While the field of learning disabilities has grown substantially over the past several decades (Grigorenko et al. in Am Psychol 75:37, 2020) little work has explored the role of internalizing symptoms among struggling students. The present study compared struggling and typical readers on several child reported internalizing measures at both the beginning and end of a school year during which time they received either classroom-as-usual or research-team provided intensive intervention. Struggling readers who did and did not meet reading benchmarks were also compared at year-end. While minimal differences were present at the beginning of the year, numerous differences were observed at the end, with students exhibiting persistent reading struggles reporting significantly greater distress. Bi-directional associations emerged with beginning of year group status predicting internalizing symptoms and beginning of year internalizing symptoms predicting end of year intervention response group status. Findings are discussed in terms of future directions for enhancing intervention studies of struggling readers.