Practices

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…

For most people who get as far as asking for help with ADHD, medication is the single change that shifts the most. It is not compulsory and plenty live well without it, and it does deserve an honest look rather than a place at the back of the queue.

The reason is unglamorous. Nearly every strategy anyone teaches assumes you can pause before responding, hold a plan in mind while doing something…

If you are not the one prescribing, you can still take an active part in the medication conversation. You see the person weekly and hold the ordinary detail their prescriber never gets to see.

Ask what they notice and write it down in their own words. With their permission, send the prescriber a short note that can be read in a minute: when…

A child who has spent years being told they are careless will often say yes to whoever finally seems glad of them. Work on how they see themselves is not a soft extra to the clinical work.

Count the corrections in a single day and it is easy to see what accumulates. By the time an offer comes from someone friendly, the pull is belonging…

Most people who try do find something that helps, but often not the first thing they try. Not responding to one class of stimulant says surprisingly little about the other.

The high response figures you may have read come from people who worked through more than one option, not from one prescription going well. Response…

One of the founding figures of biological psychiatry summed the whole business up as some medicine helping some people at some doses some of the time. Knowing that before you start makes the first disappointment much easier to survive.

Most people need more than one adjustment: the dose, then the timing, sometimes the drug itself. Go in expecting the first prescription to be the…

When you need to correct one person, say it to the room. Everyone gets the instruction and nobody gets the sting.

Good instructors do this without thinking: they see one child dropping their guard and say that everybody needs to keep their hands up. The teaching…

Use a timer you can see rather than a warning you have to remember. A dial that shrinks, or a light that goes from green to red, does the work that five more minutes never quite does.

Time is not something everyone feels passing. Turning it into something you can look at moves the job from guessing to seeing, which is much easier.…

When someone describes a day like that, do not answer with a lecture on living better. Say that this is hard, and that you find parts of it hard too.

They have heard the virtue speech many times already and it has never once helped. Admitting that you also struggle to exercise, or to keep up with…

Teaching a child to fight works better when it comes with a plain rule: you defend, you never start it. The rule is doing as much work as the training.

A child whose brakes are slow benefits from having the decision made in advance, out loud, many times over. Then it is not something to work out in…

Before you decide a club is out of reach, ask. Some let children earn the uniform through the levels, and plenty have quiet arrangements for families who need them.

Cost keeps more children out of these things than lack of interest does. A single phone call is worth making, and the answer is often better than the…

A scheduled break does not break concentration. It is the unplanned wandering off that does that, and a known break tends to replace it.

Teachers usually expect movement breaks to shatter the lesson and find the opposite: children come back more easily because the break is part of the…

When nobody has checked whether a benefit lasts, that is not the same as finding out it does not. Following people up for a year costs money that most studies never had.

Two mistakes sit either side of this. One is reading a gap in the evidence as bad news. The other is assuming something lasts because a trial…

Speech has a beat inside it. When a child cannot hold a steady rhythm, that often sits alongside difficulty with reading and with the flow of talking, so time spent clapping or tapping a beat together is doing something real.

You need nothing for this. Clap a slow pattern, ask them to clap it back, then keep it running while you both count or walk in time to it.…

Start the movement slow enough that it is almost boring. Speed it up once it has gone smooth, and only then add the thinking part.

Throwing a beanbag back and forth, bouncing a ball, drumming on the table: pick something plain and let it become automatic before you make it…

When somebody does not take up the movement you suggested, ask what got in the way before deciding they did not want to. Usually it is money, childcare, transport or time.

Cost, an awkward class time, nobody to watch the children, a room full of people you would have to make conversation with. None of that is…

If you are the therapist, you do not need to become the movement teacher as well. Sending somebody to a person trained for it is the better version of helping.

The evidence is for movement alongside therapy, not for therapy with a few stretches added by someone who picked them up from a video. Handing it…

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…