My soon to be 11 yr old 5th grader has been this way forever. Our problem is he was a 26 week preemie and everyone wanted to write it off to "prematurity". Well, I've discussed this with his pediatrician and instead of opting to throw medication at him, she suggested a sleep study to be done at Children's Hospital. We discovered that he didn't have enough deep REM sleep and his patterns indicated that by the afternoon, he was just exhausted. Hard to focus on stuff when you're plain ole tired.
We've stabilized bedtime back to being 8:00, whereas he was wanting to stay up until 9:00 before. We also have everything ready for school the night before so there isn't so much to do in the morning, which allows him an extra half hour of sleeping in, verses his sister. For breakfast, he gets a 1200 mg capsule of flax seed oil and about 8 ounces of green caffinated iced tea with a high fiber cereal or oatmeal or a grain based cereal, occasionally a scrambled egg with veggies in it (he loves onions and peppers). The grain and/or oatmeal is slow release energy for him. The regularity of the flax seed capsules seems to have made the biggest change with him.
For a snack mid morning, he takes a home-baked baked oatmeal bar with some type of fruit in it (apples, raisins, etc). Very easy to make at home and has no preservatives, dyes, etc. Again, the oatmeal seems to get him through the day better.
When they go outside for their 3:00 recess, he sneaks another little snack of some sort- usually a baggie of presliced apples or a box of raisins. Just something to keep the energy going.
He has no food allergies that we know of and has never been a picky eater, but I try to stay away from the convenience foods as much as possible. Just too much unknown stuff in them and I'm not sure that he doesn't just have some of those normal sensitivities- dyes, HFCS, etc, like so many others.
I was so glad that his pediatrician didn't just throw a prescription at him and rather, guided us in a better path. Certainly if someone could prove to me that his body NEEDS the ADD medication because of some chemical imbalance that can't be controlled any other way, then I'd work with that too; kind of like when a diabetic needs insulin.
We also have to break up tasks into smaller jobs or he is easily overwhelmed. We have written on our bathroom mirror (in dry erase markers) to remind him to brush his teeth and wash his face before bedtime - seems that when we say "go get ready for bed", he sometimes can't get it all together without a little reminder. We do pick out clothes the night before and I have 3 x 5 cards, a different color for each day, with his school specials (one day is music, one day is computer lab, one day is gym, etc) as a reminder. I attached magnets to the back of the cards and since our entry door is steel, I post which ever one is needed on the door by his backpack. Same with a card "remember lunch money!" or "get lunch box from fridge" or "don't forget meeting with your tutor today" type notes.
I try to give him chores that are repetitive - like taking out the trash on Wednesdays because it becomes a routine then and something he doesn't have to really think about. (It's another 3 x 5 card we post on Wednesdays). On Mondays I wash whites and his job is to sort the socks and underware and put everyone's away- we call it "sock day".
As we progress through the day, the 3 x 5 cards are changed as needed which means he did what he needed to do (Sock day sign is put away) and he can see when he's "done".
Now that we're in 5th grade, things are much better. I think the fact that boys mature a bit slower than girls also plays in to all this as well. He's leaned how to manage his homework- again by breaking it into smaller tasks. He normally gets all his homework for the week on Mondays, and then priortizes it by the due date. We spend 1 hour on homework, and half hour on independant reading per night, and it's up to him to see that what needs to be done is done on time. SO, if he gets Tuesdays work done and has time left over, he will sometimes work on Wednesdays to fill out the hour, etc. Beccause we limit the homework time, he gets some time to himself each day to do whatever he wants and doesn't feel under the gun all the time. Afterall, they are still kids and need to do kid stuff too!
Another trick I learned is give things a time limit. Don't say "get the homework done", say instead "spend 15 minutes and work on spelling first, then let's see where that puts us." By giving a time limit, there's a finite end to the task and it's not so daunting to see the mile high pile of papers and not know where to start. It also lets him feel in control of the homework, and that he is in charge for that hour. The little break after 15 minutes is enough to allow the mind to rest a bit, then we go for another 10 minutes or so, or just work on math problems 1 thru 3, and take another breather before finishing. This time limit thing works wonders with messy bedrooms too! ("Hey, can you take 5 minutes and see how much you can get done with your room" is so much more effective than "Go clean up that mess you call a bedroom!" It's amazing what can be done in 5 minutes- and be excited to see what was done, even if it is only 85% done in the end)
Sorry I rembled on too much - hope there was some information in there for you!