Practices

A long stretch at home is never neutral time. It teaches two things at once: staying away stops the dread, and staying away is pleasant.

That double lesson is why a few months out is so much harder to undo than a few days. First comes relief, then the slow morning, the screen, the…

If escape is holding the pattern in place, the plan closes off the escape a step at a time. If what waits at home is holding it, the plan moves those good things to the other side of the effort.

Most stuck cases are stuck because only one half was addressed. A careful ladder of steps does very little while the afternoon at home is still the…

If a child is at home, run the day as though it were a school day. Same wake time, same breakfast, bag packed, work starting when lessons would have started.

Ten hours of sleep followed by a slow morning turns home into somewhere far nicer than school, and a body clock that drifts later makes the next…

When a young person is struggling to launch into adult life, it is usually two things at once: the practical scaffolding, and the social side. Work on one only and the other tends to pull it down.

Calendars, laundry and deadlines are the visible half. The harder half is friendship, saying no, asking for something, being alone in a room full of…

If you have been the one holding someone's schedule, meals and reminders together, do not put all of it down on the day they leave. Pass it over a piece at a time, each with a date on it.

Write out what you are actually doing for them: waking, appointments, repeat prescriptions, food, deadlines, forms. Most families are surprised by…

The next step has to be theirs. A job that looks like nothing to you might be the first thing in two years they chose without being pushed, and that is exactly why it holds.

Parents tend to want the step that recovers the lost ground. The young person needs the step they can actually take on Monday. Shifts in a shop, one…

When someone has shut down, pressure to get moving usually pushes them further in. Safety first and activity afterwards, even when the whole household is desperate for a sign of life.

Safety here is ordinary and physical. Food that turns up without being asked for. A room nobody is inspecting. Conversation that is not a progress…

Often the most useful thing a clinician does is not delivered by the clinician. It is delivered by the teacher, or the parent, after a conversation you had with them.

Taking that seriously changes how the hour gets spent, towards talking with the school, coaching the parents and designing the arrangement, and away…

The classroom is the strongest place to help and most clinicians cannot get into one. That is a reason to work well in the next best place, not a reason to give up.

ADHD sits in how a brain is built, and the work is on the executive skills themselves rather than on attitude or effort. Where the moment of…

If you are testing whether a food affects you or your child, the test has to be complete. Among children with suspected sensitivity to artificial colouring, most reacted to as little as 100 mg, so a bit left in is enough to blur the answer.

What usually happens is that a family removes the obvious sources, misses the ones hidden in medicines, sauces and cereals, sees no change, and…

Cutting artificial preservatives out can genuinely help a child who reacts to them, because a child who feels unwell behaves worse. What it does not do is treat the ADHD underneath, which will still be there once they feel better.

Worth being clear with yourself about what you are hoping for, because these diets are expensive and hard to keep up. If your child does have…

Gluten free and dairy free eating is essential in coeliac disease and in a genuine milk allergy. Neither one treats ADHD, and putting a child on them without a reason carries costs of its own.

The cost is not only money and nutrition. It is the birthday party where they cannot have the cake and the lunch table where their food is different…

If you are going to test whether a food matters, work out in advance where the plan will leak. School lunch swaps, a grandparent's biscuit tin, your own memory on a hard week: all of it decides whether the answer means anything.

Change one thing at a time and keep everything else steady, otherwise you cannot tell which change did what. Then be honest about who is running the…

Nobody puts a child who cannot swim into the shallow end and calls it teaching. Before anyone goes near the thing they dread, they need something to do with their body and their head when the fear arrives.

It takes only one overwhelming attempt to teach the opposite of what was intended: that it really was too much, and that the adults will push anyway.…

If you run a group for people with ADHD, keep it to about five or six, or bring in a second facilitator. Past that you spend the session keeping order instead of doing the work.

The limit is not really about behaviour. It is about how many people one person can genuinely track while also holding the thread of the session.…

If reminders, other people's deadlines and a bit of chivvying are what keep you moving, you are allowed to keep them. Inner drive arrives later for some of us, and taking the scaffolding away early does not hurry it along.

Families often pull the supports back on a birthday, as though a certain age should switch on self-direction. What tends to happen is that the only…

When a child with attention difficulties is also at war with every instruction, that pairing is worth taking to someone early rather than waiting to see whether it settles.

The two travel together often, and a minority of children follow a path from constant defiance into more serious trouble later. Every stage of that…

When a child truly does not mind losing the privilege, taking more away will not get you anywhere. That is the moment to change approach rather than raise the stakes, usually to a structured parent programme that works on the pattern between parent and child.

Star charts fail with these children because the reward was never the point of the behaviour. What helps is a proper course of parent management…

After a course of intensive work, this student's sound skills moved from the middle of the range to near the top. Average was never the ceiling. It was simply where an untreated difficulty had left them.

Hearing single sounds in a word, holding sounds in memory, repeating made up words: all of them shifted a long way once the teaching was right. That…

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…