Challenges in social competence are common in children with Learning Disabilities (LDs), particularly those who present with co-occurring mental health challenges (LD + MH). Social competence calls upon a complex set of skills, including social skills, perspective-taking abilities, and an understanding of the social environment. Successful enactment of these skills necessitates behavioral and emotion regulation, an area of weakness for many youth with LD + MH. Using a mixed-method design, the present study assessed the efficacy of a social competence group program for children with LD + MH (mean age = 11.4 years) in which group size, content, and structure are tailored to the child’s level of emotion regulation, information processing abilities, and social competence goals. Quantitative measures completed by parents and coded behavioral observations completed pre- and post-treatment indicated significant gains in initiation and engagement in positive social interactions, foundational skills that support improvement in social competence. Qualitative interviews with parents, children and teachers suggested improvements in social self-concept, initiation, and emotion regulation. Tailoring treatment to the child’s information processing and emotion regulation abilities, as well as ‘in the moment’ feedback, supported gains made and contributed to participants having a positive social experience. Directions for future research are discussed.