My daughter has been having problems since 1st grade also. After she was tested, after I insisted a few times, the ESE specialist advised me to take her to her primary doctor. She had all kinds of tests, including a CAT scan and then we were referred to a psyshologist who made the final diagnosis and prescribed the Ritalin.
I would be carefull with the drug if this is the route you end up taking. It made my daughter into a zombie and did not improve her concentration or grades very much. After about a month and a half, I took her off the medication. However, because of all the testing, she qualified to remain in the ESE program and to this day (she is a sophmore in highschool) she gets extra reading and language help. She has struggled with school the whole time. Tutors helped somewhat, but only if she put in the effort in the class. This year, both her and her twin sister, who always has done much better in school, are involved with the marching band. It keeps them very busy, but has taught them some responsibility and helped them keep focused in class. The consequence for not keeping up their grades is that they do not get to pariticpate during the football games.
Other friends that have children with ADD or ADHD have found activities, such as music, sports, dance, etc. has helped.
Jazmin is also very into the Japanese anime art. She is very good but could use some art classes to improve. Having something that she is good at has helped her self confidence and that has lead to some improvement with school.
Well I hope all this babbling will help you out. I would definitely start with the school ESE program if they have one or check with your pediatrician as to what can be done.