Internalizing problems in individuals with reading, mathematics and unspecified learning difficulties: a systematic review and meta-analysis

We conducted a systematic review and meta-analysis to examine if individuals with reading difficulties (RD), mathematics difficulties (MD), or unspecified learning difficulties (ULD) experience internalizing problems (i.e., anxiety, depression, somatic complaints, and social withdrawal) to the same extent, and if the effect sizes are influenced by moderators (age, internalizing problems type, anxiety type, rater type, selection criteria, and attention control). We reviewed 2,806 studies published in English between January 2000 and April 2023. Our final sample consisted of 96 studies that reported effect sizes or data to calculate them (a total of 120 unique samples, 83,260 participants, age range = 7.3 - 34.8 years). Risk of bias and sensitivity were assessed. A random-effects model analysis revealed a significant and moderate overall effect size (Hedge's g = -.54), indicating that individuals with RD, MD or ULD experience more internalizing problems than their chronological-age (CA) controls. Follow-up analyses showed that neither learning difficulties type nor age of participants were significant moderators, but selection criteria (diagnosis versus screening) and internalizing problems type were. These findings suggest that individuals with RD do not differ from those with MD or ULD in internalizing problems, and all fare poorly compared to CA controls.

Learning Disabilities Elevate Children's Risk for Behavioral-Emotional Problems: Differences Between LD Types, Genders, and Contexts

Our purpose was to study the frequency of behavioral-emotional problems among children identified with a learning disability (LD). The data were obtained for 579 Finnish children (8-15 years) with reading disability (RD-only), math disability (MD-only), or both (RDMD) assessed at a specialized clinic between 1985 and 2017. We analyzed percentages of children with behavioral-emotional symptoms reaching clinical range (i.e., z score ≥1.5 SDs) and the effects of the LD type, gender, and context (home vs. school) on them. Furthermore, we analyzed the effect of the severity of LD and gender on the amount of behavioral-emotional symptoms reported by teachers and parents. Alarmingly high percentages of children, irrespective of LD type, demonstrated behavioral-emotional problems: more than 37% in Affective, Anxiety, and Attention-Deficit/Hyperactivity Disorder (ADHD) problems. Contextual variation was large, as more problems were reported by teachers than by mothers. The unique effects of gender and LD type were rare, but the results raised concern for those with MD-only, especially boys. The results underscore the need to draw attention to the importance of assessing children with LD for behavioral-emotional problems and emphasize the importance of teachers' awareness of behavioral-emotional problems among students with LD and cooperation among child, teacher, and parents in assessment and support planning.

Comorbidities Between Specific Learning Disorders and Psychopathology in Elementary School Children in Germany

Children with reading and/or spelling disorders have increased rates of behavioral and emotional problems and combinations of these. Some studies also find increased rates of attention-deficit/hyperactivity disorder (ADHD), conduct disorder, anxiety disorder, and depression. However, the comorbidities of, e.g., arithmetic disorders with ADHD, anxiety disorder, and depression have been addressed only rarely. The current study explored the probability of children with specific learning disorders (SLD) in reading, spelling, and/or arithmetic to also have anxiety disorder, depression, ADHD, and/or conduct disorder. The sample consisted of 3,014 German children from grades 3 and 4 (mean age 9;9 years) who completed tests assessing reading, spelling as well as arithmetic achievement and intelligence via a web-based application. Psychopathology was assessed using questionnaires filled in by the parents. In children with a SLD we found high rates of anxiety disorder (21%), depression (28%), ADHD (28%), and conduct disorder (22%). Children with SLD in multiple learning domains had a higher risk for psychopathology and had a broader spectrum of psychopathology than children with an isolated SLD. The results highlight the importance of screening for and diagnosing psychiatric comorbidities in children with SLD.