• Diagnosis;
  • co-morbidity;
  • learning disability;
  • attention deficit disorder;
  • pervasive developmental disorder

The interface between disorders of learning and development and disorders of behavior presents challenges for researchers and clinicians alike. In the Elk et al. paper, a large group of children were screened for learning and/or behavioral problems. A relatively large number of children screened positive and their IQ scores were analyzed using a cluster analytic approach. Various patterns were identified including lower and higher functioning children. In our commentary, we point out the challenges for diagnosis of mental health problems in both lower and higher functioning children; the potential overlap of problems in learning and social interaction remains an area in need of additional work.

Conclusion: There is a complex interaction between developmental status and behavioral difficulty; further research is needed to clarify diagnostic validity and areas where existing diagnostic systems need further refinement.