Emotional and Behavioral Problems of Primary School Children With and Without Learning Disabilities: A Comparative Study

Abstract

Abstract
The aim of this study was to investigate the behavioral and emotional problems of children with and
without learning disabilities. The study sample consisted of 15 teachers and 424 primary school children with
and without learning disabilities were selected from two governmental primary schools at Beni-Suef City, using case –control research design. Data were collected by the teachers using the Strengths and Difficulties
Questionnaire (SDQ) for children and adolescents aged 4-16 years. The results conducted that the prevalence of total difficulties scores among primary school children with learning disabilities was 98.1% abnormal difficulties compared to 79.7% of normal children. Results also found that statistical significant differences were found between children with and without learning disability in all sub domains of emotional and behavioral disorders. This study documents that the high prevalence of difficulties among primary school children is an alarming condition that needs attention and early intervention. The study recommended that a periodic screening test should be provided for early detection of emotional and behavioral problems for children with learning disabilities.

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Journal of Education and Practice www.iiste.org
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Vol.5, No.8, 2014
1
Emotional and Behavioral Problems of Primary School Children
With and Without Learning Disabilities: A Comparative Study
Amany Sobhy Sorour
1,
Noha Ahmed Mohamed
2
and Mona Mohamed. Abd El-Maksoud
3
Assistant Professor of Community Health Nursing, Faculty of Nursing,
Zagazig University, Egypt
1
.
Lecturer of Community Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt
2
.
Lecturer of Community Health Nursing, Faculty of Nursing, Helwan University, Egypt
3
.
Address Correspondent: Mona M. Abd El-Maksoud
,
Nursing College, Females Studies Center, Abha Saudi
Arabia [Drmona158@gmail.com], 00966549766355
Abstract
The aim of this study was to investigate the behavioral and emotional problems of children with and
without learning disabilities. The study sample consisted of 15 teachers and 424 primary school children with
and without learning disabilities were selected from two governmental primary schools at Beni-Suef City, using
case –control research design. Data were collected by the teachers using the Strengths and Difficulties
Questionnaire (SDQ) for children and adolescents aged 4-16 years. The results conducted that the prevalence of
total difficulties scores among primary school children with learning disabilities was 98.1% abnormal difficulties
compared to 79.7% of normal children. Results also found that statistical significant differences were found
between children with and without learning disability in all sub domains of emotional and behavioral disorders.
This study documents that the high prevalence of difficulties among primary school children is an alarming
condition that needs attention and early intervention. The study recommended that a periodic screening test
should be provided for early detection of emotional and behavioral problems for children with learning
disabilities.
Key words: Primary school children, learning disabilities, emotional and behavioral problems
Introduction
Learning disabilities are problems that affect the brain's ability to receive, process, analyze, or store
information. These problems can make it difficult for children to learn as quickly as someone who isn't affected
by learning disabilities; these children do not fall under other categories of handicap (Lyness, 2010). Learning
disability constitutes one of the major health problems which affect the educational processes. Its prevalence is
about 10-15% of the school age children (Robinson & Roberton, 2003). Currently, prevalence of learning
disabilities was 7.66% among school-aged children in the United States (Boyle et al., 2011). In Egypt a study
done by Ahmed et al. (2003) showed that the prevalence of learning disabilities (LD) among primary school
children at Abbassia district was 15.7%, which increased among boys than girls.
Although the actual causes of learning disability can never be known, and this problem does not
become evident until the child enters the primary grades, but a variety of suspected causes of learning
disabilities have been proposed. The causes or influencing factors can be biomedical, developmental,
behavioral, emotional, social, environmental and family issues. The problem may be in the area of reading,
math, written expression, auditory perception and communication disorders (Nag & Snowling, 2012).
