Practices

For younger children, make the reward small, concrete and soon. Stickers, points, a smiley face, five minutes of something good, handed over the same hour rather than at the end of the week.

Points that build towards something bigger work well, as long as the point itself arrives immediately. Hourly is not too often for a young child, and…

Keep consequences for the sake of honesty, but let praise and reward do most of the work. Punishment can tell a child what to stop and it cannot tell them what to do instead.

Children with this difficulty collect an extraordinary amount of correction over a childhood, from teachers, from parents, from other children.…

Go looking for the moment the child does the thing you have been asking for, and say so while it is still happening. Most of us watch for the problem and only notice the good behaviour when we have run out of trouble.

It helps to decide in advance what you are hunting for, so that starting the homework without being asked, or waiting a turn, actually registers…

If the internal clock is not there, put clocks in the room. Somewhere the child can see without turning round, a timer on the desk, one on the wall by where they work.

Think of it as a prop rather than a cure. The aim is not to train an ability into existence before the child is allowed to cope, it is to let them…

You did not choose which things hurt you. Where you are tender was set long before you had any say in it, and the only live question is what you do with it now.

This is worth saying out loud between two people, because each usually thinks their own soft spot is embarrassing and the other's is obvious. Try…

There is a real difference between not caring and not knowing how. A lot of what gets called failing at a relationship is simply a skill nobody ever taught you.

If you go blank when your partner cries, or answer hurt with logic, ask who ever showed you anything better. Probably nobody did. A gap like that can…

Before you offer anyone the upside of their ADHD, say the hard part out loud first. One patient's answer to being told it was a gift was to ask where he could return it.

A reframe offered too early does not sound hopeful, it sounds like you were not listening. Name the cost in specifics, the job that went, the…

Before you explain anything about ADHD to someone, ask what they already think it is. What they tell you decides what your explanation can land on.

People arrive with family stories, cultural rules about mental health and firm views about medication, and none of it shows up unless you invite it.…

By the time somebody comes for an assessment, the poor opinion of themselves is usually decades old. Assume it is there even when the person in front of you is visibly doing well.

It rarely arrives as a complaint. It shows up as apologising for taking up your time, as brushing off achievements, as a joke about being useless…

When a young person with ADHD goes through a first breakup or loses a friendship group, stay closer than usual. Do not wait for the next arranged contact.

Rejection lands harder here, and impulsivity shortens the gap between feeling unbearable and acting on it. A short unannounced check in, a lift…

With children, acting a situation out teaches far more than talking about it. Play the scene, swap roles, get it wrong, do it again.

Explaining social rules to a child who missed them leans on the same steady attention that let them slip past in the first place. Rehearsal skips…

Rather than arguing that someone ought to get organised, ask one question. Would your life be better if fewer things slipped, fewer people were annoyed with you, and you spent less of the day worrying about what you had forgotten?

The answer is nearly always yes, and it lands differently when the person says it instead of hearing it. Keep the list concrete and drawn from their…

A child who cannot yet catch their own drifting needs somebody close enough to catch it for them. Where they sit does a lot of that work quietly.

From nearby a teacher sees attention go before the work is lost, and can bring the child back without stopping the lesson for everyone. Proximity…

Bring a child back with the smallest signal that does the job. A tap on the desk, a hand on the shoulder, or simply standing beside them will usually be enough.

Say a child's name across a room and everyone turns to look. Do that twenty times a day and the child learns something about themselves in front of…

Get the child's eyes first, then give one instruction. The page, how much, and by when, and then stop.

An instruction thrown at a busy room never reaches the child who most needs it, so the name and the eye contact come before any content at all. Then…

If a young person hears your suggestion of a planner as one more instruction, they will refuse it, and the refusal is about who is in charge rather than about diaries. Hand over the choice of format and the choice of what goes in.

It helps to be plain that this is theirs and not a monitoring device. That means not reading it over their shoulder and not producing it as evidence…

Anything with more than one step gets written down, and the child does the writing. Ten problems, check them against the answers, correct what is wrong: three lines in their own hand.

A handout would carry the same words, but writing it themselves does two extra things. It puts the sequence somewhere they can look again when step…

Put the rules up on the wall where everyone can see them, and put the child's own version on a card on their desk.

A rule that lives only in memory is not there in the second it is needed, which is the second something more interesting has just walked past. A card…

Some children need to move, and the choice is whether that movement is allowed for or whether it arrives as a disruption later on.

A ball chair, a standing desk, a seat near the front, or permission to walk to the back and return with a nod and nothing said: any of these let the…

While you are talking, have them writing. Notes give attention something to hold onto, and they let you see at a glance who has gone.

Listening on its own asks a child to do nothing visible for a long stretch, and attention quietly drains away with nobody able to tell. A pen moving…