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Focus, starting, and ADHD
Most advice about focus is written for a brain that starts easily. This area is not. It covers what ADHD actually is, how to make a start when starting is the hard part, how to bring a future consequence close enough to feel, and how to stop paying for it in shame.
Narrowed down
10 practicesTheme · Treatment and medication
How long you have
Approach · ADHD skills
When · Any ordinary day
This explains how treatments work. Never start, stop or change a medication because of something you read here.
The point of treatment is not a tidier score on a questionnaire. It is fewer accidents, a finished course, work that holds, relationships that survive, a longer and better life.
Symptoms are worth reducing because of what they do downstream, and that is where the goal should be set. It changes what you review, too. Instead of…
After a working lifetime in this field, Barkley names the change in how a family sees the child as the most important step of all. Not the medication, not the charts.
The reason is practical rather than sentimental. Every other part of treatment asks parents to keep going for weeks with very little to show for it,…
Being told ADHD is largely inherited can sound like being told nothing can be done. It does not follow, and the two questions are separate ones.
How much of something a person shows, day to day, moves a good deal with what is around them, even when the underlying trait is strongly heritable.…
A child can be almost trouble free with a grandparent who has all afternoon for them, and impossible in a class of twenty five. Same child, same condition, very different demand.
What a setting asks for is the ratio between the self control a person has to supply and the structure being supplied for them. One adult, close…
Two of the three big advances in ADHD over recent decades were not new treatments at all. They were clearer thinking about what the difficulty actually is, and honest accounting of what psychological treatment can and cannot deliver.
Understanding ADHD as a problem of self regulation rather than a shortage of attention changed what help gets aimed at. Knowing which psychosocial…
A ramp does nothing for someone's legs, and it gets them into the building. Timers, visible clocks, a shorter task list and a calendar somebody else keeps do the same job here.
Accommodations are not treatment and they are not pretending to be. What they do is take the parts of the work that live inside a person's head,…
Think of it the way you would think about diabetes. Something to manage with several things at once, most days, for as long as it is there.
That frame does a lot of quiet work. It says the treatment is ongoing rather than a course you finish, it explains why things slide back when…
The stack goes: understand it, medicate where that is right, change what the adults do, change what the day asks, and keep arguing the child's corner. Each layer does a job the others cannot.
None of them stands in for another, which is why swapping one out leaves a gap rather than a smaller plan. Medication does not reorganise a…
Behaviour work for ADHD is mostly about changing what the adults do. The child's behaviour shifts afterwards, as a consequence.
Consequences live in other people's responses, and a child who cannot yet hold a reward in mind across three days cannot supply them for themselves.…
The trouble now is not that nothing works. It is that the things which work are spread unevenly, and whether a family gets any of them depends heavily on where they happen to live.
Medication travels reasonably well, since a prescriber can be found in most places. The psychological and behavioural work travels badly, because it…