Thanks for your input, however, I guess I didn’t explain the situation well enough.  He is getting the highest grades possible on the scale his school is using.  He is performing to the highest level for 4th grade, but not to his own potential.

We already have a reward system tied to the report card grades.  Without bugging the teacher on a day-to-day basis, I am not sure what kind of system I could develop for the daily things.  His teacher has said she also notices that he puts forth more effort when he knows there is a specific grade attached to an assignment.  I haven’t yet talked with him about our conference (trying to find the right non-confrontational time/place), but one of the things he needs to understand is that EVERYTHING factors into the final "grade" for a subject, even if there is not an individual grade assigned to each paper/project.  Of course, since he is already making the top grade, I am not sure how much good that will do!!

The teacher is aware of my concerns, and I of hers, but at this point neither of us have any solutions.  That is why she asked if the meds could possibly be affecting his attitude/behavior.  He does not have a behavior problem (he is actually a very good kid, at school), but she has read his body language a few times and knew he wasn’t too thrilled with assignments.  I, too, have seen this at home.  His body language is terrific if he pursues an acting career (he actually is somewhat talented in this area!), but in most other walks of life it could cause him problems!!

Like your daughter, he also hates failure and I have seen him just give up on things which he feels are too difficult.  Fortunately, this has not (yet) been an issue in school and the few times it has been related to school over the years, it has been while doing homework assignments at home and I get the pleasure of dealing with it.  Most of the time I think he just doesn’t have the patience to deal with things that he doesn’t get right away, since he is so used to everything coming easy.  We have already had about a million discussions about that subject!!

Thanks again for your input.  I will certainly do some brain-storming about other reward options.