What might the inability to learn cause?
Options:
- intelligence
- education
- effectiveness
- distress
- a stupid
Let's think carefully first. Step-by-step reasoning process:

Show your work and conclude with the exact phrasing "Therefore, the final answer is [answer]." where [answer] is just the final number or expression that solves the problem.
user
Distress is extreme anxiety, sorrow or pain. The inability to learn might cause distress. So the final answer is distress.