Often times, internationally adopted children do beautifully until they reach school age. Upon encountering the academic/educational and social challenges of school, new behaviors may emerge. These behaviors may be a function of underlying visual, hearing, or other sensory problems. These behaviors may occur due to the child's ability to respond appropriately to social situations, based upon their experiences living in an institution. It is not unusual to hear that "my child has been doing wonderfully all these years. He/she is smart, has good language skills, and suddenly his/her teacher is saying that we should consider Attention Deficit Disorder." Children who are post-institutionalized may be at risk for ADD, however, there are also many other psycho-educationally relevant diagnosis which should be considered including: attachment problems, sensory integration problems, functional vision problems, emotional issues (such as anxiety, decreased ability to interpret the social cues of others, etc), and nutritional deficits. Each of these areas can contribute to what may look like as "inattention" but which respond to very different treatments.