Young children who show signs of depression are six times more likely to lag in social and academic skills, a new study has found. It’s unclear whether depression and learning difficulty are co-occurring, or if one causes the other, but the two are clearly linked, researchers say — making poor social and academic skills also a symptom of depression in young children.

This means parents and teachers are both critical in identifying depression in children, and getting kids the help they need, the study authors add.

“When you ask teachers and parents to rate a child’s level of depression, there is usually only about 5 to 10% overlap in their ratings. For example, the teacher might report that a child has difficulties making friends in class, but the parent might not notice this issue at home,” says study author Keith Herman, a professor in the University of Missouri’s College of Education. “Some people would view that overlap as the truth about a child’s well-being and areas of disagreement as errors, but we need to explore the possibility that they each are seeing different aspects of children’s behavior and mental health.”

This kind of coordination is difficult in India, where stigma against depression runs deep, and parents often worry about how much to confide in or inquire of schools about their children’s mental health. Indeed, a 2014 report found that school counselors, a position that might be able to facilitate the kind of exchange that Herman call for, are deeply lacking in Indian schools, despite mandates from educational bodies; where they do exist, a misunderstanding of the role by parents and administrators often leads to inefficacy.

Herman, along with education professor Wendy Reinke, studied 643 children in second and third standard, finding that while 30% of children reported feeling mildly to severely depressed, parents and teachers often failed to recognize the child’s depressed. Instead, what teachers and parents noticed were other, symptoms less obviously linked to depression in children, such as social problems, inattention and lagging academic skills.

“The gold standard for identifying children who might be at risk for developing depression later in life is to ask the children themselves,” Herman says. “However, even if a child doesn’t say they feel depressed, certain outward behaviors might provide clues to the state of the child’s mental health. It’s important for teachers and parents to catch these behaviors early to prevent long-term problems that occur with depression.”