Emotional and Behavioral Problems of Primary School Children

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Emotional and Behavioral Problems of Primary School Children

Transcript Of Emotional and Behavioral Problems of Primary School Children

Journal of Education and Practice ISSN 2222-1735 (Paper) ISSN 2222-288X (Online) Vol.5, No.8, 2014

www.iiste.org

Emotional and Behavioral Problems of Primary School Children
With and Without Learning Disabilities: A Comparative Study
Amany Sobhy Sorour1, Noha Ahmed Mohamed2 and Mona Mohamed. Abd El-Maksoud3 Assistant Professor of Community Health Nursing, Faculty of Nursing, Zagazig University, Egypt1.
Lecturer of Community Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt2. Lecturer of Community Health Nursing, Faculty of Nursing, Helwan University, Egypt3. Address Correspondent: Mona M. Abd El-Maksoud, Nursing College, Females Studies Center, Abha Saudi
Arabia [[email protected]], 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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Journal of Education and Practice ISSN 2222-1735 (Paper) ISSN 2222-288X (Online) Vol.5, No.8, 2014

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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 416 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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Journal of Education and Practice ISSN 2222-1735 (Paper) ISSN 2222-288X (Online) Vol.5, No.8, 2014

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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

n= 212

N

%

Control Group

n= 212

N

%

Test value

P value

Considerate of other people's feelings

Not true Somewhat true Certainly true Shares readily with other children Not true Somewhat true Certainly true Helpful if someone is hurt, upset, feeling ill Not true Somewhat true Certainly true Kind to younger children Not true Somewhat true Certainly true Often volunteers to help others Not true Somewhat true Certainly true Prosocial scale M ± SD Median (IQR) Prosocial scale categories Normal Borderline Abnormal

85

40.1

89

42.0

38

17.9

62

29.2

98

46.2

52

24.5

78

36.8

78

36.8

56

26.4

41

19.3

104

49.1

67

31.6

78

36.8

79

37.3

55

25.9

4.6 ± 2.4

5.0 (3.0 – 6.0)

73

34.4

45

21.2

94

44.3

70

33.0

77

36.3

65

30.7

35

16.5

65

30.7

112

52.8

46

21.7

94

44.3

72

34.0

31

14.6

82

38.7

99

46.7

39

18.4

73

34.4

100

47.2

6.1 ± 2.8

6.0 (4.0 – 8.0)

118

55.7

37

17.5

57

26.9

X2=9.4

0.009 HS

X2=36.2

<0.001 HS

X2=11.8

0.003 HS

X2=10.2 X2=26.3

0.006 HS
<0.001 HS

t=5.7 Z=5.3
X2=20.5

<0.001 HS
<0.001 HS

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

n= 212

n= 212

Test value P value

no

%

no

%

Rather solitary, prefers to play alone Not true

91

42.9

132

62.3

X2=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

X2=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

X2=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

X2=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

X2=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 Median (IQR) Peer problems scale categories
Normal Borderline Abnormal

4.6 ± 1.8 4.0 (3.3 – 6.0)

53

25.0

59

27.8

100

47.2

3.6 ± 1.7 3.0 (2.0 – 5.0)

116

54.7

30

14.2

66

31.1

t=5.8 Z=5.7
X2=39.9

<0.001 HS
<0.001 HS

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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

n= 212

n= 212

Test value P value

No

%

No

%

Often complains of headaches, stomach- aches Not true

88

41.5

113

53.3

X2=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

X2=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

X2=5.2

0.07

Somewhat true

88

41.5

66

31.1

NS

Certainly true

54

25.5

59

27.8

Nervous or, easily loses confidence Not true

61

28.8

120

56.6

X2=33.8

<0.001

Somewhat true

80

37.7

52

24.5

HS

Certainly true

71

33.5

40

18.9

Many fears, easily scared Not true

37

17.5

65

30.7

X2=13.5

0.001

Somewhat true

82

38.7

84

39.6

HS

Certainly true

93

43.9

63

29.7

Emotional symptoms scale M ± SD Median (IQR) Emotional Symptoms scale categories
Normal Borderline Abnormal

5.1 ± 2.1 5.0 (4.0 – 6.0)

