Practices

There is a rough benchmark for homework: about ten minutes a night per school year, so a child in their first year does ten minutes and a final year student tops out near two hours.

It helps to have the number before a school meeting, because "this is too much" sounds like an opinion while a benchmark sounds like a standard. Some…

A rule that holds in your house and nowhere else is not really a rule. Children locate the unrestricted house within about a week.

So the awkward job is the useful one: a short message to the parents of the two or three friends your child spends most weekends with, agreeing…

Sleeping tablets, sedatives, antihistamines and alcohol all pull on the same brake. Whoever is prescribing needs the whole list, including the things that do not feel like medicine.

People rarely mention a nightly drink or a sleep aid bought off the shelf, because neither feels like part of the treatment. Together they can add up…

If you have been given a drug from one category for a problem in another, it is fair to ask which part of it is doing the work. Often the useful effect is a side effect that has been borrowed.

The common example is an antipsychotic given in a small dose for sleep, where the drowsiness comes from its antihistamine action rather than from…

Saying that you do not know, and then showing where you would look, beats an answer improvised on the spot. It also teaches the person asking how to check things for themselves.

Name the limit, name the source you would go to, and offer to come back with what you find. Systematic reviews and an ordinary scholarly search will…

These medicines work on a timescale of four to six weeks, not days. Say the number out loud at the start, because someone expecting relief this week will have decided by Friday that it failed.

Something does happen on the first day, but it is only the first step of a change that takes weeks to finish. The useful version of this is a date:…

Describe what the first fortnight might feel like before the first tablet, not after the first worried phone call. A warning given in advance turns a bad week into a milestone.

The wording can be plain. Some people feel more wound up for the first week or ten days, it usually passes, and nobody changes anything without…

Wanting it to stop right now is not a character flaw, it is what anxiety does to a person. Saying the hurry out loud, instead of acting on it quietly, keeps it from making the decisions.

That urgency is the reason people creep a dose up, hop between supplements, and abandon anything slow before it has had a chance. Treating the hurry…

The dose that lifts low mood is often not enough for anxiety, and for obsessive symptoms it is usually well short. Needing more of it is a feature of the problem rather than anything wrong with the person taking it.

This matters because a fair trial of something has to include a fair dose. A person can spend eight weeks on a starting amount, decide the medicine…

Somebody will eventually ask you whether you want what is best for your child. It is a sales line, and knowing that in advance is most of what you need to withstand it.

Parents of a newly diagnosed child are frightened, motivated and often exhausted, which is exactly the state that gets marketed to. The question is…

Decide at the start what you are actually aiming at. Eight difficulties down to six, then to four, then perhaps to two. Never zero, because zero was never on offer.

Everybody has some of these traits, and ADHD is largely inherited, so a life with none of it was never a realistic target for anyone. Naming a number…

Hear this before you start rather than after: change here is gradual. Habits built over twenty years do not come apart in three weeks.

Waiting is genuinely harder with ADHD, and a treatment whose reward is months away is exactly the sort of thing that gets dropped in week five.…

Everything has side effects, including doing nothing. The only real question is whether what you gain outweighs what it costs you.

The conversation about medication often gets set up as a risky drug against a safe natural alternative, and that is not the choice anyone is actually…

What a person expects from a treatment genuinely changes what they get from it. That is not a trick to be exploited, and it is not nothing either.

In some trials the dummy treatment helps around half the people who receive it, and there is work showing benefit even when people were told outright…

Treatment is not only about school reports. Lower rates of accidental injury and of other serious harms are reasons in their own right, even for a child whose marks are perfectly fine.

This is the answer to the question about the bright child who is coping academically and whose impulsivity worries you in traffic, on a bike, or…

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…

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…

Said plainly, because it should be: medication is the most effective treatment for ADHD, and by a good margin. Everything else in this area is something you add to that decision, not something that replaces it.

This is not a push to medicate. Families weigh side effects, age, other conditions and their own convictions, and those are proper things to weigh.…

If a treatment comes with a contract, take it to a solicitor before signing. Not because you cannot read it, but because that puts a few days between the pitch and your signature.

Being told not to sign rarely helps, and it asks somebody to admit in the moment that they might act rashly, which almost nobody does in front of a…

Paediatric and psychiatric bodies have moved towards treating earlier than used to be usual. The reasoning is that the damage builds on itself.

A year of falling behind makes the next year harder, a reputation among classmates is quick to form and slow to shift, and a household that has been…