Practices

When a young person is struggling to launch into adult life, it is usually two things at once: the practical scaffolding, and the social side. Work on one only and the other tends to pull it down.

Calendars, laundry and deadlines are the visible half. The harder half is friendship, saying no, asking for something, being alone in a room full of…

If you have been the one holding someone's schedule, meals and reminders together, do not put all of it down on the day they leave. Pass it over a piece at a time, each with a date on it.

Write out what you are actually doing for them: waking, appointments, repeat prescriptions, food, deadlines, forms. Most families are surprised by…

The next step has to be theirs. A job that looks like nothing to you might be the first thing in two years they chose without being pushed, and that is exactly why it holds.

Parents tend to want the step that recovers the lost ground. The young person needs the step they can actually take on Monday. Shifts in a shop, one…

When someone has shut down, pressure to get moving usually pushes them further in. Safety first and activity afterwards, even when the whole household is desperate for a sign of life.

Safety here is ordinary and physical. Food that turns up without being asked for. A room nobody is inspecting. Conversation that is not a progress…

Often the most useful thing a clinician does is not delivered by the clinician. It is delivered by the teacher, or the parent, after a conversation you had with them.

Taking that seriously changes how the hour gets spent, towards talking with the school, coaching the parents and designing the arrangement, and away…

The classroom is the strongest place to help and most clinicians cannot get into one. That is a reason to work well in the next best place, not a reason to give up.

ADHD sits in how a brain is built, and the work is on the executive skills themselves rather than on attitude or effort. Where the moment of…

If reminders, other people's deadlines and a bit of chivvying are what keep you moving, you are allowed to keep them. Inner drive arrives later for some of us, and taking the scaffolding away early does not hurry it along.

Families often pull the supports back on a birthday, as though a certain age should switch on self-direction. What tends to happen is that the only…

When a child with attention difficulties is also at war with every instruction, that pairing is worth taking to someone early rather than waiting to see whether it settles.

The two travel together often, and a minority of children follow a path from constant defiance into more serious trouble later. Every stage of that…

When a child truly does not mind losing the privilege, taking more away will not get you anywhere. That is the moment to change approach rather than raise the stakes, usually to a structured parent programme that works on the pattern between parent and child.

Star charts fail with these children because the reward was never the point of the behaviour. What helps is a proper course of parent management…

There are two jobs here, not one. Free up the time, and then be able to sit in it without feeling like a fraud.

Working more efficiently buys hours back, and that is the easier half. The harder half is the belief that rest is only for people who have finished…

There is a rough ladder for tech overuse. Build a schedule together with some outside control at first, add substitutes once the person can stop for a while, then more intensive care, and residential only when someone is entirely taken over by it.

The order matters more than the rungs. You cannot install a better alternative in someone who has no capacity yet to put the thing down, so a bit of…

Where you can, let the learning be something done rather than something sat through. Typing instead of writing, a calculator instead of longhand, a built model instead of an essay.

The knowledge is usually already there. What fails is showing it through a long, still, low feedback task, and that is the part worth redesigning.…

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.…