Maria is an eight-year-old daughter of Mexican-American parents who recently immigrated to the United States. They speak some English, and Maria is fluent in both English and Spanish. She is enrolled in third grade at the local public elementary school. Since second grade, her parents have reported concerns about her difficulty in paying attention or maintaining her concentration. They indicate that she has significant difficulty in completing her homework because she daydreams and is easily distracted by sounds and activities in the home. Maria has the same problem in the classroom, so she often has to bring unfinished classroom work home to complete. Maria gets frustrated at school and during homework time, often stating that she “can’t do” the work and referring to herself as “dumb” or “not smart enough.”

Maria’s frustration with her schoolwork has led to some irritability lately, as well as some desire to avoid school. She tends to have more of a temper at home recently and expresses hopelessness at times. She is most content playing soccer or video games. She tends to concentrate very well during those activities.

Standardized testing completed by all children in the third grade indicates that Maria is of average intelligence. Screening by the school psychologist indicated that she most likely does not have a learning disability.