A child's poor performance in school can be caused by many things, but should be a signal to parents to take a closer look.

As kids go back to school, parents should take note. Up to 20 percent of school age children are struggling academically, and what can appear as a lack of motivation or chronic inattention may actually mask a learning disorder.

Because Attention Deficit Disorder (ADD) and Attention Deficit Hyperactive Disorder (AD/HD) are frequently associated with learning problems, it's important to screen children who are consistent underachievers (those whose school performance is not aligned with their intelligence and abilities).

A child with Attention Deficit Disorder typically has difficulty with concentration and organizational skills. Problems can arise related to school work. Students with this affliction may fail to keep track of assignments or forget to bring home needed books or materials.

Often attempts to complete school work are thwarted by an inability to concentrate on the task.

Attention Deficit Hyperactive Disorder is characterized by hyperactivity in addition to distractibility and poor organization skills. When a child is hyperactive he or she can be profoundly restless (unable to remain seated for a period of time), fidgety and impulsive.

Hyperactive kids often have trouble keeping their hands and feet still. Problems with impulsive behavior cause hyperactive children to suddenly act on a thought even if the action is inappropriate at the time (such as jumping up to look at something when the rest of the class is seated to take a test).

It's important for parents to know that neither disorder represent deficits in intelligence but have to do with the individual "wiring" of a child's brain. Both behavioral and drug therapies can be effective in treating the disorders, but a thorough diagnosis by a medical professional is critical for proper treatment.

Symptoms that appear to be the cause of the disorders can actually be caused by another form of learning disability or other health problem, so an accurate diagnosis is essential.

The good news is that Attention Deficit Disorder and Attention Deficit Hyperactive Disorder and other learning disabilities can be effectively treated, especially when the problem is identified early on.

With treatment, many children overcome the academic and social problems brought on by the disorders and go on to be successful adolescents and adults. As parents, the action you take now may benefit your child for life.

Steve Dassel is a pediatrician at Virginia Mason Sand Point where he specializes in the diagnosis and treatment of ADD and AD/HD in young people. He can be reached at (206) 525-8000.