionnaire also contained items from the GAD-7 anxiety scale (General anxiety disorder). The survey was fielded in both Icelandic and English. Data were then analysed using the chi-square test, to determine statistical significance between youth diagnosed with dyslexia and others. The association between dyslexia and anxiety was analysed using linear regression models.

**Figure 1** shows the prevalence of dyslexia in the group of survey respondents. It was found that more than 20% of the respondents were diagnosed with dyslexia. A higher percentage of men than women had dyslexia, and it was most common that the respondents had received the diagnosis between the ages of 10 and 15.

At the end of the survey, those who reported that they were diagnosed with dyslexia were asked if they were willing to take part in a qualitative interview on the matter. The guide used for the interviews was divided into three main themes. First, the interviewees were asked to describe their experiences with the dyslexia diagnosis. Secondly, they gave an account of the school system and the assistance they received or would have needed at school. Finally, they were asked whether they had experienced anxiety and how they associated their own dyslexia with

*The Interplay between Dyslexia, Anxiety, and Educational Attainment among Young Adults… DOI: http://dx.doi.org/10.5772/intechopen.113750*

**Figure 1.** *Percentage of survey respondents that are diagnosed with dyslexia.*

anxiety. The interviews were carried out over the phone, recorded, and transcribed. The data was analysed by applying template analysis using the interview guide as the coding template [29]. The interviewees were all born around the turn of the last century. Ten people were interviewed, five women and five men. The interviewees had diverse educational backgrounds and held different positions in the labour market.

## **4. Results**

We now present the results of the mixed-method study. We first present results on how a dyslexia diagnostic was associated with anxiety, following results on the educational attainment of those diagnosed with dyslexia compared to those who do not have a dyslexia diagnosis.

#### **4.1 Associating dyslexia with anxiety**

In the survey, anxiety was measured with seven questions belonging to the GAD-7 (General anxiety disorder assessment) scale. The participants were asked how often in the past two weeks they had been nervous, worried, restless, angry, and afraid. Average responses to the questions were then used to create an anxiety scale. The scale has a value from 1 to 4, the higher the value, the greater the anxiety. The mean of the scale was 2.05 (standard deviation = 0.72). **Figure 2** shows the average scores on the anxiety scale for those diagnosed with dyslexia after the age of 10, those diagnosed with dyslexia before the age of 10, and for the participants without a dyslexia diagnosis. Although there were limited mean differences between the groups (*p* = 0.197), the group diagnosed with dyslexia after the age of 10 was slightly more anxious than the group diagnosed with dyslexia before the age of 10 and the non-dyslexic group.

The association between dyslexia and anxiety was further analysed using linear regression models. The purpose was to see if there was an association between dyslexia and anxiety when controlling for factors that may be related to anxiety. The effects of gender, place of residence in childhood, whether the young people received help with homework, parents' education, and respondents' native tongue were controlled for.

#### **Figure 2.**

*Anxiety symptom scale scores, by dyslexia diagnosis.*


#### **Table 1.**

*Results of linear regression analysis predicting anxiety.*

The regression analysis revealed that women were generally more anxious than men. When examining how dyslexia was associated with anxiety, when controlling for the aforementioned factors, it was found that the association strengthened when gender was considered. Thus, it seems that dyslexia did not have a strong association with anxiety on its own, but when taking into account that women are more anxious than men, a dyslexia diagnosis adds considerably to anxiety. Results show that participants diagnosed with dyslexia before the age of 10 were no more anxious, on average, than those without a dyslexia diagnosis. On the other hand, those diagnosed with dyslexia after the age of 10 had more anxiety, on average, than those who were not dyslexic. Thus, it seems to matter whether the young people were diagnosed with dyslexia early or relatively late. Another result is that those who found it easy to get help with their studies at home had less anxiety than those who found it difficult. Anxiety was also lower among those who had a universityeducated father than among those who had a father with a lower level of education (**Table 1**).

Thus, overall, the survey findings suggest that early intervention and support within the home environment significantly influence whether young people between the ages of 18 and 24 experience anxiety.

When asked about their experience with anxiety, the interviewees all said that they had dealt with anxiety or distress since childhood, and all associated their anxiety with

#### *The Interplay between Dyslexia, Anxiety, and Educational Attainment among Young Adults… DOI: http://dx.doi.org/10.5772/intechopen.113750*

school and their academic performance. Apart from one, they all had experienced dyslexia as their own incompetence, powerlessness, and "stupidity". The powerlessness was often associated with having to read out loud. One mentioned that it was "difficult to stand in front of the class and read. [It is] one of the greatest humiliations one can experience". Another said that he was "ashamed of reading so slowly and kind of hid the dyslexia". The method used by the interviewee to "hide" his dyslexia was to read the texts so often that he remembered them by heart. Several interviewees used the word "stupidity" to describe how they felt at school. One interviewee, who was not diagnosed with dyslexia until late, said she felt "stupid and worthless" as she was never on par with her classmates academically, despite her hard work.

Several interviewees were in special education and experienced it in different ways. However, most of them had a negative experience. One said that her classmates asked a lot about the special education and why she did not get higher grades despite receiving "special help", which gradually reduced her self-confidence. When being removed from the class to receive special education, the interviewees felt like something was wrong with them and that they were not part of the group, as mentioned by one of the young men. "You were taken out of the class, all the others remained. Then you missed class and were scolded for not knowing what was being discussed in class, but I was not in the class". One interviewee described how she began to feel anxious at the time she was placed in special education, despite having otherwise been "socially strong". Thus, it seems that the special education programmes have not always turned out to be the solution they were intended to be. Rather, the interviewees felt that they had two bad options to choose from. Either to be taken out of the group, and put in special education, or to be in the class and expose their weakness in front of their class.

