SCHOOL DIFFICULTIES difficulty detailed history review of school records detailed physical exam environmental. neglect physical abuse and domestic violence sexual abuse sleep issues nutrition and feeding issues malnutrition socio-economic cultural home environment issues bullying mental health anxiety depression behavioral disorders conduct oppositional defiance disorder substance use and abuse neurodevelopmental intellectual disability global delay specific learning disability attention-deficit hyperactivity disorder autism spectrum disorder medical hearing impairment visual changes neurological disease tumor seizures head injury neurodegenerative disease sleep issues obstructive sleep apnea hypothyroidism iron deficiency indicates key condition this is not an exhaustive list of medical conditions

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