We held our son back in third grade and it was the best thing we ever did. He was "fine and average" academically, but with the wrong peer group. Chronologically he was their age, however, he was very young developmentally. (He had strep 3 times in second grade.) We moved him in Jan. and the kids were educated and prepared before the move. It went so smoothly and he was so relieved to be where he belonged. I NEVER thought it could go so well or be so easy. Having academic stress on top of the "regular PANDAS worries" is tough. If you do decide to "change grades" (that's what we called it) it will probably be far more difficult on you than on your sweet girl ) Uggg. I remember how hard this decision is Good luck with yours!