Students whose achievement lagged behind their intellectual potential present a serious problem to the
parents, society and finally to the nation; instead of being the contributing members they turn out to be a social
problem (Neill, 2008). Other possible outcomes for individuals with LD who have not received appropriate
intervention or help are emotional and behavioral problems which include low self-esteem, suicide, family
instability, substance abuse, depression, psychiatric problems and unemployment (Kemp et al., 2013).
Learning disabilities are lifelong. Individuals with learning disabilities can face unique challenges that
are often pervasive throughout the lifespan. However, with appropriate cognitive/academic interventions they
can overcome the effects of their disability (Neill, 2008; Nag & Snowling, 2012).
Teachers and paraprofessionals often are the first to recognize a student’s lack of success with
assignments, and his or her continuous problems with peer or adult relationships. While this fact may eventually
result in a formal referral, a teacher’s primary goal is to identify interfering behaviors and help students to
overcome them. Teachers and paraprofessionals begin this process by analyzing the kinds of behavior that put
students at risk (Quinn et al., 2000).
The community health nurses are in an excellent position to detect and support children with learning
disabilities, usually in a multidisciplinary team, and concern with their clients' health in the widest context. They
help clients of all ages to live their lives as fully and independently as possible, while respecting their rights and
dignity (Slevin & Sines, 2005).
Significance of the study
Learning disabilities are noticed when children struggle with learning in their school years techniques.
Eighty percent of children with learning disabilities, who have not been discovered and treated, have aggressive

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behavior toward family and community. Thus, a child with poor academic performance has tendency to engage
in criminal acts more than a child with higher school performance. Studying behavioral and emotional problems
among those children will produce reliable information that creates a basis for early detection and intervention.
Early detection allows time for follow up to occur before the child is expected to function in an advanced
learning environment (Hales, 2009).
Epidemiological information about the prevalence of child behavior and emotional problems is essential
to inform policy and public health practice. This information is weak in many developing countries and those in
developmental transition. There have been few such studies in Arab countries as well as in Egypt (Abd--
Elhamid et al., 2009).
Research question
What are the differences regarding behavioral and emotional problems among primary school children with and
without learning disabilities?
Aim of the study
The aim of this study was to investigate the behavioral and emotional problems of children with and without
learning disabilities.
Subjects and Methods
Research design: A case-control research design was utilized in this study to achieve the aim of the current
study.
Setting: The study was conducted at two governmental primary schools, selected randomly representing two
educational zones in Beni-Suef City;Abo Bakr El Sedek School represents West Zone and Madenat Beni-Suef
Elgededa School represents East Zone.
Sample: The population of this study consisted of 15 teachers for helping in data collection, and 424
primary school age children residing in the study settings during the time of data collection. They were
categorized into group (1) those who have a learning disability, including all available samples of 212
students with learning disabilities. They were recruited from the 4th (46), 5th (70) and 6th (96) grades
of these schools. The second group consisted of (40) at 4th grade, (80) at 5th grade and (92) at 6th
grade. The sample criteria included age range 10-12 years, free from chronic diseases, and the class
teachers agreed to participate in the study.
Tools of data collection
One tool was used in this study, it consisted of two parts:
First part: concerned with personal data such as; age, sex, scholastic achievement, and grade.
Second part: The Strengths
,
and Difficulties
,
Questionnaire (SDQ) for children and adolescents aged 4-
16 years were utilized in this study (Goodman, 1999; Goodman & Scott, 1999; Mathai et al., 2002; Youth in
Mind, 2005). The SDQ has become one of the most widely used tools in child and adolescent children’s
emotional and behavioral symptoms across the globe. Although the SDQ was originally developed and validated
within the UK, and its reliability and validity have been simulated in many countries, including Arab countries;
important cross cultural issues have been raised (Alyahri & Goodman, 2008).
The SDQ consists of 25 items: emotional symptoms (5 items), conduct problems (5 items),
hyperactivity/inattention (5 items), peer relationship problems (5 items) and prosocial behavior (5 items) (Youth
in Mind, 2005).
