Studies of clinical populations have suggested that genetic factors may be involved in the etiology of learning disabilities. The present study included 44 children (ages 7-16) with sex chromosome anomalies (SCA) who were identified in a 10-year sex chromosome screening of all newborns in 2 large hospitals and thus represents an unbiased sample of children with a genetic etiology. 17 chromosomally normal siblings are included as controls. All subjects were given IQ and achievement tests, and extensive, repeated school histories were taken from parents and school personnel. Results demonstrate that SCA children are at an increased risk for encountering learning problems and receiving special education intervention in school. Furthermore, the nature of the learning disabilities may be karyotype specific, although the results are not invariant within karytypes. 45,X children demonstrate a visuo-spatial deficit as evidenced by lower-performance IQ scores and an increased incidence of handwriting problems, while 47,XXY children experience a verbal language deficit seen in lower verbal IQs and a tendency toward more reading delays. 47,XXX children demonstrate a more global delay crossing most cognitive skill areas, although retardation is rare. Mosaic children are relatively unaffected by their karyotypic variations and hence serve as a second control group which guards against the effects of a negative self-fulfilling prophecy. It is concluded from this evidence that learning disabilities can have a genetic basis, although the specific biological mechanism that affects cognitive development in this population remains elusive.