Objective: This study used latent class analysis to identify patterns of co-occurrence among common childhood difficulties (inattention/hyperactivity, internalizing, externalizing, peer problems, and reading difficulties). Method: Parents and teachers of 501 children ages 6 to 9 provided mental health and social ratings, and children completed a reading task. Results: Four latent classes were identified in the analysis of parent ratings and reading: one with inattention/hyperactivity, externalizing, peer problems, and internalizing difficulties; one with inattention/hyperactivity and reading difficulties; one with internalizing and peer problems; and one normative class. The analysis of teacher ratings and reading also identified four latent classes: one with inattention/hyperactivity and externalizing, one with inattention/hyperactivity and reading difficulties, one with internalizing problems, and one normative class. Children in latent classes characterized by one or more difficulties were more impaired than children in the normative latent class 1 year later. Conclusion: The results highlight the need for multifaceted interventions.