Scoring system:
The SDQ comprises 25 items; 5 scales of 5 items each. The responses to items always being in the same
way (as Somewhat True, Not True and Certainly True), but they are not all scored the same way. Standard
values were used for coding item responses and summary scores. The standard values for coding individual item
responses are 0 (Not True), 1 (Somewhat True), 2 (Certainly True); and the missing‟ values 7 (Unable to rate), 8
(Protocol exclusion) and 9 (Missing data) for all items except items 7, 11, 14, 21 and 25, these items are
“reverse-scored”, that is, the standard value is mapped to Item scores as follows: 0→2, 1→1, 2→0. SDQ scores
also were classified as normal (0-11), borderline (12-15 ) and abnormal (16-40).
Summary scores were calculated if at least three of the five items have been completed (that is, coded 0,
1 or 2). Otherwise the summary score is set to missing. For the summary scores, the missing value used should
be 99. The summary scores were computed using the equation shown below, with the result being rounded to the
nearest whole number. In the first 25 SDQ questions, each summary scale is composed of five items.
Summary score= Calculating the Total Difficulties scores
Total Score = Emotional Scale + Conduct Scale + Hyperactivity Scale + Peer Problem Scale (but
doesn’t include the Pro-Social score). The total difficulties score ranges from 0-40 (Youth in Mind,
2005).
Other questions are NOT completed if respondents have answered “No” to Item 26, which asks for an
overall opinion about the difficulties being present. In this case, all item responses for items 27 through 33
should be coded to “8” for “not applicable”, and the impact score should be coded to zero. Item 27 is not

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included in the impact Score, since it assesses the chronicity of the difficulties – the length of time they have
been present. Item 33 is not included in the impact Score, since it assesses the burden on others rather than on the
child/youth.
Ethical considerations:
Oral consent was taken from teachers of classes included in the study, they were informed that the data
collected will be used for the research only, and confidentality manner is assured.
Field work:
Official permission was obtained first from the Security Department, then the Ministry of
Education, and from the directors of educational zones. Based on their approvals, permission was taken from the
directors of the selected schools to collect the data.
The researcher started by explaining the purpose of the study briefly to the teachers of the selected
classes. Then, the researchers started to meet the teachers of the classes to give an explanation for emotional and
behavioral problems about each child. The duration ranged from 10 to 15 minutes. The researcher visited the
schools from 9.00 a.m. to 1.00 p.m. two to three times per week, to give teacher's explanation and provide
clarifications for any ambiguity in the questionnaire sheet and ensure accuracy of the data collected. The
duration of data collection took about three months from beginning of October to the end of December, 2012.
Pilot study:
A pilot study was carried out on 10% of the studied sample (20 students) to test the content of the
questionnaire, as well as to estimate the time needed for data collection. Those who shared in the pilot study
were excluded from the main study sample.
Statistical design:
Pre-coded data were statistically analyzed using the Statistical Package of Social Science (SPSS)
software program, version 21. Data were summarized using mean, standard deviation, median and interquartile
range for quantitative variables and frequency and percentage for qualitative ones. Comparison between groups
was done using independent sample t-test (if parametric) or Mann Whitney test (if non-parametric) for
quantitative variables and Chi square test or Fisher’s exact test for qualitative ones. Pvalues less than 0.05 were
considered statistically significant and if less than 0.001, they were considered highly significant. Graphs were
used to illustrate some information.
Results:
The current study results showed that the mean age of children with learning disabilities was 9.7±1.8 compared
to 9.8±1.9 of normal children. Regarding children, gender, more than half of children with learning disabilities
were males (54.2 %) , compared to 47.6% of normal children.
Table (1): shows that highly statistically significant difference was found between both studied groups regarding
pro-social sub domain. More than two fifths (44.3%) of children with learning disabilities compared to 26.9% of
normal children were in abnormal line of preschool domain.
Table (2): reveals highly statistically significant difference was found between both studied groups regarding
peer problems sub domain. The study results show that less than half of children with learning disabilities
(47.2%) compared to less than one third (31.1%) of normal children were having abnormal peer relations.
