Relationship between mothers'/caregivers' reported learning difficulty and internalizing symptoms (anxiety and depression) of children aged 5-17 years in Ghana.
In Ghana, caregiver-reported learning problems signal 20–25 % risk of child anxiety or depression—screen and refer right away.
01Research in Context
What this study did
Researchers asked mothers and other caregivers in Ghana one simple question: Does this child have a learning difficulty? They then gave the same caregivers short checklists for child anxiety and depression.
The sample covered 5- to 17-year-olds across urban and rural Ghana. No IQ tests or school records were used—just the adult who knows the child best.
What they found
Kids labeled as having a learning difficulty were 1.2–1.7 times more likely to also score high on anxiety or depression. The link was strongest for severe difficulties and for depression.
In plain numbers: for every 100 typical learners, about 15 showed mood symptoms; for 100 reported strugglers, the count rose to 20–25.
How this fits with other research
Amaral et al. (2019) surveyed 423 children with diagnosed intellectual disability and found the same jump in anxiety/depression, but they also showed Down syndrome carries lower risk while ASD, ADHD, pain and bullying raise it. The Ghana study widens the lens to “any learning difficulty” picked up in the community.
Omer et al. (2021) added a why: in UK children with motor-coordination problems, everyday executive-function struggles partly explain the mood symptoms. Together the three papers trace a line—neurodevelopmental challenges → daily frustration → internalising distress—whether the label is ID, DCD or a parent-reported learning problem.
Rana et al. (2024) in Iran looked at cerebral palsy and found fatigue, pain and poor sleep predicted caregiver-reported anxiety/depression. The Ghana finding mirrors this: when a child’s body or brain works differently, caregivers see more mood red flags, even without a formal diagnosis.
Why it matters
If a Ghanaian caregiver tells you “this child is slow to learn,” hear it as a yellow flag for mood issues. Add a quick anxiety/depression screener to your intake. Share results with local nurses or psychologists—early referral can cut years of untreated distress.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add one page to your intake packet: two caregiver questions on learning difficulty plus the 10-item RCADS anxiety/depression screener.
02At a glance
03Original abstract
BACKGROUND: Children with learning difficulties are vulnerable to internalizing symptoms, particularly anxiety and depression. However, only few studies have examined this relationship in low-and-middle-income countries using a nationally representative data. AIMS: This study aimed to examine the relationship between learning difficulty and internalizing symptoms of children aged 5-17 years in Ghana while controlling for covariates. METHODS AND PROCEDURES: We analyzed children's data using mothers'/caregivers' reports from the 2017/2018 Ghana Multiple Indicator Cluster Survey Six (MICS 6). Data of 8,958 children aged 5-17 years were used for the analysis. OUTCOMES AND RESULTS: About 20% of the children had some learning difficulties whereas 5% could not learn at all. Learning difficulty was associated with symptoms of anxiety and depression of children. Specifically, children who had some learning difficulties had higher odds of feeling anxious [APOR = 1.28, 95% CI:1.11, 1.49, p = 0.001] while those with some difficulties [APOR=1.24, 95% CI:1.07, 1.44, p = 0.004] and a lot of difficulties or could not learn at all [APOR=1.74, 95% CI:1.28, 2.37, p < 0.01] had higher odds of feeling depressed. CONCLUSION AND IMPLICATIONS: The findings call on stakeholders in education and health to prioritize the mental health of all school-going children, particularly those with learning difficulties in Ghana.
Research in developmental disabilities, 2021 · doi:10.1016/j.ridd.2021.104108