Areas › Focus, starting, and ADHD
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
48 practicesTheme · Treatment and medication
How long you have
When · Any ordinary day
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Play based programmes that build executive skills in young children have done reasonably well with children at risk of struggling at school. None has yet been tested in children actually diagnosed with ADHD, and that is a real difference rather than a technicality.
Results found in a broad at risk group tend to shrink, sometimes to nothing, when the same thing is tried with clinically diagnosed children, where…
Showing a teenager live pictures of activity in one targeted part of their own brain has been tried once, in a small trial, and it looked encouraging. That was around a dozen young people, and nobody has repeated it yet.
This is worth knowing about mainly so you can tell it apart from the neurofeedback that is widely sold. The clinic version reads surface brain…
There is a headband worn at night that stimulates a nerve in the face, cleared by regulators and tested against a dummy version in a single trial. Some children improved. Some felt sick or slept badly and stopped.
Regulatory clearance answers whether a device is safe enough to be sold, not whether it beats what you are already doing. One trial, funded by the…
Magnetic stimulation of the brain has been tried for ADHD and has not yet shown anything. The studies are small, often single cases, and not built in a way that could give a trustworthy answer.
Small uncontrolled studies are generous places. Hope, attention and the freedom to report only the good parts all push results upwards. That does not…
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…
People who use several kinds of help tend to report more benefit than people relying on one. Medication, therapy, coaching, reading, sleep and movement all seem to add something rather than compete.
That turns a hard conversation into an easier one. Instead of pressing a reluctant partner towards the single thing they least want, you can offer a…
Managing the ADHD is not the goal. Being happy together is the goal, and the ADHD work is only worth doing to the extent that it gets you there.
Keeping that order straight changes the atmosphere of the whole effort. A partner who has spent years being a project stops being one. Requests stop…
Two ideas will let you judge most claims for yourself. In a good trial nobody involved knows who got the real treatment, and a study of five people can be swung by one of them having a good month.
Researchers want their treatment to work, and that hope leaks into how they rate what they see, which is why the person handing out the pill and the…
Programmes built on crossing the midline or on balance and inner ear work do not appear to beat ordinary exercise. If movement is what you are after, movement is available free.
These packages come with a theory about why they work, and the theory is usually where the confidence comes from rather than from the results. What…
Massage may well leave you calmer, and calmer is worth having. It is not a treatment for ADHD, and the two are worth keeping in separate boxes.
Living with ADHD is stressful in a measurable way, so anything that genuinely lowers that load is doing real good and deserves a place. The error is…
Do not write off simply sitting with someone. When researchers looked into why dummy treatments helped, one of the things they kept finding was half an hour of a person's full attention.
Thirty minutes of someone listening properly to your difficulties is not filler around the real treatment. Across the talking therapies, who the…
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,…
One social approach does have a real evidence base behind it, and what makes it different is who delivers it. Parents do the coaching, in the middle of actual play with actual friends.
In practice it looks small and ordinary. You set up a play date, you stay within earshot, you give a nudge before things tip over, and afterwards you…
Coaching for adult ADHD comes down mostly to one thing: a standing appointment with somebody who will ask how it went. That sounds thin until you have tried keeping a plan alive entirely on your own.
A coach is not a therapist and does not need to be. They hold the horizon you keep losing and the fortnight that has quietly gone by, and they make…
Mindfulness for adult ADHD is promising and thinly researched at the same time. If it helps you, that is worth having. It is simply not yet in the same bracket as medication or practical therapy.
There are only a handful of studies, mostly small, and few of them set mindfulness against another active treatment rather than against not much.…
A great many people are diagnosed and then left with a starting dose nobody ever revisited, no reading, no group, nothing else at all. If things have stalled, the first thing to check is whether the treatment was ever actually finished.
Optimising is unglamorous and often the quickest thing available. Was the dose ever adjusted upwards, and on what basis. Does the cover reach the…
If the prescriber, coach or therapist is not delivering much, say so and ask for someone else. Working around poor care quietly is the thing that convinces a couple this is simply as good as it gets.
A dose never revisited, or a therapist who has never worked with ADHD, sets a low ceiling. The trouble is that the ceiling gets read as the person:…
Sleep, food and movement will not cure anything, but they lengthen the fuse. Bad moments still arrive, and you handle them differently when your body is not already running on empty.
This matters more here than it sounds, because ADHD tends to wreck exactly these three and then the wreckage feeds back into the flare ups. Late…
The diet evidence has drifted away from cutting particular things out and towards eating decently overall. That is easier on everyone at the table.
Removing additives or colourings helps a small number of children, and the trouble is that you cannot tell in advance who they are, so most families…
Think of ADHD as sitting at the centre of an onion. Poor sleep, sleep apnoea, low vitamin levels, allergy, ongoing pain, untreated anxiety or low mood all sit in layers around it, and each one makes the centre look worse than it is.
This explains something that otherwise looks strange: treatments that do nothing whatever for ADHD can still make a real difference, because they…