Concerning emotional symptoms domain, table (3) clarifies that highly statistically significant differences were
found between both studied groups regarding emotional symptoms sub domain except for worry and depression.
More than two fifths (43.9%) of children with learning disabilities compared 31.6% of normal children were
having abnormal emotional symptoms.
Regarding to conduct problems sub scale between both groups, study results show a statistically significant
difference in all sub domains except for often fights with other children, and 64.6% compared to 40.1% were
categorized as abnormal (table 4)
Table (5): Points to statistically significant differences were found between both studied groups regarding all
sub domains of hyperactivity except for restlessness.
Regarding details of questions concerned with difficulty type, 12.1% of children with learning disability were
having extreme difficulties and regarding to its duration 34.3% of them was for more than 12 months.
Furthermore 41.1% of children with great learning disabilities compared to 37.7% of normal children their
difficulties put the burden on the class as whole (table 6).
Figure (1): Illustrates that 98.1% of group 1 compared to 79.7% of group 2 had abnormal difficulties.

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Table(1): Comparison between both groups in relation to Pro-social domain as reported by class teacher
(n=424).
Pro-social Domain Study Group Control Group Test value P
value
n= 212 n= 212
N % N %
Considerate of other people's feelings
Not true 85 40.1 70 33.0 X
2
=9.4 0.009
Somewhat true 89 42.0 77 36.3 HS
Certainly true 38 17.9 65 30.7
Shares readily with other children
Not true 62 29.2 35 16.5 X
2
=36.2 <0.001
HS
Somewhat true 98 46.2 65 30.7
Certainly true 52 24.5 112 52.8
Helpful if someone is hurt, upset, feeling ill
Not true 78 36.8 46 21.7 X
2
=11.8 0.003
Somewhat true 78 36.8 94 44.3 HS
Certainly true 56 26.4 72 34.0
Kind to younger children
Not true 41 19.3 31 14.6 X
2
=10.2 0.006
HS
Somewhat true 104 49.1 82 38.7
Certainly true 67 31.6 99 46.7
Often volunteers to help others X
2
=26.3 <0.001
HS
Not true 78 36.8 39 18.4
Somewhat true 79 37.3 73 34.4
Certainly true 55 25.9 100 47.2
Prosocial scale M ± SD 4.6 ± 2.4 6.1 ± 2.8 t=5.7 <0.001
Median (IQR) 5.0 (3.0 – 6.0) 6.0 (4.0 – 8.0) Z=5.3 HS
Prosocial scale categories
Normal 73 34.4 118 55.7 X
2
=20.5 <0.001
HS
Borderline 45 21.2 37 17.5
Abnormal 94 44.3 57 26.9
Table (2): Comparison between both groups in relation to peer problems domain as reported by class
teacher (n=424).
Peer Problems Study Group Control Group Test value P value n= 212 n= 212
no % no %
Rather solitary, prefers to play alone
Not true 91 42.9 132 62.3 X
2
=23.4
<0.001
Somewhat true 69 32.5 61 28.8 HS
Certainly true 52 24.5 19 9.0
Has at least one good friend
Not true 57 26.9 33 15.6 X
2
=30.7
<0.001
Somewhat true 95 44.8 63 29.7 HS
Certainly true 60 28.3 116 54.7
Generally liked by other children
Not true 61 28.8 23 10.8 X
2
=29.6
<0.001
Somewhat true 97 45.8 92 43.4 HS
Certainly true 54 25.5 97 45.8
Picked on or bullied by other children
Not true 71 33.5 117 55.2 X
2
=22.7
<0.001
Somewhat true 96 45.3 55 25.9 HS
Certainly true 45 21.2 40 18.9
Gets along better with adults than with other children
Not true 65 30.7 46 21.7 X
2
=33.7
<0.001
Somewhat true 110 51.9 74 34.9 HS
Certainly true 37 17.5 92 43.4
Peer problems scale M ± SD 4.6 ± 1.8 3.6 ± 1.7 t=5.8
<0.001
Median (IQR) 4.0 (3.3 – 6.0) 3.0 (2.0 – 5.0) Z=5.7
HS
Peer problems scale categories
Normal 53 25.0 116 54.7 X
2
=39.9
<0.001
Borderline 59 27.8 30 14.2 HS
Abnormal 100 47.2 66 31.1

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Table(3): Comparison between both groups in relation to emotional symptoms domain as reported by
class teacher (n=424).
