Anxiety is one of the most common and early onset mental health problems in youth (Grills-Taquechel & Ollendick, 2012; Merikangas et al., 2010b). Approximately one third of US adolescents have had an anxiety disorder in their lifetimes, and the median age of onset among these adolescents is 6 years old, coinciding with the beginning of elementary school (Merikangas et al., 2010b). However, less than one third of US youth with an anxiety disorder receives any mental health treatment, and younger children are less likely than adolescents to receive services (Merikangas et al., 2010a). Anxiety is a pervasive mental health problem for children, and it may also interfere with educational outcomes (Grills-Taquechel et al., 2012).
Consistent findings report a negative association between anxiety and reading achievement in children (Francis et al., 2019; Grills-Taquechel et al, 2012). Reading is an important educational target in elementary school and a predictor of academic achievement longer-term (Suggate et al., 2018). As such, anxiety represents a promising area of research for understanding how best to support reading achievement in early education (Grills-Taquechel et al., 2012). Prior research suggests that associations between anxiety and reading are bi-directional, with reading abilities influencing later anxiety levels and anxiety levels influencing later reading abilities (Grills-Taquechel et al., 2012; Ramirez et al., 2019).
Reading performance in children may also be associated with particular subtypes of anxiety (Grills-Taquechel et al., 2012). Poorer reading outcomes have been associated with elevations in separation anxiety and generalized anxiety disorder symptoms, but not specific phobia symptoms (Carroll et al., 2005). A study by Grills-Taquechel et al. (2012) found that reading fluency at the beginning of the school year negatively predicted separation anxiety symptoms at the end of the school year in first grade students. However, the same study found that harm avoidance, a facet of anxiety related to perfectionism, was positively associated with reading achievement, illustrating that certain facets of anxiety may play a motivating or performance-enhancing role (Grills-Taquechel et al., 2012).
Most studies examining the links between anxiety and reading performance have focused on reading skills such as decoding and fluency, with few examining the more complex skill of reading comprehension (Macdonald et al., 2021). Successful passage comprehension requires several cognitive tasks, including decoding words, reading fluently (with speed and accuracy), understanding word meanings (vocabulary), linking the text with prior knowledge, and monitoring one’s understanding of the text (Edmonds et al., 2009). One study of fourth and fifth grade struggling readers found that anxiety was more strongly associated with poorer reading comprehension than with basic reading skills (Macdonald et al., 2021). Additionally, this study found that domain-specific reading anxiety uniquely predicted reading comprehension, whereas generalized anxiety did not predict reading outcomes (Macdonald et al., 2021).
Attentional Control Theory
Many of the findings connecting anxiety and reading are consistent with Attentional Control Theory (ACT; Eysenck et al., 2007), which posits that anxiety consumes cognitive resources, reducing performance on certain tasks. According to the theory, anxiety reduces goal-directed, top-down attentional control in favor of the bottom-up, stimulus driven system of attention (Eysenck & Derakshan, 2011). For example, a child trying to read may become distracted by a worried thought or anxiety-related stomachache, making it difficult to concentrate on reading. A recent meta-analysis of fifty-eight studies of children and adults largely supported the hypotheses of ACT (Shi et al., 2019). The effect size of anxiety on attentional control appears to be larger for tasks requiring higher cognitive loads compared to lower (Shi et al., 2019). As Macdonald et al. (2021) note, this effect may explain why anxiety reduces performance on comprehension to a greater extent than decoding and fluency, as comprehension is a more complex task requiring more cognitive resources.
Research examining the link between anxiety and attentional control often does not differentiate state and trait anxiety, though researchers generally use trait anxiety questionnaires as measures (Myles et al., 2020). Since individuals high in trait anxiety are more likely to experience state anxiety during a given task, it is unclear if findings linking trait anxiety with impaired attentional control reflect a stable difference in cognition in individuals high in trait anxiety or a temporary impairment in functioning caused by high state anxiety (Myles et al., 2020). One study of adults found that induced state anxiety was associated with impaired attentional control in individuals high in trait anxiety, but not in those low in trait anxiety (Myles et al., 2020). Thus, state and trait anxiety may interact to influence attentional control in adults. In children, there is a lack of research differentiating the impact of state and trait anxiety on attentional control. However, one study found that domain-specific reading anxiety was more strongly associated with poorer reading achievement than other anxiety subtypes, suggesting that state anxiety likely plays a key role, interfering in the moment with cognitive processes during reading (Macdonald et al., 2021).
In addition to explaining negative links between anxiety and cognition, ACT also states that anxiety may enhance effort and facilitate the use of compensatory processing strategies, which can protect against its deleterious effects on cognitive performance in some situations (Eysenck et al., 2007). Eysenck et al. posited that for this reason, anxiety may impair efficiency more than accuracy, so that a highly anxious person may put forth greater effort yet achieve the same results.
