I have kept in contact with the teacher to see if she has seen any improvements, and she has not seen any change. She said she will give him until the beginning of the nine-week grading period and if there has been no improvement she suggested he should see our family doctor. What is your input on this issue?

Answer: It never hurts to consult your family doctor when school problems crop up; this way, you can rule out medical explanations and present the teacher with a clean bill of health. Or, if medical intervention is required, your doctor can get you started on the right path. Before you call the doctor, however, try to get a clearer picture of the exact nature of the math teacher's concerns.

Because you didn't mention any problems with math in earlier grades, and the teacher identified "focus" as the problem, it would appear that your son's skills and abilities are not in question and the teacher is leaning toward a medical explanation, such as ADHD.

For a diagnosis of ADHD, some symptoms must have been present before the age of 7 years; did your son have hyperactive-impulsive or inattentive symptoms earlier that were easily managed until now? If so, you may be looking at a disorder that can no longer be managed without medical support.

If not, consider other factors that may be involved. In the fifth grade there are increased challenges for children in many areas, including both academics and behavior (for example, greater independence is required of fifth-graders as they are being prepared for middle school next year). Has the level of work become too challenging for your son? Consider having him work with a tutor or other educational specialist, as the work will only get more challenging over time.

Finally, bear in mind that sometimes fifth-graders' social lives begin to eclipse academics, as adolescence begins to bloom and peers take on greater importance. Your son's lack of focus could be something as simple as the peers he sits next to in class, especially if he is trying to impress them.

Dr. Stacie Bunning, Psy.D, is a licensed clinical psychologist in the St. Louis, Missouri, area. She has worked with children, adolescents and their families in a variety of clinical settings for 20 years. She also teaches courses in child psychology, adolescent psychology and human development through the lifespan at Maryville University in St. Louis.

Advice from our experts is not a substitute for medical or other professional advice and services from a qualified health-care provider familiar with your unique situation. We recommend consulting a qualified professional if you have concerns about your child's medical or emotional condition.

March 2007