Adolescent school failure: failure to thrive in adolescence.

The role of the primary clinician in dealing with school failure can be critical by linking the epidemiological with the clinical and encompassing the pediatric/adolescent life span. It includes components of social and public health advocacy, preventive medicine, evaluation, education, treatment, and referral. The most effective interventions are early and multifaceted. The primary care role includes: community advocacy; counseling about prenatal drug and alcohol abuse; early detection and treatment for attentional disorders, underachievement, and learning disabilities; interviews addressing multiple risk factors, grades, school attitudes, behavior, and friends; anticipatory guidance; education about individual learning style and good "learning hygiene"; early referral and intervention for preadolescent conduct problems and parent-child conflict; early referrals for family distress; and prevention of substance abuse and adolescent pregnancy.