Practices

Somewhere between five and ten children in every hundred struggle to get to school at some point, and one or two of those need real help with it. Your family is not a strange case.

It feels rare because nobody mentions it at the school gate. In a school of a thousand that is a dozen or more children needing active support at any…

Anxiety is the most common mental health difficulty of childhood, with something like a third of young people meeting the threshold at some point and a smaller group badly held back by it. Both halves of that are worth saying.

The first half is for the shame: this is ordinary, and keeping it secret is its own kind of avoiding. The second half is so that nobody hears…

A plan followed on some days and not others can be worse than no plan at all. Choose the smallest version you are sure you can keep to, and keep to that.

When staying home works on one morning in four, that occasional success makes the pleading more determined rather than less. Cut the plan back until…

Someone who will tell you the part that was not good is someone whose 'that was fine' you can believe. That is what settles the doubt, not reassurance.

Blanket praise carries no information, so it slides off and the doubt is back within the hour. If you tend to worry about how you came across, ask…

Not knowing how to do an ordinary thing, a bank transfer, a form, a phone call to book something, says nothing about your intelligence. It says nobody ever sat down and showed you.

These gaps hide well, because they embarrass people in a way that larger problems somehow do not. Someone can talk fluently about difficult ideas and…

Health advice usually assumes a kitchen, a fridge and money for the week. If you are working with less than that, the answer is not to try harder at the advice. It is to shrink the plan until it fits what you actually have.

A plan you cannot keep does more than fail. It quietly adds to the pile of evidence that nothing you do makes any difference, and that pile is heavy…

A wave across the road, a joke with the man in the shop, asking someone how they are and meaning it. These unplanned seconds count for more than they look like they should.

They are also the easiest place to start when arranging a proper meet up feels like too much. Almost nothing is at stake in a greeting, so a fear of…

When someone has gone flat, the question is not what they ought to be doing. It is what still has any life in it for them, however small or unimpressive, and then how to get more of that.

Activities handed out from the outside do not lift much. Someone who brightens talking about their car, or a cousin, or a game has just given you the…

When somebody looks like they have stopped caring, it is often that they have stopped expecting it to go well. Giving up on yourself tends to come after a long run of trying and being told it was not enough.

That changes what helps. Another plan, another chart, another talk about wasted potential all land on the wrong problem. What shifts things is a…

Some of what looks like muddle is the system's fault. Our tenth month is named for eight, because two months were added later and nobody renamed the rest.

Worth saying to anyone who feels stupid about dates and forms. A calendar whose numbers are out of step, a tax year starting in April, forms asking…

Let the breath go along with the movement rather than counting it out. If you are guiding someone, do not set the pace of their breathing for them.

Being told exactly when to breathe in and out is unpleasant for more people than you would expect, and for anyone whose breath was held tight through…

When a child keeps failing at a task, try reducing what it demands of attention and memory before you increase the practice. Shorter steps, one instruction at a time, the working written down where they can see it.

Attention, holding things in mind and switching between steps all set a ceiling on how much of a lesson gets through. You cannot easily raise that…

Pouring more in does not help while the lid is still on. A child who is exhausted, wound up or not yet settled will keep very little of the lesson, however good the lesson is.

Do the settling first, even when it costs ten minutes of the hour. Sleep, food, movement and a calm start look like the soft part of the day and they…

A child who talks well, listens well and seems bright will have their reading failure read as laziness. The strengths are exactly what makes the blame stick.

Strong spoken language, decent attention and an easy manner give an impression of capability that nobody can square with work coming back unfinished.…

Doing badly on one long acting product does not mean the medicine inside it was wrong for you. The same molecule in a different capsule can behave differently enough to be worth trying before anyone gives up on it.

What gets described as the medicine not working is often the shape of the day being wrong: too slow to start, too abrupt at the end, strongest at the…

People usually stop for one of three reasons: the side effects are not worth it, the price is too high, or the dose was never raised far enough to do anything. The last one is the saddest, because it makes a workable medicine look useless.

If a trial ended with the words nothing happened, it is worth going back over what dose was actually reached and for how long it was held there. A…

Before anyone concludes that medication does not work for you, check what dose was actually reached. Doses in general practice often stay lower than a specialist would use, and a fair share of so called non responders respond once the dose goes up.

You are allowed to ask this, gently and without any accusation in it: what was the highest dose tried, and how long did it stay there? A trial that…

If one family of stimulant did nothing, or felt awful, that tells you very little about the other. Methylphenidate and amphetamine work in overlapping but different ways, and plenty of people who do badly on one do well on the other.

Stopping after a single class is one of the commonest routes to believing that nothing helps. Trying the second one is a normal next step rather than…

For someone who cannot swallow tablets, or whose mornings fall apart long before the tablet gets taken, patches exist that release medicine slowly through the skin over hours.

Going through the skin skips the first pass through the liver and smooths out the peak, which changes the timing and sometimes how well it is…

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…