possible (probable) contributing factors:
1.
micronutrient deficiencies including iron; see article below w/brief discussion and listing of some micronutrients that have been identified as affecting cognitive function in children
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140638/
J Nutr. 2003 November; 133(11 Suppl 2): 3927S–3931S.
Micronutrient Deficiencies and Cognitive Functioning
Maureen M. Black
2.
anxiety/stress - this doesn't go away just because a child is in good-fair remission - I know my son still wonders when the "other shoe" will drop but he doesn't talk about it a lot.
3.
having an immune disorder affects many body systems - not just the gut in the case of IBD
J Neuropsychiatry Clin Neurosci. 2011 Fall; 23(1): 90–97.
The Emerging Link Between Autoimmune Disorders and Neuropsychiatric Disease
Dr. Matthew S. Kayser, M.D., Ph.D. and Dr. Josep Dalmau, M.D., Ph.D.
4.
aging into cognitive/learning disability - many children who have language or other processing differences may do well in the early years of school when the demands are low or there is the ability to "copy" what their peers are doing. If you can't figure out what the teacher said to do you can always look at what the kid next to you is doing and do the same. As they rise through the grades children with learning differences typically begin to struggle at those grades where there are big changes in the expectations for learning. At those points many children are identified with learning differences who were previously thought to be "fine".
Tipping points are 4th grade when the expectation that you will be able to read and understand what you have read independently is the first big one. It is also the grade that most children start to learn fractions and encounter a higher requirement for the ability to do abstract thinking.
6th grade or transition to jr. high is another point where children age into their disability, again because the expectations suddenly increase in ways that are especially difficult for kids with learning differences. Greater independence in managing workload, increased workload, increased expectations for analytical and abstract thinking, greater expectations for social control and ability to endure longer periods in classrooms are obvious factors.
And of course then there's high school. Don't think I need to say much about why a child with learning differences who has managed to get by so far will hit the wall and need help.
You can always ask her school to do some basic assessment of cognitive function and attention, particularly if you conference with her teachers and they see a problem in the classroom.
I guess I would have her take her lunch in a plastic bag or paper one. If it's different from everyone else maybe she will be motivated to remember her lunch bag when she earns one back through doing odd jobs or such? Maybe helps an elderly or sick neighbor or family friend a couple of times?
