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Rarely do school problems start or end at the classroom door. Inadequate sleep, learning disabilities, and even food insecurity, among other factors may lead to a child’s poor report card. According to a new report by the American Academy of Paediatrics, primary care physicians are in a distinctive position to screen for and treat contributing conditions, and also offer support for the secondary challenges — often low self-esteem and social struggles — that follow school disappointments.

What role can a paediatrician play in addressing and remedying a child’s academic problems? “If the child is having academic problems or what we call learning difficulties, the paediatrician can assess the problem and refer the child to the required team of specialists like speech therapists, psychologists, and cognitive behavioural therapists, depending on the condition,” explains Dr Wafaa Faysal, Consultant Paediatrician at Medcare Pediatric Speciality Centre and at Medcare Woman & Children Hospital. “The most important thing is to never give up on your children and to get the best out of them, as they are our most important resources for the future.”

The common learning problems children face are impairment in understanding or using written or spoken language, impairment in information processing, memory issues, reading, writing (dyslexia), and behavioural problems. “When children are struggling in school, the first step is to talk to their teachers,” says Dr Deepti Gulhane, Specialist Paediatrician, Paediatric Neurodevelopment and Paediatric Neurology, Burjeel Medical City. “Early recognition and intervention are important. The paediatrician needs to be familiar with cognitive, emotional, and developmental problems that affect school performance and assist the parents in becoming active participants in their children’s education. They should take an active role in the initiation, development, and implementation of individualised education plans. The primary care paediatrician should emphasise that everyone learns differently.”

Pediatricians have to be more involved in their patient’s educational achievement as well as well-being, reiterates Dr Nahla Sobhi El Tehaiwi, Specialist Paediatrician, Prime Hospital.

“Paediatricians have a role to help solve problems that manifest in the classroom, while effective solutions can be devised only when the specific problem is identified,” says Dr El Tehaiwi. “It then comes to the parent’s role to know how to shake off last year’s frustrating habits.”

She adds: “Each child is a special individual, and a lack of academic progress is often a symptom of complex issues that need to be approached with careful thought. They may show up as neurologic, nutritional, emotional, social or behavioural issues — or different combinations of them.”

The role then of a medical evaluation is to determine why academic progress is compromised. Doctors need to assess perinatal and developmental history, sleep and behavioural patterns, and physical elements, and dealing with a child’s learning disability.

“The child may have difficulty in reading, writing, mathematics, listening, and/or speaking,” says Dr El Tehaiwi. “There is usually a large difference between what is expected based on a child’s intelligence and his actual performance, which comes after ruling out other health problems such as hearing loss, vision problems, behaviour or emotional disturbance, attention deficit hyperactivity disorder (ADHD or ADD) and autism. These conditions must be ruled out before a learning disability can be diagnosed.”

Doctors can also provide realistic options to help children succeed in moving forward in their education. “Many diseases may affect the education journey of children such as anaemia, nutritional and vitamin deficiencies, asthma, hypothyroidism, epilepsy and other chronic diseases,” says Dr Abeer AlKhalafawi, Consultant Paediatrician, Medcare Women & Children Hospital. “Doctors play an important role in early diagnosis by conducting regular health check-ups, ordering the required lab tests and then prescribing the proper treatment to keep the child asymptomatic. In some cases, doctors may refer to other sub-specialty to assure best and updated treatment for the patient’s health and safety.”

To put it simply, paediatricians can identify early signs of learning disability including poor attention span and memory, difficulty following directions, and the inability to discriminate between letters, numerals or sounds.

“More in-depth evaluation by a neurodevelopment paediatrician will help recognise key areas where the child needs help,” says Dr Gulhane. “Early screening and rescreening will avoid years of academic difficulty. Doctors should screen for underlying medical conditions including visual and hearing problems, and also rule out environmental factors and language that might impact academic success. Teacher and school-related problems, insufficient nutrition and sleep, family discordance, problems with emotional disturbances such as anxiety and depression should be considered.”

To help children overcome their learning challenges, Dr Gulhane says doctors and parents must be the child’s advocate and play an important role in formulating an individualised education plan. She recommends the following:

● Recognise how the child learns – auditory (learns by listening), visual (learns by watching) or kinesthetic (learns with touch and by doing) and modify the teaching techniques as per the child’s requirements.

● Impose self-awareness and self-confidence in children.

● Identify a few short- or long-term goals; follow a timeline to achieve the goals. Think of life success rather than school success.

● Teach children to ask for help when required and develop a strong support system.

● Along with healthy lifestyle habits, it is important to encourage healthy emotional habits by giving them outlets for expressing emotions, anger, and frustration.

● Celebrate with your child when they achieve a goal.

“The paediatrician’s role is to start by preventing and protecting the child from facing problems and struggling in academic learning, early detection of problems and screening of expected challenges, which may face the child resulting in declined school performance, to evaluate and treat the child’s existing problems and guide the family and school in the correct way in dealing with it,” concludes Dr El Tehaiwi.