This cross-sectional study examined the associations between adherence to 24-hour movement behaviour (24-HMB) guidelines and indicators of school achievement, social-behavioural problems, and emotional functioning among a nationally representative sample of US children and adolescents with learning disabilities (LD). Data were retrieved from the 2020–2021 National Survey of Children’s Health (NSCH), including 4999 children and adolescents (aged between 6 and 17 years) with LD. Multivariate logistic regressions were conducted to estimate odds ratios (OR) with 95% confidence intervals (95%CI), adherence to 24-HMB guidelines was considered as independent variables (Model 1: continuous variable; Model 2: categorical variable), and indicators of school achievement, social-behavioural problems, and emotional functioning as dependent variables. Covariates included age, sex, race, overweight status, the severity of learning disability, educational intervention, parental education, and household poverty level. Overall, 2156 participants (41.47%) met one of the three 24-HMB recommendations, 1289 (26.04%) met two 24-HMB recommendations, and 336 participants (6.62%) met all three 24-HMB recommendations. Positive associations between adherence to 24-HMB guidelines and most of the assessed outcomes were observed. Those who adhered to at least two of the three 24-HMB guidelines (PA + SL, PA + ST, SL + ST, and PA + SL + ST) had better school achievement and fewer social-behavioural problems. Additionally, adherence to PA + SL or SL + ST guidelines was linked with improved emotional functioning. This study provides evidence that adherence to 24-HMB guidelines is associated with superior school achievement, social-behavioural problems, and emotional function, and thus suggests future public health efforts should promote adequate levels of PA, limited ST, and sufficient SL among children and adolescents with LD.
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