Emotional Symptoms Study Group Control Group Test value P value n= 212 n= 212
No % No %
Often complains of headaches, stomach- aches
Not true 88 41.5 113 53.3 X
2
=11.5
0.003
Somewhat true 87 41.0 83 39.2 HS
Certainly true 37 17.5 16 7.5
Many worries or often seems worried
Not true 51 24.1 48 22.6 X
2
=0.98 0.6
Somewhat true 93 43.9 103 48.6 NS
Certainly true 68 32.1 61 28.8
Often unhappy, depressed or tearful
Not true 70 33.0 87 41.0 X
2
=5.2 0.07
NS
Somewhat true 88 41.5 66 31.1
Certainly true 54 25.5 59 27.8
Nervous or, easily loses confidence
Not true 61 28.8 120 56.6 X
2
=33.8
<0.001
HS
Somewhat true 80 37.7 52 24.5
Certainly true 71 33.5 40 18.9
Many fears, easily scared
Not true 37 17.5 65 30.7 X
2
=13.5
0.001
HS
Somewhat true 82 38.7 84 39.6
Certainly true 93 43.9 63 29.7
Emotional symptoms scale M ± SD 5.1 ± 2.1 4.1 ± 2.5 t=4.4
<0.001
HS
Median (IQR) 5.0 (4.0 – 6.0) 4.0 (2.0 – 6.0) Z=4.1
Emotional Symptoms scale categories
Normal 76 35.8 112 52.8 X
2
=12.4
0.002
HS
Borderline 43 20.3 33 15.6
Abnormal 93 43.9 67 31.6
Table (4): Comparison between both groups as regards conduct problem domain as reported by the class
teacher (n=424).
Conduct Problems Study Group Control Group Test value P value n= 212 n= 212
N % N %
Often loses temper
X
2
=11.2
Not true 74 34.9 100 47.2 0.004
HS
Somewhat true 90 42.5 58 27.4
Certainly true 48 22.6 54 25.5
Generally well behaved,
Not true 55 25.9 47 22.2 X
2
=7.1
0.03
Somewhat true 96 45.3 78 36.8 S
Certainly true 61 28.8 87 41.0
Often fights with other children
Not true 75 35.4 99 46.7 X
2
=5.7
0.058
Somewhat true 69 32.5 55 25.9 NS
Certainly true 68 32.1 58 27.4
Often lies or cheats
Not true 65 30.7 132 62.3 X
2
=47.7
<0.001
Somewhat true 79 37.3 56 26.4 HS
Certainly true 68 32.1 24 11.3
Steals from home, school or elsewhere
Not true 128 60.4 172 81.1 X
2
=22.5
<0.001
Somewhat true 58 27.4 30 14.2 HS
Certainly true 26 12.3 10 4.7
Conduct problems scale M ± SD 4.4 ± 2.3 3.1 ± 2.5 t=5.3
<0.001
Median (IQR) 4.0 (3.0 – 6.0) 3.0 (1.0 – 5.0) Z=5.4
HS
Conduct problems scale categories
<0.001
HS
Normal 49 23.1 99 46.7 X
2
=29.2
Borderline 26 12.3 28 13.2
Abnormal 137 64.6 85 40.1

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Table (5): Comparison between both groups as regards hyperactivity domain as reported by the class
teacher (n=424).
