The relationships between learning difficulties (LD) and behavior problems (BP) in 11 to 12-year-old children was determined at the Royal Children’s Hospital, Melbourne, Australia. Of children identified with LD, more than half had BP diagnosed by DSM-III-R criteria. Those with mathematics difficulties were at greater risk of BP than children who had spelling problems (69% cf 31% affected). Children with a single LD (spelling or math) were equally likely to have an internalizing diagnosis (anxious-fearful), while those with both types of LD were more prone to externalizing disorders (hostile-aggressive or hyperactive-distractible). Of children identified with LD at 7 to 8 years, 80% had persisting literacy difficulties and 57% had arithmetic problems at 12 years of age. [1]

COMMENT. Children with learning disorders are at high risk of developing behavior problems, and children with LDs and BPs have persistence of difficulties through grade school years, particularly for boys. Mathematical LD predisposes to anxiety disorders whereas multiple LDs are predictive of hyperactivity or hostile-aggressive behavior.

Cocaine exposure and behavioral problems. Children of drug abusers (CDAs) are at increased risk of internalizing and externalizing problems, attention deficits, and impulsivity. Stanger C and associates, University of Vermont, found that CDAs showed more behavior problems than matched nonreferred children, but significantly less psychopathology than a sample of children referred for mental health services. [2]