I am just starting down the path of pursuing a diagnosis for my 10 year old dd. The school suggested attention issues towards the end of last year, but her grades were high, and she was not struggling. This year, she is very much struggling, is starting to spiral and her life is not in her control. I liked how someone put it that their head is still in Mars. That's my child. I'm pursuing a diagnosis because I want her life to not be a constant struggle to maintain a thought, a homework assignment, a test, a conversation, etc. I have tried other things first. I've been very careful about her diet, her structure and support at home. Her school is fabulous at creating an environment where she can be successful. But, she still has to put out a tremendous effort for pretty minimal results. She has pretty good grades, still, but I think this is a reflection of fantastic coping skills, rather than anything else. And the grades are starting to slip. As is her self esteem.
This has also been our experience. My DS's grades were always stellar, despite obvious attention issues, until he hit 5th grade. Then things started to deteriorate quickly and dramatically. We spent all of that year trying everything we could to help, but it just wasn't enough. We pursued a dx in the summer after 5th, decided to trial meds, and he is in 6th this year.
For him, it was very much the right choice: the meds allow him to focus and follow-through, and his grades have shot way, way back up, as has his self-esteem. He doesn't have a formal 504 plan at school, but his teachers provide accomodations to help, anyway, like allowing him to test away from the class if he chooses, or letting him listen to his iPod while doing schoolwork (certain music improves his concentration a lot, which came as a surprise to me, since it has the opposite effect on me, lol) He also attends therapy once a month to give him more strategies for organization and time management, b/c meds are definitely not a magic solution for the lack of those. We also have had to put an emphasis on eating and high calorie foods, b/c he has lost weight as a result of the meds, but even with that, DS firmly believes the benefits outweigh the downsides. I know this is a difficult decision; we've struggled with it ourselves for years.