Practices

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…

Here is a question that costs nothing: has anyone in your family been told their vitamin D was low? It runs in families through genes, skin tone, where you live and how much time anyone spends outside.

The clinician telling this story found out only afterwards that his mother, father and brother had all been low. Nobody had mentioned it, because it…

Around seven in ten people who use herbal products never mention it to their doctor. Not out of secrecy, mostly because a tea or a gummy does not feel like it belongs on a list of medications.

The useful move is to answer a wider question than the one you were asked. When someone asks what medication you take, tell them what else you take…

A real food allergy shows itself on the body: a rash, a swollen or inflamed throat, something you can see. Behaviour on its own does not identify one, although behaviour often improves once a genuine allergy is dealt with.

One child's attention and mood went back to her usual level once berries came out of her diet, and what made that findable was the rash and the sore…

Most eating advice quietly assumes a budget. Fresh food is expensive and does not keep, so a household relying on food assistance ends up buying what lasts, and what lasts comes in tins and packets.

If money is the constraint, say it out loud rather than nodding along and then failing quietly at home. The advice can be rebuilt around what is…

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 child struggling with attention, anxiety and daily reflux at once may be dealing with one problem wearing three coats. Undiagnosed coeliac disease and other food reactions can produce all of it, and the gut symptom is the clue worth following.

Symptoms that arrive together are worth asking about together. If reading, mood and stomach all went wrong over the same period, that pattern is…

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…

Point at the body. 'Your hands went up just then', or 'you put your head in your hands', gives a feeling something solid to stand on.

Feelings argued about in the abstract go round and round. A gesture you both just watched is much harder to dispute, and it opens a door: what was…

When someone goes quiet and you can see they have gone inside, that is not your moment to help. Stay still and let the silence run.

You will feel the pull to summarise, to check they are alright, to bring the other person back in. All of it lands as an interruption. Give it a few…

When someone finally gets one true word out about how they feel, resist explaining it to them. Ask what that word is like from the inside and let them find the rest.

The temptation is to say the clever thing: of course you felt rejected, anyone would. It is often accurate and it usually ends the moment, because…

Once the feeling is actually in the room, ask the plain question: what did you hear her saying about you? The answer is usually where the sting really lives.

A comment about the washing up does not floor anyone by itself. It floors you because of what you heard underneath it, something along the lines of…

Watch for the swerve. Right after something tender gets said, along comes a story about a brother or a colleague or a thing from years ago, and the tender part quietly gets left behind.

Swerving is not dishonesty. It is what people do when a feeling gets close, and it works, which is exactly why it is so easy to follow along.…

If a conversation has wandered off and you have lost the thread, go back to the last thing that had real feeling in it, and go back using the words they used.

Not a summary of those words. The actual phrase: 'you said she has her standards and you will never meet them, and your eyes went red when you said…

You do not have to reflect back everything a person just told you. Pick up the part that carries the weight and say that much.

A long, careful summary can flatten what someone has just risked saying. If the heart of it is that he feels defeated and frightened of never being…