Practices

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…

What frightens a body is usually not how hard a thing is, it is having no way out. So put movement as an offer. If it feels alright, you might try lifting your arms.

The wording is doing quiet work here. Lift your arms, and see what happens if you lift your arms, are the same physical event, but only one of them…

Whatever a person walks in carrying belongs in the practice. The ache in the hip, the irritation, tears that arrive for no reason, the part that thinks all of this is nonsense.

Complex trauma teaches people to leave pieces of themselves at the door, and a yoga mat is an easy place to carry on doing exactly that, particularly…

When you start paying attention to your body, things wake up. More feeling, a deeper breath, memories arriving sideways. That is the practice working, not the practice going wrong.

Say this at the start, not afterwards. People who were not told tend to decide the movement made them worse and stop, when what actually happened is…

Keeping your eyes open holds you in the room while you feel what is going on inside. One channel on where you actually are, one on yourself.

Closed eyes are the default in most classes and they are not always kind. When a lot is stirring, letting the eyes stay soft but open, so the light…

Play belongs here. Being a lion, a tree, a hissing snake, the way children do it with no embarrassment at all.

A lot of people meet trauma work as something solemn, and solemn is easy to sit through without ever softening. Silliness is harder to fake. If a…

Going silent and hard is not a neutral act. A fixed stare and a set brow land on the other person's body as threat, even though you have not said a word.

People often think they are being restrained when they go cold, and are then surprised by how frightened or defensive the other person becomes. If…

Before anyone does something exposing, let them check their own conditions and give them a clean way to say no. A public yes given under pressure is not really a yes.

It can be as ordinary as asking someone to consider whether they have the privacy, the time and the state of mind for this today. Ask it first and…

You can be genuinely indignant and still say the thing evenly. The feeling does not have to travel in your voice.

Notice what actually changes when the heat comes out of it: the words stay, the point stays, the volume and the edge go. It helps to know beforehand…

Saying it is done when it is not is a common next step, and it makes more sense than it looks. The lie is rarely about the parcel, it is a way out of the look on somebody's face.

It also makes everything worse, because being found out turns a forgotten task into a trust problem, and that is a much longer repair. If this is…