Practices

A child struggling with attention, anxiety and daily reflux at once may be dealing with one problem wearing three coats. Undiagnosed coeliac disease and other food reactions can produce all of it, and the gut symptom is the clue worth following.

Symptoms that arrive together are worth asking about together. If reading, mood and stomach all went wrong over the same period, that pattern is…

You cannot decide to feel closer to people. You can decide to eat with them, walk with them, sit near them and say one true thing, and the closeness tends to follow.

The chemistry gets talked about a great deal and it is the least useful part. What you can act on is the diary: a standing meal with someone, a hand…

Go long enough without company and almost anyone will do. That is worth knowing about yourself, and worth watching for in someone who lives alone.

Loneliness does not make you a poor judge of character on purpose. It just lowers the bar until whoever turns up seems fine. The steadier answer is…

Four ordinary things take the edge off a hot temper: being touched by someone you trust, eating with people, moving your body hard enough to breathe, and sitting still for a few minutes a day.

None of them are about anger directly, which is the point. Exercise lowers what you are already carrying before the argument starts. A shared meal…

If eating together helps, it is the together that is helping. Being full is not a route to feeling close, and treating it as one goes wrong quickly for some people.

Sit down with somebody once a week and eat whatever you were going to eat anyway. That is the whole practice. If you notice yourself reaching for…

The same loss of appetite means very different things in different children. A slight child who was already struggling to gain weight may need a different formulation or a different medicine altogether.

For a sturdy child a smaller lunch is a nuisance. For one with nothing spare it is a reason to change the plan. Non-stimulant options exist and are…

Every workplace runs on a map nobody prints: who really decides, who to ask, what the polite route is. Picking that up by osmosis is exactly the channel that struggles here.

So you follow the written process, do it correctly, and it goes wrong anyway, and nobody can tell you why. The repair is to have it taught rather…

When appetite disappears at lunchtime, work with the child's rhythm instead of against it. Feed them properly at the hours they are actually hungry, which is usually breakfast and then the late afternoon and evening.

What counts over a week is the total, not whether it arrived at the socially correct hour. A decent breakfast before the medicine takes hold, a light…

Non-stimulants are usually tried after the stimulants rather than instead of them, mostly because they are harder to tolerate. That is about order, not about the drug being second rate.

There are people for whom one is the right first choice: tics, real anxiety alongside, a history that makes a stimulant a poor idea, or a body that…

Treat the first fortnight as a stretch that needs contact rather than silence. Say plainly that things may feel worse before they feel better, and arrange to hear from the person during that window instead of after it.

This is when most people quietly stop. Somebody who has been warned experiences a rough two weeks as expected; somebody who has not experiences it as…

A long acting injection into muscle releases its medicine slowly over weeks. It lifts the daily burden of remembering, at the price of not being able to stop quickly if the medicine disagrees with you.

That trade is worth naming out loud rather than settling on someone's behalf. For a person whose entire difficulty is the daily doing, weeks of cover…

Arrange to meet someone. A neighbour at the gate at eight, a friend expecting you, even an app counting a streak. Turning up for someone else is easier than turning up for yourself.

Benefits that arrive in six months are weak motivators. Something that pays out today works better: a person waiting, a number that goes up, a…

If a child is climbing the walls, green space helps most, a walk down a busy street helps a bit, and staying in the room helps least. Any of the three beats none.

The research on this puts them in that order rather than saying only a forest will do. A park, a scruffy playing field, the bit of grass behind the…

Bolt the movement onto something you would want to do anyway. A game with a friend, a walk to somewhere with good coffee at the end, a route past the river.

People keep up a weekly game with a mate for forty years and never once call it exercise. The friendship is what they turn up for and the moving…

Clumsy is not a description you can work with. Balance, core strength, shifting your weight, big movements, small ones, catching a ball, keeping a beat: those you can look at one at a time.

Break it down and you usually find a child is fine in four of those and struggling in two. That turns a vague sense that they are awkward into…

Not every family can get occupational therapy. Almost anyone can get outside with a skipping rope, a long rope turned by two people, or a board.

Skipping and boarding ask for much of what a therapist would be working on anyway: both sides of the body keeping time with each other, judging the…

Children need to move before school, during it and after it. Keeping a child in at break until the work is finished takes the movement away from the very child whose finishing depended on it.

Break time is not the whole of it either. A few minutes on their feet between lessons, a walk before the day starts, something physical when they…

A weighted vest seems to do its work in roughly the first quarter of an hour. Twenty minutes did not beat fifteen, so longer is not more help.

Use it as a tool for a moment rather than a garment for the day: on before the piece of work that needs the most sitting still, off once that is…

If you are thinking about a weighted blanket or vest for a child, let an occupational therapist set the weight. It is a specific number for a specific body, not something to guess at in a shop.

The pull to order one straight away is understandable, especially after months of bad nights. What an OT does is match the weight to the child's size…

When a test trips a child on something it was never meant to measure, change how they answer rather than what is asked. A spelling test spoken aloud is still a spelling test.

One girl saw letters as solid three dimensional shapes that would not sit together on a page, so writing them was a perceptual problem rather than a…