An 8-year-old, who is in third grade, presents to her pediatrician's office with her mother, who is concerned about her daughter's falling behind in school. For the fourth time in 6 weeks, the girl's teacher has called to report problems. The girl does not follow, or does not listen to, simple instructions. She says that she "hates" school because her teacher keeps telling her to pay attention when she is daydreaming. She rarely finishes assignments, and when she does, she makes careless mistakes. Even during recess, she will drop out of games and sit by herself to play with a doll. The mother reports that the girl usually forgets her lunch or has misplaced it by the time she gets to school. She is in good physical health and is normal height and weight for her age. She has had a hearing test, and her hearing was good.