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Sir.—The article by Kappelman et al, which appeared in the February issue of the Journal (129:191, 1975), offers a challenge to all persons trying to provide a program of care for the child with learning difficulties of whatever origin. The breakdown of causes plus verification of the multiplicity of causes and verification of the substantial increase in functional disorders with the older children who have been subjected to school failure provide added proof of the need for us to work harder to identify these children in the very early grades.
There can be no doubt that the solution for the child with learning disabilities depends on effective cooperation between that child's physician and the resources that are available in his school district for analysis and treatment of the problem.
I am disturbed that nowhere in the article do the authors mention any form of involvement of the child's primary
BIEDEL CW. The School Health Team and School Health Physician. Am J Dis Child. 1975;129(7):867. doi:10.1001/archpedi.1975.02120440083021