Hyperactivity Domain Study Group Control Group Test value P value n= 212 n= 212
N % N %
Restless, and overactive
Not true 59 27.8 66 31.1 X
2
=1.5 0.5
NS
Somewhat true 88 41.5 76 35.8
Certainly true 65 30.7 70 33.0
Constantly fidgeting or squirming
Not true 66 31.1 92 43.4 X
2
=14.4
0.001
HS
Somewhat true 94 44.3 57 26.9
Certainly true 52 24.5 63 29.7
Easily distracted, concentration wanders
Not true 35 16.5 83 39.2 X
2
=55.3
<0.001
HS
Somewhat true 55 25.9 80 37.7
Certainly true 122 57.5 49 23.1
Thinks things out before acting
Not true 115 54.2 44 20.8 X
2
=70.8
<0.001
HS
Somewhat true 74 34.9 79 37.3
Certainly true 23 10.8 89 42.0
Good attention span
Not true 134 63.2 50 23.6 X
2
=81.6
<0.001
HS
Somewhat true 46 21.7 52 24.5
Certainly true 32 15.1 110 51.9
Hyperactivity scale M ± SD 6.3 ± 2.0 4.2 ± 2.6 t=9.0
<0.001
HS
Median (IQR) 6.0 (5.0 – 8.0) 5.0 (2.0 – 6.0) Z=8.2
Hyperactivity scale categories
Normal 63 29.7 141 66.5 X
2
=58.0
<0.001
HS
Borderline 57 26.9 31 14.6
Abnormal 92 43.4 40 18.9

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Table(6): Comparison between both groups regarding details of social difficulties as reported by class
teacher (n=424).
Social Difficulties Study Group Control Group Test
value P
value
n= 212 n= 212
N % N %
Overall, do you think that your child has difficulties in any of
the following areas: emotions, concentration, behavior or
being able to get along with other people?
No
(total=140)
5 2.4 135 63.7 X
2
=180.2
<0.001
HS
Yes
(total=284)
207 97.6 77 36.3
Difficulty type (n=284)
Simple difficulties 102 49.3 58 75.3 X
2
=16.6
<0.001
Clear difficulties 80 38.6 17 22.1 HS
Extreme difficulties 25 12.1 2 2.6
How long have these difficulties been present? (n=284)
< 1 month 27 13.0 13 16.9 X
2
=67.0
<0.001
HS
1-5 months 67 32.4 62 80.5
6-12 months 42 20.3 2 2.6
> 12 months 71 34.3 0 0.0
Do the difficulties upset you (n=284)
No 45 21.7 22 28.6 X
2
=14.4
0.002
HS
Little 69 33.3 39 50.6
Moderate 66 31.9 10 13.0
Great 27 13.0 6 7.8
Peer relationships (n=284)
No 36 17.4 11 14.3 X
2
=27.9
<0.001
HS
Little 53 25.6 44 57.1
Moderate 68 32.9 17 22.1
Great 50 24.2 5 6.5
Class learning (n=284)
No 5 2.4 14 18.2 X
2
=51.1
<0.001
HS
Little 13 6.3 15 19.5
Moderate 77 37.2 36 46.8
Great 112 54.1 12 15.6
Do the difficulties put a burden on the class as a whole?
(n=284)
No 8 3.9 0 0.0 X
2
=44.7
<0.001
HS
Little 49 23.7 46 59.7
Moderate 65 31.4 2 2.6
Great 85 41.1 29 37.7
Figure (1): Total difficulty score between both groups
Discussion
A great attention has been given to the social emotional development of children with learning
disabilities. Studies on this topic reveal that those with learning disabilities are at increased risk for mental health
problems. Existing studies have focused on specific aspects of mental health such as stress, anxiety and

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depression (Wilson et al., 2009). A multidisciplinary approach is essential for early recognition of learning
disabilities.