Anxiety, Reading, and Attentional Control Theory in Children
Though many studies support ACT, few have tested its hypotheses as they may apply to anxiety and reading performance in children (Shi et al., 2019). Blankenship et al. (2019) found that executive function, closely related to attentional control, was directly associated with reading performance in 6-year-old children. However, this study did not include a measure of anxiety. Carroll et al. (2005) found that children with separation anxiety disorder or generalized anxiety disorder were more likely to have reading problems than their peers without anxiety disorders. Attention partially accounted for this anxiety-reading association, supporting the possibility that attentional control at least partially mediates the relationship between anxiety and reading performance.
A few studies directly examined anxiety and attention in the context of academic performance. Two studies have used dot-probe tasks to test attentional bias toward academic stressors in youth. Scrimin et al. (2016) found that eighth grade students who rated their school anxiety as higher showed greater bias toward academic stressors, supporting the hypothesis of ACT that individuals with anxiety have a harder time disengaging from threatening stimuli (Scrimin et al., 2016). However, this study did not examine associations between reading and anxiety. Another study of children ages 9 to 16 years found that those with specific learning disorders (mostly reading disorders) had a significant threat bias away from reading-related stimuli compared to typically-developing peers (Haft et al., 2019). While ACT would predict an attention bias toward threat, the results in this study are likely due to methodological choices (Haft et al., 2019; MacLeod et al., 2019). Specifically, a long presentation time in the dot-probe paradigm is more likely to reveal top-down attention rather than tapping into the bottom-up, stimulus-driven attentional processes that concern ACT (MacLeod et al., 2019). The longer presentation time was chosen for this study since children had low word-reading ability; however, the choice makes this study inconclusive regarding the hypotheses of ACT (Haft et al., 2019). In a study of first grade children, teachers rated children’s attention levels and children completed anxiety and reading measures (Grills-Taquechel et al., 2013). Among children rated as more attentive mid-year, elevated mid-year separation anxiety was associated with poorer end-of-year reading, whereas elevated mid-year harm avoidance was associated with better end-of-year reading (Grills-Taquechel et al., 2013). It is possible that these findings reflect the cognitive interference caused by separation anxiety in children who usually show good attentional control, or enhanced effort put forth by children high in harm avoidance.
Present Study
Currently, there is evidence suggesting that attentional control could explain the links between anxiety and reading achievement; however, there is a lack of research testing this hypothesis. Since ACT accounts for both impaired efficiency in some cognitive tasks and increased effort and use of auxiliary strategies, it may be that certain facets of anxiety, such as harm avoidance, are particularly related to performance-enhancing aspects of anxiety, while other facets of anxiety are more related to cognitive interference. Though there is support for ACT in children, the theory has not been tested to explain the positive and negative relationships between subtypes of anxiety and reading in children. This knowledge could help us to understand facets of anxiety that are adaptive and maladaptive for attention and, in turn, reading, which has implications for designing interventions that can best support both mental health and academic achievement for students.
The current study presents an analysis of data collected during a reading intervention study with a diverse sample of public elementary school students in the Southwestern US (see Denton et al., 2014 for details). The study aims to test the hypotheses that different subtypes of anxiety will be differentially associated with children’s reading comprehension performance (H1), and the links between anxiety symptoms and reading comprehension will be attenuated when accounting for attention (H2). Specifically, for H1 we hypothesize that harm avoidance will be positively associated with reading comprehension and other subtypes of anxiety (social anxiety, separation anxiety, and physical symptoms) will be negatively associated with reading comprehension in elementary school students. Regarding H2, we predict that harm avoidance will be positively associated with attention, and that when attention is included in the model, the positive relationship between harm avoidance and reading comprehension will be attenuated. For all other anxiety subscales, we predict they will be negatively associated with attention, and when attention is included in the model, the negative relationship between these subscales and reading comprehension will be attenuated. This study evaluates whether attentional control serves as a potential mediator between anxiety and reading performance.
Additionally, the current study examines whether gender moderates the associations between anxiety, attention, and reading comprehension. A wealth of literature documents gender differences in attention and anxiety in children. In a large community sample, boys were rated as significantly more inattentive than girls by their parents, and boys are more than twice as likely as girls to be diagnosed with ADHD (Ramtekkar et al., 2010; Merikangas et al., 2010). In contrast, girls report higher levels of anxiety than boys, and this difference persists through adulthood (de Lijster et al., 2017). In contrast, reading performance in second-grade children appears unrelated to gender (Vlachos & Papadimitriou, 2015). Thus, it is important to examine whether gender moderates the relationships between anxiety, attention, and reading performance in this study.