Adolescents with learning problems

The adolescent with learning problems presents a multifaceted diagnostic and therapeutic challenge to the primary care clinician. The adolescent failing in school often manifests secondary affective symptoms that tend to obscure underlying developmental deficits. Inadequate educational experiences, family stress, environmental deprivation, and preoccupation with nonacademic sources of gratification can further cloud the picture. Efforts at remediation must overcome the tendency of medical and school professionals, parents, and students themselves to be overly pessimistic about the long-term outcome. With the knowledge of the common causes of school failure and developmental dysfunction in this age group, the general physician can reach a reasonable diagnosis, develop a functional profile of strengths and weaknesses, and collaborate with parents, educators, and the adolescent to effect a comprehensive management plan. The physician's ongoing involvement can be a very important factor stimulating the school to continue to evaluate an individual student's needs and abilities. Parents may need assistance to recognize their child's own strengths and to help the child utilize them appropriately. If the adolescent is helped to see that he or she can make important contributions to society within the spectrum of his or her talents, then the clinician has played a crucial role in the development of a potentially happy and successful adult.