Is my son a nalayak?

This is the common question that every parent asks themselves when their child is not
doing well in school. Poor academic performance can have many consequences for the child, family and society at large. National crime record bureau recorded 2471 suicides in 2013 across India due to academic failures. As per a UNESCO report of 2016, 47 million children in India dropped out of school by 10th grade. These are alarming numbers for a country which is aspiring to leap into the high-income-nations league.

There are many developmental disorders in children and adolescents which can cause difficulties for students to perform in school. Attention Deficit Hyperactivity Disorder (ADHD), Specific learning disabilities, intellectual impairment, Autism Spectrum Disorder are some of the
common developmental disorders. The first step in the learning process is Attention, followed by comprehension, encoding and retrieval of information. Disruption in any of these steps can lead to poor learning and performance in school.

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common, treatable
cause of learning difficulty. Five to ten out of hundred children suffer from this disorder. There are three core problems in a child with ADHD: Inattention, hyperactivity and impulsivity. Inability to sit still and pay attention to the task leads to poor learning. The child may be highly intelligent, but as he fails to pay attention to the task at hand leads to failure to learn. Most kids get punished in school for this behaviour. This condition is easily treatable with medication and ADHD coaching. If the child seems to be doing poorly in one subject but does well in others, he may be suffering from a specific learning disability. Specific learning disabilities of math (Acalculia), reading (Dyslexia), and nonverbal learning disorders (NVLD) are common. These conditions are diagnosed by administering special neuro-psychological tests by clinical psychologists.

These conditions are not treatable by medications, but by using special teaching techniques like Orton-Giligham approach, using audio books and individual tutoring. If a child is struggling across the board in most subjects the problem could be intellectual
impairment. About 2 to 3 out of a hundred children have intellectual impairment. If a child appears to be struggling not just with learning in school but also in other routine activities, he may be intellectually impaired.

Extra help in class room with one-on-one teaching and also modification of the curriculum would help to make the child grow to its full. If child was doing reasonably well, but suddenly or gradually deteriorating in school
performance the contributing causes could be some form of mental illnesses. Anxiety disorders are some of the most common psychiatric conditions in children. A child may be preoccupied with their worries leading to an inability to pay attention. Children with depression struggle with poor attention, low motivation and low energy to perform in school.

If a child is struggling with social communication he may be suffering from Autism Spectrum Disorder. Serious mental illnesses like schizophrenia and bipolar disorders are uncommon conditions in childhood. However, these conditions start to appear in late teenage years. Psychiatric conditions are easily treatable with the help of talk therapy and medications. Identifying these problems early and intervening promptly can have a significant impact. Early detection and intervention can change the trajectory of the life of the child, family and the nation.

(The writer is a US-based child and adolescent psychiatrist)