Regarding gender of the studied sample, the current study result showed that more than half of children
with learning disabilities were boys. The researchers have suggested that the prevalence of learning disabilities
more among boys is due to their biological vulnerability. In the same line, Mascheretti et al. (2013) found that
boys were more likely to have learning disabilities than girls. Similarly, Giuliani and Bacon (2010) found that
boys outnumber girls by about three to one in the LD category
The prevalence of total difficulties was higher in the current study results than those reported in studies
from other countries, the results of total difficulties indicated that almost all children with learning disabilities
rated abnormal, compared to more than three quarters of the normal children. In a similar study, Poblete et al.
(2007) found that more than half of the children with learning disability having abnormal behavioral and
emotional difficulties. Recently, a study done among Libyan children by Zeglam et al. (2011) found that
behavioral problems were more common among children with learning disability. On the other hand, Syed et al.
(2009) stated that more than one third of children without learning disabilities are falling under abnormal
difficulty category. Furthermore, a study done in Egypt by Abd Elhamid et al. (2009) who found that the total
difficulties of children without learning disabilities were 20.6%.
The present study result confirms previous reports that the children with LD have an enhanced
likelihood of associated emotional, behavior, and social difficulties. The children with LD have significantly
more than normal children in total pro-social scale and all of its sub items. In the same line, Terras et al. (2009)
found that the rates of pro-social difficulties were significantly higher in population with learning disabilities
than in the general population. Pastor et al. (2012) stated that children facing common social challenges at
school identify concerns, they are often rejected by their peers and have poor self-concepts and were more likely
to internalize the problem rather than trying to resolve it or asking for help. After reviewing 152 different
studies, Giuliani and Bacon (2010) concluded that 75% of students with LD exhibit deficits in social skills.
Studies of teacher ratings also suggested that students with learning disabilities have lower social status than
other students.
Additionally, the current study results indicated that there was a statistically significant difference
between children with and without LD regarding emotional difficulties, which nearly half of children with LD
rated abnormal emotional symptoms compared to less than one third of normal children. This might be due to
that some children showed excessive anxiety, and depression and not meeting the expected academic
requirements. In agreement with the findings of the current study, Dilshad (2006) found that the children with
and without learning difficulties show significant differences in emotional problems.
The current study results found no differences between both groups regarding depression and worry. On
the contrary, Mag and Reid (2006) found that children with learning disabilities obtained statistically higher
scores on measures of depression than their peers without learning disabilities. As well, these children appeared
sad, gloomy, and showed hopelessness, great dissatisfaction with self and unhappiness than their counterparts. In
this respect Charles and Hellen (2003) emphasized that children with learning disabilities (LD) often have
problems that go far beyond those experienced in reading, writing, math, memory, or organization. For many,
strong feelings of frustration, anger, sadness, or shame can lead to psychological difficulties such as anxiety,
depression or low self-esteem, as well as behavioral problems such as substance abuse or juvenile delinquency.
Consistently, Wong et al (2006) clarified that lack of self esteem experienced by students with learning
disabilities might create feelings of inadequacy or inferiority which could be an impediment to establishing
social relationships. In the same line, Bevington and Wishart (2006) emphasized a significant association
between learning difficulties and emotional problems of children, whereas the difficulty level increased the level
of problems also increased.
As regards to peer problems, the findings of this study revealed that nearly half of children with LD
have peer problems compared to less than one third of children without LD. In accordance with these research
findings, children with LD reported higher than their normal peers in solitary, having one good friend, bullied by
other children. Children with learning difficulties appeared aloof and socially isolated and they described
themselves as quiet and higher sense of loneliness when compared to their typical developing peers (Al-Yagon
& Mikulincer, 2004). Recently, Snyder (2013) highlighted that LD children were not interested in any hobbies
and solitary playing and bullying was obviously prevalent among them. Hence, surveys of 4th-6th graders in
several states indicated that 25 percent of all children had been bullied at least several times. Further, Essa
(2010) stated that the subjects claimed that they sometimes had been teased or bullied because of their reading
and writing difficulties. So, the feeling of well-being had been significantly lower. In a similar study, Peter
(2011) mentioned that children with learning disabilities have problems with family and peer relationships. This
may be the result of processing problems which make it difficult for LD children to pick up social cues. When
learning disabilities and behavioral problems appear together, it is important to identify whether the behavior is
secondary to the learning disability or co-morbid. When the negative behavior is caused by the learning

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disability, the solution to that behavior often lies in dealing with the learning disability. When it is co-morbid, the
interventions become more complicated.
