There are innumerable reasons why a child might be struggling academically at school. In my practice, this is one of the most common presenting complaints when a parent brings a child for an intake. The most important part of the treatment is often a thorough assessment.

Below are five main reasons which may cause children to perform poorly in school.

  1. Cognitive deficits. When a kid comes into my office struggling in early elementary school, the first thing I wonder is if there are any cognitive deficits. Typically, I think of this as the different domains on an intelligence (IQ) test, which include verbal, nonverbal or perceptual, working memory and processing speed. It is important to know the child’s true capabilities rather than assuming they should be doing better than they are. Testing by a psychologist would be a good step to take.
  2. Learning disability. Sometimes a child has normal IQ, but has a relative deficit in one of the cognitive domains listed above or has difficulty with a certain type of learning or understanding, e.g., nonverbal communication, or dyslexia. Again, testing would show this.
  3. Social-emotional difficulties. Many kids do very well with the academic and learning part of school, but struggle in non-academic areas such as social communication and emotional regulation. This does not mean these kids have autism, but can be considered to have social-emotional deficits. Some signs of this are awkwardness in social settings, difficulty initiating conversations and lack of give-and-take socially. The emotional side can include tantrums and low frustration tolerance that gets in the way of a kid staying on task and enduring through the challenges of the learning curve. Social skills groups and teaching emotional language and regulation can help this.
  4. Attention-deficit hyperactivity disorder (ADHD) and executive dysfunction. There is conflicting evidence whether this is an overdiagnosed condition. My belief is that many kids and adults could meet the criteria for this diagnosis (see DSM-IV criteria by searching online), but many of them in fact have other reasons for their difficulty concentrating, staying on task, or inability to complete projects. Reasons might include anxiety, depression, difficult temperament, learning issues, as well as executive function difficulties. Executive function includes mental processes such as planning, organizing, sorting, regulating, prioritizing, and abstracting. These are vital abilities in both academic and most professional roles. And, they are housed in the part of the brain that develops last in humans, the frontal lobes, of which children and teens do not have much. A psychiatrist or psychologist would be an appropriate professional to help sort out these different possibilities to arrive at a diagnosis and options for treatment.
  5. Stressors. Bullying, chaos at home, separation from parents due to divorce or busy work schedule, uncomfortable physical changes — there are more potential stressors than can be listed, but the important point is that stress can negatively affect school performance. Typically, a child will display other manifestations of stress including anxiety, sadness, or avoidance of school, as stress does not occur in a vacuum. Being able to talk to a child so that they feel comfortable sharing their feelings, worries and stressors with you is an extremely important step in helping to identify the stress and therefore be able to do something about it.