The schooling and its individual aspects, such as reading, special education, tests, and more, caused anxiety for all interviewees. One described how he "was anxious about going to school" and another said that she "cried herself to sleep before an exam". Reading tests were thought to be extremely anxiety-provoking as they revealed the interviewees' greatest weaknesses. Many wondered about the practical value of speed-reading tests and what purpose they should serve. Speed reading is especially difficult for dyslexic children because "as soon as dyslexics start reading at high speed, their heads get confused", as one pointed out.

Some participants directly associated the anxiety with dyslexia or rather with going to school with dyslexia. They felt they had "more anxiety than others" because of their dyslexia, and most said they were "still stressed" or had "occasionally mild panic attacks". When asked, none of the interviewees had been offered help to deal with their anxiety. No school psychologist or other professional was available to help them understand and cope with their dyslexia or help them find their way in education. Several interviewees had sought psychological help in later years, but on their own initiative and at their own expense. The participants agreed on the importance of having easy access to psychological support and "learn about yourself", or in the words of one interviewee, getting help "to find ways to avoid high stress and learn to deal with panic attacks".

#### **4.2 Educational attainment**

Survey participants were asked about the highest level of education they had completed. **Figure 3** shows that participants with a dyslexia diagnosis were more likely to have not studied further after completing elementary school, than participants who had not been diagnosed with dyslexia. Considerably more respondents with dyslexia had completed vocational training or 11–12% compared to 6% of participants without a dyslexia diagnosis. About 10% of the respondents who had not been diagnosed with dyslexia had completed a university education, 6% of those who had been diagnosed before the age of 10, and 3% of the participants who had been diagnosed with dyslexia after the age of 10.

The participants who were not studying when the survey took place, were asked if they aimed to study in the near future. When the responses were analysed according to whether the participants were diagnosed with dyslexia or not, it was found that over half of those who were not diagnosed with dyslexia intended to study at a university, but the same held true for a much lower proportion, or just over a third of those who were diagnosed with dyslexia (**Figure 4**).

Respondents who were pursuing education at the time of the survey were asked about their specific type of study. The majority of those without a dyslexia diagnosis were enrolled in university programs, while the proportion was notably lower, ranging between 37% and 39% for individuals who had been diagnosed with dyslexia (**Figure 5**).

The interviewees' narratives shed some light on why young people with dyslexia are more likely to have dropped out of school than those who do not have such a diagnostic. Results from the interviews revealed that participants did not feel they received sufficient support in school. The resources available in elementary school and the secondary schools were coloured films or papers, longer test time – one spoke of "extra 15 minutes" - and some had access to audio books. Although most felt that "some of them helped" they stressed that they "wished the school had sent [them] to have the diagnosis much earlier" and that they had been immediately assigned "individualized assistance" and provided with "flexibility in their studies". In retrospect, the support that the interviewees said was lacking, was not only in the form of additional resources, but what one interviewee called "additional attention and follow-up". Thus, the interviewee points out that the teachers should have "looked into the reasons" why he performed poorly at school, including sending him earlier to test for dyslexia. Then, after being diagnosed, the interviewees emphasised that the support needed to be tailored to the individual in question, instead of a limited and standardized, some kind of "one-size-fits-all" remedy, as one put it.

**Figure 3.** *What is the highest level of education you have completed?* *The Interplay between Dyslexia, Anxiety, and Educational Attainment among Young Adults… DOI: http://dx.doi.org/10.5772/intechopen.113750*

#### **Figure 4.**

*Are you planning to study in the near future?*

#### **Figure 5.**

Several interviewees had received help with reading and other subjects in special education programmes. The interviewees gave a two-sided story when discussing special education. Some thought it was a relief to "go to a private room to read and not be in front of people", as one person put it, but others found it "embarrassing to be removed from the group" and placed in another room to study. The classmates asked a lot of questions about where they had been and why, and this led to further discomfort. Many interviewees had in common that they experienced their own disorder as a "failure" or a deviation from the norm, and the special education classes supported the feeling of being "the black sheep". In other words, the young people were made to feel that they were different, which is not in line with the policy of inclusive education.

Many of the interviewees talked about dyslexia having a series of negative consequences. Dyslexia led to insecurities related to reading, which affected most other studies: "When you have difficulty reading, you have difficulty focusing and then [studying] is not fun, one thing leads to another, like a domino effect" said one interviewee. Poor performance, often despite hard work, lack of information about dyslexia, and lack of resources and support made the interviewees feel "something is wrong with [them]". In the interviews, emphasis was placed on the importance of being informed of one's own diagnosis and at the same time being able to focus on one's strengths. According to the interviewees, "all the emphasis was on reading and

*What kind of studies do you do?*

mathematics" and there was no space for art subjects. All the interviewees shared the opinion that "too much emphasis [was] on reading" and a few also specifically criticized the emphasis on reading at high speed, which is a problem for many people, especially dyslexics.

Many of the interviewees had at some point dropped out of high school or "switched high schools" and one had dropped out of school after elementary school. One interviewee reported having reached the point of "not caring anymore [in 9th/10th grade], [I was] apathetic and rebellious" although she later completed secondary school and another "gave up school and now works in the construction industry". However, most of them had eventually finished secondary school, and some were undergraduate university students at the time the interviews were conducted.
