ABSTRACT
Objectives. To investigate the association between learning difficulties (LDs) and behavioural and emotional problems of 8-year-old children in the Northern Finland Birth Cohort 1986 (n=9432). Study design. A cross-sectional study.
Methods. Teachers assessed children's behaviour with a Rutter scale (RB2) and assessed their learning with questions about whether a child had difficulties in reading, spelling and mathematics.
Results. Of the children, 21.4% (n=1774) bad 1 or more learning difficulties (LDs): 12.3% (n=1026) had a verbal LD, 3.0% (n=248) a mathematical LD and 6.0% (n=500) a combined LD. For boys with LDs, an  djusted odds ratio of having behavioural problems was 3.1 (95% CI 2.5-4.0) and emotional problems 3.0 (2.0-4.6), and for girls 3.9 (2.6-5.8) and 5.3 (3.6-8.1), respectively In boys and girls, verbal difficulties were associated with behavioural and emotional problems whereas mathematical difficulties were associated with behavioural problems in boys and with emotional problems in girls. Divorced and reconstructed family types were significant risk factors for LDs and behavioural problems, whereas a lifelong one-parent family type was a risk factor for behavioural problems, but not for LDs. A child's younger age compared to that of classmates, a mother's and a father's low education level and a low family SES were risk factors for having LDs.
Conclusion. More attention should be paid to children whose families are facing adverse circum-stances, especially as it affects their preschool education, in order to support their learning and school attendance. (Int J Circumpolar Health 2011; 70(¡):59-71)
Keywords: learning difficulties (LDs), emotional and behavioural problems, comorbidity, motor development, family structure, mother's and father's education, socio-economic status (SES)

Introduction

In Einland in 2001, 21.2% of the school-aged children were referred to special education because of learning difficulties and, in 2004, the figure was 28% (1). The percentage is similar to that of other Western countries (2), but higher figures have also been presented. Eor instance, in a comprehensive follow-up study from Australia in 1994, 36.6% of the primary and secondary school children were identified as having some area of special learning needs in their first school year, and by 1996, it had dropped to 33.3% (3). Moreover, a large. National Survey of Children's Health (NSCH) from the year 2003 in the U.S., concerning the lifetime prevalence of learning disabilities and special health care needs of children under 18 years of age, indicated the life time prevalence to be 9.7% and, depending of the number of definitional criteria (from 1 to 5), the prevalence of learning disabilities ranged from 15.0% to 87.8% (4).

Learning disabilities are often associated with different co-morbidities, for instance, problems in motor development as well as emotional and behavioural problems (5). These disabilities can occur alone or in varying combinations and can range from mild to severe. The prevalence of children's emotional and behavioural problems have been reported to range from 5% to 20%, being more common among boys than girls (6-9) and, the association between learning disabilities and behavioural and emotional problems has been indicated in many previous studies (3,10-15). They have also been found to be more persistent when they co occur with behaviour problems in the early school years compared to learning disabilities occurring alone (10,11,13,16,17). Behavioural problems at 5 years of age related to speech/language and developmental delays seem to be good predictors of later learning disabilities (12,18,19).

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