Emotional disorder and educational underachievement.

Of all the problems seen in school-aged children, learning disorders are among the most common. These disorders are first the concern of the school teacher and school psychologist, but many cases get referred to medical specialists of various kinds. Paediatric referral may be initiated because quasineurological syndromes such as 'developmental dyslexia' (Critchley, 1970; Naidoo, 1972) or 'dyscalculia' (Cohen, 1961; Slade and Russell, 1971) are suspected; or because the learning difficulty is associated with cerebral palsy, epilepsy, or some other overt neurological condition (Rutter, Graham, and Yule, 1970a); or because it seems that the learning disorder had its origin in a developmental speech delay (Ingram, 1969; Rutter and Martin, 1972). The importance and significance of neurological and developmental factors in learning disorders have been considered elsewhere with respect to reading (Rutter and Yule, 1973). However, children with educational underachievement commonly suffer from the additional handicap of emotional or behavioural disorders. The fact of this association has long been noted, but its meaning remains poorly understood. There has been controversy over the extent to which emotional disturbance causes learning difficulties, the extent to which learning disorders result in secondary maladjustment, and the extent to which both the learning and emotional disorders stem from some common causal factor. Nevertheless, it is essential to understand the mechanisms involved in the association if the appropriate remedial or therapeutic action is to be taken. This paper reviews what is known on this topic.