Practices

Try swapping the word picky for particular. A fair number of people with ADHD have more densely packed taste buds, so the bitterness in a sprout arrives at full volume.

That changes what is going on at the table. A child is not refusing in order to be difficult, they are tasting something stronger than you are.…

When a parent is set on something that will not hold, one honest story often lands better than a pile of studies. A family finished the better part of a year of neurofeedback and watched their child slide back to where he started within weeks.

Told plainly, with no note of triumph in it, a story like that raises durability without telling a parent they were foolish. They were not foolish.…

Saying that something does not work leaves a parent holding the same worry that sent them looking in the first place. Say what the time and money would buy instead, and put exercise at the top of the list.

The energy behind an unevidenced treatment is usually love with nowhere to go, and if it is not given somewhere to go it moves on to the next…

Ask which direction a person's sensory difficulty runs before offering anything. Someone who is under responsive needs more input and someone who is over responsive needs less, and the wrong one makes the day harder.

The under responsive child is the one climbing, chewing, pressing into things, hunting for sensation in order to feel settled. The over responsive…

Keep something to eat and drink within reach for hard conversations. Handing someone a biscuit and a glass of water often settles a room faster than any instruction does.

Part of why it works is that nobody has to be told how. A person too wound up to follow a breathing exercise can still take a sip and chew. Sharing…

Ask what someone takes that is not food, rather than asking what medications they are on. People do not file their supplements under drugs, so the usual question comes back empty.

There is a case worth carrying around for this. A liver transplant patient kept rejecting the organ, and it turned out he was quietly taking…

More clinicians now raise supplements themselves, and more of them will suggest something like omegas. The shift matters less for what gets recommended and more for what it does to disclosure.

People hide what they expect to be laughed at. Someone braced for an eye roll simply does not mention the four bottles in the kitchen cupboard, and…

Sensory integration training is popular and it does not help ADHD. Whatever value it has elsewhere, the capacity it works on is not the one that is impaired here.

What is impaired in ADHD is holding back a response and steering your own behaviour over time. Sensory modulation is a different thing altogether.…

A child can learn a self control routine beautifully in the therapy room and not use it once all week at school. Knowing the steps and performing them under pressure are two different skills.

This is why supports that sit in the moment tend to beat supports that sit in the mind. A prompt at the point of need, a changed seat, a rule the…

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…

Ask for photographs of every bottle rather than a list from memory, then pass that list to the prescriber. Recall is patchy about names and hopeless about doses.

Intake forms catch some of it and a photo of the shelf catches the rest, including the two things nobody mentions because they seem too minor to…

Food colouring is the one narrow exception in this area. Large studies suggest it may mildly wind up some very young children, so a trial removal in a preschooler is a reasonable thing to do.

Keep it in proportion though. This is a minor irritant in a subset of little children, nowhere near the sweeping dietary cause that was claimed…

The restrictive elimination diet has real methodological problems, and it is expensive and exhausting to run. If a family still wants to try it, they can, because unproven and dangerous are different words.

There is usually more to lose by forbidding it. A family who feels blocked either does it anyway without telling you or spends another year…

Benzodiazepines turn the volume down. They do not change the setting the volume keeps returning to, and it is worth saying that plainly before someone starts one.

They work by strengthening the braking system the brain already runs, which is why they act quickly and why they need that braking chemistry to be…

Within this class the choice is mostly about how long the drug lasts rather than how well it works. They all pull on the same receptor, so the real question is what pattern of cover the person in front of you needs.

A short-acting one taken as panic arrives gives sharp relief and teaches the person to keep it in a pocket. A longer-acting one gives smoother cover…

The strengthened warning on this class covers misuse, addiction, physical dependence and withdrawal. The part most people miss is that dependence builds with ordinary correct use over weeks, with nobody doing anything wrong.

That distinction needs handling gently, because patients hear dependence and hear addict. Physical dependence is the body settling around something…

If the screen limit in your house is only your preference, every evening turns into a negotiation about your preference. Borrowing a published figure, roughly two hours a day of leisure screen time for a child over two, moves the argument off you.

The carve-outs matter as much as the number. A video call with a grandparent is a conversation, and a laptop open for homework is schoolwork, so…

For a child who finds face to face conversation frightening, a game where they talk to friends while doing something else may be the only place they socialise at all. Worth noticing before you count the hours.

Talking through a headset takes out most of what makes conversation hard: no eye contact to hold, no faces to read in real time, no silence to fill.…