School dysfunction: evaluative aspects.

Inability of a child to function in a formal school setting necessitates a review of potential physical, mental, emotional, and behavioral etiologies. A thorough, systematic history and examination is expected; the time of onset, age, and grade of the patient helps to narrow the differential diagnosis. A careful assessment should determine the work-up, correct diagnosis, and treatment. Additional primary care physician responsibilities in school dysfunction cases include patient education, family support, and specialist referral, if necessary.