Is it LD or ADHD?

These two conditions often co-exist, and only a thorough evaluation can sort things out.
My third-grader is starting to have problems keeping up with the class. He's very bright, but has a problem staying focused and completing class work. The school wants to put him in special education, but I'm fighting that because he's not dumb. He has proven that he can do the work, but sometimes he just won't do it. Does this sound like a learning disability or ADHD? How can I find out for sure? When a child is placed in special education, how does this affect his self-esteem?
The behaviors you describe could be caused by an undiagnosed learning disability. Kids with LD often start to shut down in third grade, because that's when the focus changes from learning to read to reading to learn. Students who can read, write, or do math well don't get much satisfaction out of a school day that's filled with these activities.

You say your son has proven that he can do the work, but I would ask if he's able to do it independently and successfully. If he does it with an adult hovering over him, offering help at every task, then he may, in fact, not be able to do the work. A thorough evaluation should be done to make sure that he has no difficulty making sense of words, letters, or numbers. If there's no evidence of a learning disability, then he might have ADHD, which is associated with inattention, distractibility, and often (but not always) hyperactivity. Since these two conditions often co-exist, he could even have both, so a thorough evaluation is doubly indicated.

However, very bright kids who find the work too easy or too repetitive often turn off in the classroom. They focus their attention on activities or thoughts that are far more interesting and stimulating than schoolwork. They are often misdiagnosed as having ADHD or LD, when the real solution is making the curriculum more intellectually stimulating, multi-sensory, and experiential. Unless you rule out that possibility, then a ticket to the resource room -- unless it serves gifted-and-talented children well -- is the wrong ticket.

You ask about the effects of special education on self-esteem. If special education means, as it unfortunately still does in some schools, that a child is segregated into inferior classroom space, with kids with a wide variety of poorly addressed special needs, the impact on a child's self-concept can be devastating and long-lasting. On the other hand, a child with special needs who is left in the regular class without proper instruction can fall farther and farther behind, and this situation also can poke holes in even a good self-concept. If special education is really special, then it should allow all children to learn in the ways that they can, in environments that are conducive to learning, which can be a self-contained special class or the regular classroom with adequate supports.

Jerome (Jerry) Schultz is the founding clinical director of the Learning Lab @ Lesley University, a program that provides assessment, tutoring, and case management services for children with learning challenges. Schultz holds a Ph.D. from Boston College, and has completed postdoctoral fellowships in both clinical psychology and pediatric neuropsychology.

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