Pediatric Physicians, PC

When School isn't Going Well

By Roy Benaroch, MD
As printed in Around Town Publishing, November 2006

My child isn't doing well in school. What are the first steps I should take to see if there is a medical problem?

There are many reasons why some children don't do well in school. Often, the best way to address a problem is with input not only from your pediatrician, but also from your child's teachers, tutors, and school counselors. Sometimes, an evaluation by a psychologist with expertise in academics can help zero in on the problem and set up a plan for treatment.

Common medical problems that can contribute to poor school performance include some very simple things. Is the child getting enough good quality sleep? Most school aged children need nine hours of sleep a night, and some need even more. Children who are hard to get up on school days or who like to "sleep in" very late on weekends are not getting their sleep during the school week.

Sleep apnea, in children often caused by large tonsils and adenoids, can cause symptoms of inattention and poor focus. Likewise, children who consume caffeine from sodas (especially citrus sodas), coffee, or iced tea may not get good sleep quality. Allergies, chronic pain, or other illnesses can also interfere with a good night's sleep.

Children also need to get enough unstructured time to "run off steam." Many schools have cut back on recess, but this puts the more active kids at a disadvantage. If your child has trouble unwinding in the classroom, try to allow enough time after school for running off that extra energy.

Although good nutrition is important, there's no need for any child to take mega-doses of vitamins. These won't help in school. If your child is a picky eater, an inexpensive generic multivitamin will "fill in the gaps" and provide the nutrition that's needed. Every child should start the day with a decent breakfast to provide enough fuel for the morning.

Your pediatrician should already know if any chronic health condition or developmental disorder could affect your child's school performance. A review of your child's health history and physical exam will reveal almost all medical issues that could lead to school problems. Blood testing is very unlikely to uncover any unsuspected problems, and more advanced medical testing is almost always unnecessary. More subtle conditions, including learning disabilities and problems with language or visual processing, will need to be diagnosed by a psychologist. Likewise, if you, your pediatrician, and your child's teachers suspect attention deficit disorder (ADD), work with a psychologist to do thorough testing for this and similar disorders before beginning therapy.

Dr. Roy Benaroch practices general pediatrics with Pediatric Physicians, PC of Roswell and Windward. His book, A Guide to Getting the Best Health Care for Your Children, was published in February 2007.

If you have a pediatric question of general interest, please submit it to advice@PediatricPhysiciansPC.com. One of the board certified pediatricians from Pediatric Physicians, PC will answer a selected question in this column each month.

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