In relation to hyperactivity, the study results revealed that more than two fifths of children with LD
reported hyperactivity. This finding was consistent with Dockrell and Lindsay (2000) who found that
approximately 44% of children are having problems with hyper activities. Incongruent with this finding, Abd
Elhamid et al. (2009) stated that the hyperactivity disorder was 0.7% of primary school children without
learning disabilities. As well, the findings of the present study indicated that the children with learning
difficulties showed poor concentration, short attention problems, fidgeting and not thinking before acting things
more than their normal peer. In the same line, Dilshad (2006) showed stubborn, rebellious and uncooperative
behaviors, easily excitable, impulsive, fidgety and restless behaviors were found more often in children with
learning problems than their peers. Wherever the current findings stated there are no statistically significant
differences in restless and over active between both groups, this might be due to the children's age group.
Concerning conduct problems, the current study results indicated that two thirds of children with LD
compared to two fifths of children without LD had conduct problems. Similar rates of conduct difficulties among
school children were found by Syed et al. (2009). On the other hand, a study done in Egypt revealed that
conduct disorder constituted 6.6% of primary school children without learning disabilities (Abd Elhamid et al.,
2009). Children with learning difficulties tended to have frequent change of mood and act out their feelings,
using verbal threats and physical aggression (Pastor et al., 2012). In this context, Kavale and Frness (2000)
found that children who have learning disabilities had higher scores on aggression – conduct disorder scale than
do other children with a difference of 1.02 points (scores of 2.29 &1. 27, respectively). However, Statistics in
Canada (2005) reported that children with learning disabilities exhibit only slightly higher behavioral problems
than other children.
The present study outcomes suggested that school-age children with LD showed great difficulty in peer
relationship than did their non LD peers. In the same way, Al-Yangon and Mikulincer (2004) found that the
children with learning disability reported higher levels of avoidance and anxiety in the close relationship as
compared to children with typical development. Whereas studies conducted among children with typical
development, demonstration revealed inconsistent outcomes (Arnold et al., 2005; Carroll & Illes, 2006).
Results of the current study revealed a significant difference between children with and without
learning difficulties regarding classroom learning behavior. Meanwhile, Hernandez (2013) mentioned that this
result refers to their frequent changing mood, inattentiveness and lack of concentration and disinterest. In
accordance with the previous results, Mourad et al. (2006) denoted that the children who are at risk for learning
disabilities often tended to be less on-task and to exhibit more off-task behavior than their classmates.
Conclusion:
The conclusion which can be drawn from this study would be that the prevalence of total difficulties' scores
among primary school children with learning disabilities was 98.1% abnormal difficulties compared to 79.7% of
normal children. The results also revealed that statistically significant differences were found between children
with and without learning disability in all sub domains of emotional and behavioral disorders. Furthermore, the
results showed that 12.1% of children with learning disability were having extreme difficulties, and more than
half of them (54.1%) compared to 37.7% of normal children their difficulties put the burden on the class as a
whole. High prevalence of difficulties among primary school children is an alarming condition that needs
attention and early intervention.
Recommendations:
● A periodic screening test should be provided for early detection of mental health problems for children with
learning disabilities.
● There is a need for developing programs to train, sensitize and mobilize teachers regarding the child's mental
health problems with learning disability.
● Further research with larger, more representative sample is necessary as understanding the factors that leading
to mental health problems among school children is essential for development of effective prevention and
intervention strategies.
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