What do tears, rhyming, storytelling, and gripping a pencil all have in common?

Don’t answer. Just imagine this scene: an 18-month-old falling on the ground and bawling over a lost balloon. Now picture the same child collapsing into tears because a balloon slipped from her hand eight years later.

When does a tantrum turn from difficult to diagnosable? We all know that the meaning of the behavior changes radically with the age of the child. But when it comes to our children, it can be difficult to see. As parents, filled to the brim with worry and love for our ever-changing children, we easily get caught in a limboland of wondering: Is that normal? Should she still be doing that? Her brother never did that — maybe she’s got an issue.

The common factor in the laundry list above? All can be clues that a child is struggling with a learning or behavioral problem. So says Steven E. Curtis, author of the book Understanding Your Child’s Puzzling Behavior (Greenleaf, 2008) and a licensed child clinical psychologist specializing in the assessment and treatment of children with emotional, behavioral, developmental, and learning difficulties. He offered to walk me through the first signs and symptoms of a learning disability for kids in preschool through high school.

GreatSchools: What happens in middle school? What are the signs that your child might be struggling with something beyond the huge transition from elementary school?

Curtis: One major sign is not being able to handle their complicated schedules. At this point they have multiple teachers, and so this is the time when kids with LD suddenly have trouble with organization and turning in homework.

With kids with ADHD and ADD, you start hearing about social issues. The same goes for Asperger’s disorder, a subtle form of autism. You may notice your child is having a lot of trouble in and outside the classroom. In elementary school you’ve got these nice and gentle teachers who may adapt to your child’s learning style. In middle school they may not be as tolerant if your child can’t work in groups, for instance, or doesn’t understand nuances of socialization or pragmatic language. It may become a problem for them academically. Of course there’s more social politics, and certain kids may have a harder time with that stuff. There’s less emphasis on “We all need to get along” than in elementary school.

GreatSchools: Are there really kids who don’t get diagnosed until middle or even high school?

Curtis: Sometimes I see parents who may have homeschooled their kids or may be in denial that something is wrong. Sometimes it’s just that the child is having trouble making friends.

Sometimes it’s more subtle problems that finally become apparent. The kids may not test low enough to qualify for services [earlier on], but they are now struggling with writing, organization, and completing things on time. Suddenly they’re under a mountain of work they need to do.

In high school sometimes the trigger is the college application process. It’s hard to get into college. Kids start losing interest in school — they get into drugs — and there’s this anxiety around getting into college.

GreatSchools: Do you see kids in high school coming in for assessment?

Curtis: Definitely. We actually diagnose a lot of people during their first year of college.

Theoretically, the first year of college is harder than high school. Certain hardworking kids put all these hours in, so they make it through high school, and then college is more than they can handle. Suddenly they wonder: Do I have a problem?

Sometimes they’ll learn that they are slow processors or that they didn’t learn phonics. They managed to figure out content from the context, and they worked so hard — but they don’t know how to sound out or they’ll realize they don’t have the basics of writing down notes. They’ll say, “It’s hard to form things with my pencil.” There are these bright hard workers who can get through high school, but the reality is that they have a learning disability.