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Is Your Child Struggling in School? Talk to Your Pediatrician

There was the 8-year-old boy who was not obeying his teachers and got very angry at school, Dr. Lavin said. He was seen by a local mental health professional who diagnosed attention deficit hyperactivity disorder with a single test. More detailed psychological testing revealed that his attention was actually normal, as was his cognitive function in all subjects — but he had very strong emotions, and he kept blowing up in school. He needed help learning to manage those emotions, and when he got it, the apparent attention-related issues disappeared.

The same diagnosis — A.D.H.D. — was made in a 10-year-old boy who was having trouble keeping up in school, and particularly struggled with math. Again, he was given the diagnosis after a single test, and started on a stimulant medication. But more thorough testing revealed that his math achievement scores were low, and he ended up with a diagnosis of a math learning disability, or dyscalculia. “When we got him help with math, he went from struggling in school to succeeding,” Dr. Lavin said.

Another child seemed to be having attention problems for the first time in his freshman year of high school, and it turned out that on entering high school, he had become the victim of a range of bullying, including hazing on a sports team and racist taunts around the school. “It was taken up by the principal and the school board,” Dr. Lavin said. “A, stop the bullying; B, address some of the outbursts of racism; and C, help the child recover from the trauma — and strangely enough, his school performance has gone back to A’s and B’s.”

As a developmental behavioral pediatrician, Dr. McGuinn assesses children with developmental delays, but she warns families that not all children who are struggling in school need a full developmental behavioral assessment, and wait times to get an appointment at one of these clinics can be very long. “There aren’t enough of us,” she said. “I don’t want to be the stop in the kid’s line to get help.” It may be worth it if a child seems to be struggling in more than one developmental domain, or has risk factors or early delays, she said, but kids can also get help in school as well, she said, or with other specialists who can diagnose learning problems.

“There’s often early hints that something’s going awry when your child is different from other children early on,” Dr. McGuinn said. Parents may have noticed that a child lags behind other children in learning to rhyme or learning the alphabet. A family history of learning disabilities may also indicate additional risk. “If we’re kind and empathic, it helps a lot,” she said. “They’re not doing this because they’re misbehaving — they’re working to their capacity.”

If you know your child is struggling in school, Dr. Lavin said, “make an appointment, sit down with your pediatrician, say, ‘I need your help, I hear from the A.A.P. that you’re the person I should ask for help on this.’”

That does not mean that these are necessarily medical problems (though medical problems can certainly play a role). But it’s often said that a child’s job is to learn, and when something gets in the way of the child successfully doing that job, the child will often feel discouraged, unhappy and progressively disaffected.

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