Dyslexia, Dyspraxia and Dyscalculia at Work: A Guide for Health and Care Employers

Dyslexia, dyspraxia and dyscalculia are common, often unrecognised differences in how people process information and coordinate movement. In health and care, where staff write care notes, calculate medicine doses, follow procedures and work in busy teams, they can affect people in different ways, and many adults reach their forties without a formal diagnosis. Understanding them is part of good people management, and employers have legal duties to make reasonable adjustments where a condition meets the legal definition of disability. This guide draws on NHS Wales guidance for supporting staff and general good practice. It is not legal or medical advice.

What the three conditions are

The Cardiff and Vale University Health Board toolkit describes dyslexia as a neurological difference that affects up to 1 in 10 people in the UK. It affects reading, writing, spelling and processing information, but not only those skills, and it occurs at all levels of intelligence. Dyspraxia, also called developmental co-ordination disorder, affects movement and coordination without affecting intelligence, and can influence motor skills, learning, social functioning and organisation. Dyscalculia is a specific and persistent difficulty with understanding numbers; the toolkit says it affects 3 to 6 per cent of the population and can cause weak mental arithmetic and difficulty with finances or charts. They often overlap with each other and with conditions such as ADHD; see our guide to ADHD in adults.

How they can show up in health and care work

• Dyslexia: slow or error-prone reading of long documents, spelling mistakes in records, difficulty with written policies, and fatigue after heavy reading or writing. Often accompanied by strengths such as problem-solving, communication and empathy.
• Dyspraxia: clumsiness, difficulty with handwriting or fine motor tasks, problems with organising time and equipment, and difficulty copying sequences of movements in training.
• Dyscalculia: difficulty with dose calculations, reading charts, handling money, telling the time or following numerical instructions.

The toolkit stresses that these conditions do not reflect ability. Effects are highly individual and require personalised support so that the environment does not limit the person.

Legal duties and reasonable adjustments

The toolkit notes that employers have a legal responsibility under the Equality Act to make reasonable adjustments to the workplace. In general terms, a condition is a disability under the Equality Act 2010 if it has a substantial and long-term effect on normal day-to-day activities, so whether a particular employee is covered depends on their circumstances, and employers should not wait for a formal diagnosis before considering adjustments. Our guide to equality and diversity training in care and healthcare explains how this fits into wider employer duties.

Examples of reasonable adjustments

The Cardiff and Vale toolkit gives practical examples. For dyslexia these include coloured paper, screen readers, speech-to-text software, quiet workspaces and task reminders. For dyspraxia they include regular breaks, breaking tasks into steps, clear written instructions and ergonomic equipment. For dyscalculia they include calculators, simplified numerical data, visual charts and time management tools. In health and care settings, you might also consider:

• pre-printed or colour-coded medicine charts and dose calculation aids, subject to your medicines policy;
• dictation or templates for care records, with a quick check by a colleague where accuracy is critical;
• extra time for written assessments and mandatory training;
• spoken instructions backed up with short written summaries;
• a buddy or mentor for complex tasks.

Workplace needs assessment and Access to Work

A workplace needs assessment is a semi-formal, usually remote, interview with an experienced assessor, who looks at the person's role and individual difficulties and recommends tailored support. The toolkit also points to the Access to Work scheme if initial adjustments are not enough. Managers should consider a specialist assessment if an employee's difficulties persist after simple changes.

Tips for managers

• Handle disclosure sensitively. Thank the person, keep the discussion confidential and ask what helps.
• Talk openly about needs. Agree adjustments in writing and review them regularly.
• Start with simple, low-cost changes. Many adjustments cost little.
• Keep communicating. Check in regularly rather than waiting for problems.
• Avoid assumptions. Do not equate difficulty with writing or numbers with lack of competence or care.

Managers and colleagues also benefit from awareness training, as set out in our mental health first aid training guide, since stress and low confidence are common for people who have struggled unsupported.

Frequently asked questions

Do employees need a diagnosis to get adjustments?

No. Employers should respond to difficulties they know about or could reasonably be expected to know about, and a diagnosis can help but is not always required before making changes.

Are dyslexia and dyspraxia learning disabilities?

They are learning differences, not learning disabilities in the clinical sense, and they do not affect intelligence.

Where can staff find CPD on this?

Equality, neurodiversity and inclusive management training are all relevant. Browse the Learnsignal CPD hub for healthcare compliance courses.

Source: Cardiff and Vale University Health Board, Supporting staff with dyslexia, dyspraxia and dyscalculia toolkit. This article is general information, not legal advice.