Practices

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…

Unstructured play in a big open space settles a child. A structured class teaches them how to be with other children. You want some of each, for different reasons.

If you only ever book the class, you take away the roaming that calms them down. If you only ever send them out to roam, they miss the taking turns…

For a child having a hard time, one adult who plainly thinks well of them makes more difference than almost anything else. A coach or a teacher can be that person.

Studies of children growing up through poverty, hunger and worse keep landing on the same finding: those who did well usually had somebody who…

With a small child who is struggling with both movement and speech, start with the body. Balance and steadiness come before a child can take in much language or learning.

A child who is using most of what they have simply to stay upright in a chair has little left for the words on the page. Sorting out the physical…

If every step you try keeps not working, however small you make it, that is information rather than failure. A more intensive programme is the next thing to look at, and it should be put to you as an option.

The whole point of shrinking the steps is to find one that moves. When nothing moves at any size, staying in the same weekly arrangement out of…

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…

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…

There are two jobs here, not one. Free up the time, and then be able to sit in it without feeling like a fraud.

Working more efficiently buys hours back, and that is the easier half. The harder half is the belief that rest is only for people who have finished…

Asked what all the scrolling had done to her most, one young woman did not say sad. She said angry, more or less all the time.

Constant irritability in a teenager usually gets worked up as depression or ADHD, and sometimes that is right. Saturation belongs on the list too,…

For some people the online part is not a side issue sitting next to the depression or the anxiety. It is one of the things holding them in place.

One young woman with a history of being bullied found her platform use feeding the depression, the social anxiety, the fear of leaving the house and…

There is a rough ladder for tech overuse. Build a schedule together with some outside control at first, add substitutes once the person can stop for a while, then more intensive care, and residential only when someone is entirely taken over by it.

The order matters more than the rungs. You cannot install a better alternative in someone who has no capacity yet to put the thing down, so a bit of…

Where you can, let the learning be something done rather than something sat through. Typing instead of writing, a calculator instead of longhand, a built model instead of an essay.

The knowledge is usually already there. What fails is showing it through a long, still, low feedback task, and that is the part worth redesigning.…

Behaviour work for ADHD is mostly about changing what the adults do. The child's behaviour shifts afterwards, as a consequence.

Consequences live in other people's responses, and a child who cannot yet hold a reward in mind across three days cannot supply them for themselves.…

A child's reputation is made in the classroom, mostly out of adult earshot, and it follows them from one year to the next. Teachers who work on how the class treats the child, and not only on the child, can move it.

The version that has been trialled has the teacher doing small deliberate things: pairing children with some thought, noticing this child out loud…

The most convincing programme for teenagers does the obvious thing. It runs at school, twice a week, so nobody has to be driven anywhere: homework systems, organisation, some social practice and sport, in the place where the trouble actually happens.

By the teenage years the leverage parents had is thinning, and a clinic appointment is the first thing to fall off the week. Putting the help inside…

When someone finally reaches somewhere safe, do not be surprised if they fall apart rather than bloom. Stay close through that part.

People who have lived on high alert often start grieving once the danger stops, and it can look like going backwards: more tears, more fear about the…