1 Is your child's difficulty with school mainly or solely concerned with learning?

2 Has your child always been a slow learner compared with other children of a similar age?

3 Has your child's general school performance declined over the past few weeks or months?

4 Has there been a recent change at home, such as the arrival of a new baby?

5 Does your child have difficulties in only one or two specific areas, such as reading, spelling, or maths?

6 Has your child been playing truant?

7 Has your child become reluctant to go to school?

8 Do any of the following apply to your child?

• He or she often comes home with unexplained bruises or cuts.
• Money or belongings are frequently "lost" at school.
• He or she comes home with broken belongings.

9 Does your child resist all attempts to get him or her into school?

10 Have teachers complained about your child's behaviour at school?

11 Is your child easily bored, unable to concentrate, restless, impulsive, and/or disruptive?

12 Is your child's behaviour at home acceptable?

13

Possible causes Some learning difficulties may simply be due to late development, in which case your child will probably catch up with other children over the next few years. Children who have emotional problems will be slower to learn, as will children with physical problems, such as impaired hearing.

Action Discuss your child's progress with his or her teachers, who may be able to reassure you. If your child does not appear to be keeping up, consult your doctor, who will examine your child and may arrange a developmental or psychological assessment. Most slow learners can be helped with extra teaching. Speech and occupational therapy may also be helpful. Occasionally, it may be necessary for a child to attend a special school.

14

Possible cause Upset over a change in a child's home circumstances, such as a new baby or parental separation, often has a temporary effect on a child's schoolwork.

Action Try to discover and deal with any underlying worries that your child has. It is also a good idea to tell your child's teachers if there are problems at home. If your child's work does not improve with time and extra support, consult your doctor, who will advise you whether further help, such as referral to a child guidance clinic, is necessary.

15

Possible causes A sudden decline in school performance for no obvious reason may be the result of a physical problem, such as a deterioration in hearing or eyesight. Social distractions or anxiety, such as worry about bullying, are also possibilities. Discuss the problem with your child's teachers, and then consult your doctor.

Action Your doctor will probably examine your child and check his or her hearing and eyesight. Further tests may be arranged. If no physical disorder is found, your doctor may advise further discussions with your child's teachers before arranging specialist help.

16

Possible cause A child whose general development is normal for his or her age but who has problems in one area is said to have a specific learning difficulty. For example, difficulty in reading and writing is known as dyslexia. Discuss the problem with your child's teachers initially, and consult your doctor.

Action Your doctor will probably examine your child to make sure that a physical problem, such as poor eyesight or an unrecognized illness, is not contributing to your child's difficulties. Your doctor may liaise with the school medical services. Work with your child's school to encourage your child as much as possible. In some cases, extra support in school may be necessary.

17

Possible cause Truancy combined with other antisocial behaviours, such as stealing, is more common in adolescents. In some cases, it is due to bullying or the influence of friends. Talk to your child's teachers and your doctor.

Action If problems persist despite intervention at school, it may be necessary to refer your child to a child guidance clinic. Long-standing behaviour problems may be difficult to change.

18

Possible cause This type of problem may be due to bullying, even if your child is initially reluctant to admit it (see Bullying).

Action Talk to your child about the situation, and speak to his or her teachers. Bullying or other violence at school should be taken very seriously. Your child's school should have a policy for dealing with bullying, and you can help by building up your child's confidence.

19

Possible causes School refusal may be a sign that something is seriously wrong. There may be a problem at school, such as bullying, or a failure of the school to meet the child's needs. Occasionally, refusal to go to school is caused by anxiety at home or, in a young child, by anxiety over separation from his or her parents.

Action Try to discover the underlying cause of your child's refusal to go to school so that it can be dealt with, and make every effort to ensure that your child attends school. In the meantime, discuss the problem with your child's teachers. If the situation does not improve, consult your doctor. He or she may recommend you seek help for your child through a child guidance clinic.

20

Possible causes Dislike of school may be caused by a variety of factors. For example, children starting a new school may be anxious. Your child may be having difficulties with work at school or be afraid of certain teachers or pupils. If not tackled, a dislike of school may progress into a refusal to attend school.

Action Try to find out the cause of the problem, and discuss your child's feelings with his or her teachers so that they can watch out for signs of bullying. Do not keep your child at home. Depending on the cause of the problem, it may be necessary for your child to receive extra teaching or help through a child guidance clinic.

21

Possible cause Although this type of behaviour is normal in small children, school-age children who are constantly active and disruptive may have attention deficit hyperactivity disorder. Consult your doctor.

Action Your doctor will probably refer your child to a specialist to confirm the diagnosis. Children with this condition need extra support at home and in school, and some need drug treatment.

22

Possible causes Bad behaviour that is confined to school can be due to a number of problems. Schoolwork may be too easy, leading to boredom, or it may be too difficult, possibly because of an unrecognized learning difficulty, resulting in loss of interest. Bad behaviour may also be the result of rejecting authority. In some cases, poor behaviour at school may be due to bullying.

Action Talk to your child to try to uncover the cause of the problem. It is also wise to discuss the problem with your child's teachers. Adjustments may need to be made to your child's schoolwork so that it meets his or her needs more closely. In some cases, help through a child guidance clinic may be arranged by your doctor.

23

go to Behaviour problems

24

School difficulties that have not been described on this chart should be discussed with your child's teachers. Your doctor's advice may also be helpful in some cases.