76

35.8

43

20.3

93

43.9

4.1 ± 2.5 4.0 (2.0 – 6.0)

112

52.8

33

15.6

67

31.6

t=4.4 Z=4.1
X2=12.4

<0.001 HS
0.002 HS

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

n= 212

n= 212

Test value P value

N

%

N

%

Often loses temper Not true

74

34.9

100

47.2 X2=11.2

0.004

Somewhat true

90

42.5

58

27.4

HS

Certainly true

48

22.6

54

25.5

Generally well behaved, Not true

55

25.9

47

22.2

X2=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

X2=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

X2=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

X2=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 Median (IQR) Conduct problems scale categories
Normal Borderline Abnormal

4.4 ± 2.3 4.0 (3.0 – 6.0)

49

23.1

26

12.3

137

64.6

3.1 ± 2.5 3.0 (1.0 – 5.0)

99

46.7

28

13.2

85

40.1

t=5.3 Z=5.4
X2=29.2

<0.001 HS
<0.001 HS

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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

n= 212

n= 212

Test value P value

N

%

N

%

Restless, and overactive Not true

59

27.8

66

31.1

X2=1.5

0.5

Somewhat true

88

41.5

76

35.8

NS

Certainly true

65

30.7

70

33.0

Constantly fidgeting or squirming Not true

66

31.1

92

43.4

X2=14.4

0.001

Somewhat true

94

44.3

57

26.9

HS

Certainly true

52

24.5

63

29.7

Easily distracted, concentration wanders Not true

35

16.5

83

39.2

X2=55.3

<0.001

Somewhat true

55

25.9

80

37.7

HS

Certainly true

122

57.5

49

23.1

Thinks things out before acting Not true

115

54.2

44

20.8

X2=70.8

<0.001

Somewhat true

74

34.9

79

37.3

HS

Certainly true

23

10.8

89

42.0

Good attention span Not true

134

63.2

50

23.6

X2=81.6

<0.001

Somewhat true

46

21.7

52

24.5

HS

Certainly true

32

15.1 110

51.9

Hyperactivity scale M ± SD Median (IQR) Hyperactivity scale categories
Normal Borderline Abnormal

6.3 ± 2.0 6.0 (5.0 – 8.0)

63

29.7

57

26.9

92

43.4

4.2 ± 2.6 5.0 (2.0 – 6.0)

141

66.5

31

14.6

40

18.9

t=9.0 Z=8.2
X2=58.0

<0.001 HS
<0.001 HS

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Table(6): Comparison between both groups regarding details of social

teacher (n=424).

Social Difficulties

Study Group

n= 212

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

Yes (total=284)

207

97.6

Difficulty type (n=284)

Simple difficulties

102

49.3

Clear difficulties

80

38.6

Extreme difficulties

25

12.1

How long have these difficulties been present? (n=284)

< 1 month

27

13.0

1-5 months

67

32.4

6-12 months

42

20.3

> 12 months

71

34.3

Do the difficulties upset you (n=284)

No

45

21.7

Little

69

33.3

Moderate

66

31.9

Great

27

13.0

Peer relationships (n=284)

No

36

17.4

Little

53

25.6

Moderate

68

32.9

Great

50

24.2

Class learning (n=284)

No

5

2.4

Little

13

6.3

Moderate

77

37.2

Great

112

54.1

Do the difficulties put a burden on the class as a whole?

(n=284)

No

8

3.9

Little

49

23.7

Moderate

65

31.4

Great

85

41.1

difficulties as reported by class

Control Group

n= 212

N

%

Test value

P value

135

63.7 X2=180.2 <0.001

77

36.3

HS

58

75.3

X2=16.6 <0.001

17

22.1

HS

2

2.6

13

16.9

X2=67.0 <0.001

62

80.5

HS

2

2.6

0

0.0

22

28.6

X2=14.4 0.002

39

50.6

HS

10

13.0

6

7.8

11

14.3

X2=27.9 <0.001

44

57.1

HS

17

22.1

5

6.5

14

18.2

X2=51.1 <0.001

15

19.5

HS

36

46.8

12

15.6

0

0.0

X2=44.7 <0.001

46

59.7

HS

2

2.6

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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