TABLE 1

Differential Diagnoses for Failing to Progress Academically, Organized by Category

CategoryExample Diagnoses or Conditions and Relevant Past, Family, or Social History
VascularPrematurity with intraventricular hemorrhage
Ruptured aneurysm with brain injury
Stroke
Congenital heart disease
Clotting disorders
InfectiousMeningitis or encephalitis, perinatal infections
TraumaHead trauma with brain injury
Exposure to child abuse and neglect
Traumatic stress
Toxic exposurePrenatal exposure to alcohol
Lead and/or other environmental toxicants
Substance use by child
Attention deficitsADHD
Affective disordersDepression
Adjustment disordersAdjustment disorders
Anxiety disordersGeneralized anxiety, separation anxiety, school phobia
Autism spectrum disorderAutism
MetabolicInborn errors of metabolism
IatrogenicMedication adverse effects
IdiopathicDespite thorough workup, cause cannot be determined
NeurologicIntellectual disabilities
Absence seizures
Motor coordination disorders
Tourette’s syndrome
Neoplastic or hematologicNew onset neoplasms
Neurologic effects of previous chemotherapy or radiotherapy
Sickle cell anemia
Iron deficiency anemia
SocialInadequate financial and/or material resources, poverty
Hunger
Frequent school absences, truancy
Parental or family mental health problems, substance use, domestic violence
Separation and divorce, death of a loved one, foster care
Poor school- or teacher-child fit
Bullying, ostracism, cyberbullying
Military deployment of a family member or loved one
SensoryVisual impairment
Hearing loss
SleepSleep hygiene problems
Obstructive sleep apnea
Speech and languageReceptive expressive language disorders
Articulation disorders
Learning English as a second language
Social communication disorder
Specific learning disabilitiesReading, math, and writing learning disabilities
CongenitalGenetic disorders with associated developmental delays
Congenital brain malformations
Chronic diseasesAsthma
Eczema
Diabetes
Failure to thrive
Chronic pain
Dental caries
DegenerativeNeurodegenerative disorders (mitochondrial disorders, leukodystrophies, etc)
EndocrineType 1 diabetes mellitus
Thyroid disease