Practices

When someone worries that the strength of their tablet might vary a little, the first question is how wide the safe band is for that particular medicine. For most psychiatric drugs the band is generous, and small differences never reach the person at all.

A wide therapeutic window means the gap between too little and too much is large, so ordinary variation gets absorbed on the way. A narrow one means…

Prescribers usually begin below the dose likely to work and build upwards. That means the first weeks can be underwhelming by design, and it is not the moment to decide the whole thing has failed.

Ask at the outset what the plan is: the starting dose, what it is being built towards, how quickly, and what you should be noticing at each step.…

Waiting to see how they get on carries a cost that is easy to miss. Every year a child spends behind narrows what is available to them the year after.

Treatment does not settle a life. What happens is that school reports, friendships and confidence build on one another, so a stretch of doing better…

If the medication question is the one burning a hole in your pocket, try holding it until last on purpose. Heard after everything else, the answer lands differently.

Most people arrive wanting to know about tablets and nothing else, and the risk in that is a plan made only of tablets. Sleep, movement, the shape of…

If the word exercise makes you flinch, drop it. Say moving about, or getting out, and see whether a plan turns up.

For a lot of people that word carries school changing rooms and years of not keeping things up. Swap it and the list of things that count grows:…

Nobody sits down at a piano and plays Mozart the first afternoon. Set the bar at this week rather than at the finished version of yourself.

The stretch between starting and being any good is where most attempts die, because the reward sits a long way off and today feels like nothing.…

Tai chi, qigong, karate, whatever is running near you at a time you can make. Choose on availability, cost and what you actually like, because those decide whether you keep going.

The ingredients are much the same across these: steady movement, a structure somebody else designed, and a session that happens whether or not you…

If a movement class sounds like it comes with somebody else's beliefs attached, ask what actually happens in the room before ruling it out. Much of it can be done as plain movement.

Stretching, holding a shape, breathing steadily, none of that belongs to anyone. Teachers vary, and plenty will leave out the chanting or the framing…

Give a new habit two months rather than two weeks, and change one thing at a time. The old line about thirty days sets you up to feel like a failure on day thirty one.

Routines that wobble make repetition harder, and repetition is the whole mechanism, so it simply takes longer for some of us. Pick one change, keep…

Long goals need markers you can reach this month. Belts work because you get a visible, earned step every so often instead of one distant summit.

Build the same thing into anything you are trying to keep up: a distance, a number of sessions, a move you could not do in January. Make it something…

A few sessions give you an effect that fades. A few months of it starts to change your baseline. Plan for the longer version if you can.

One class leaves you calmer for an afternoon, which is real and also temporary. Fifteen weeks of the same practice is where people start reporting…

There is no brain scan, EEG trace or blood test that can tell you whether someone has ADHD. Anything sold as an objective biological test for it is promising more than the science can give.

Group differences do exist, including in the theta to beta balance, but a difference that appears when you average hundreds of people cannot identify…

Balance difficulties do turn up more often in ADHD, by something like half again. That is a fact about company, not about cause, and it does not turn balance training into a treatment.

Plenty of things could sit behind a link like that. More falls and knocks, more risk taken, or genetics feeding both at once. Working on balance…

Protocols that spin a child in a chair or tip them backwards and forwards to train balance do not improve ADHD. What they mainly produce is a dizzy child.

There is a cost beyond the wasted afternoons. Something unpleasant that was introduced as treatment teaches a child what treatment feels like, and…

Neurofeedback rests on a tidy idea: in ADHD the slower theta rhythm shows up when the faster beta rhythm should be running, so the training rewards you for shifting the balance. Knowing the idea is worth a few minutes, because it is what the brochure is built on.

Electrodes sit on the scalp, a screen animates when the signal moves the wanted way, and the person practises staying in a state of relaxed…

Ask what happens after the course ends, not only what happens during it. A gain that fades once the sessions stop was probably never a change in the person.

Neurofeedback tends to look decent while it is being delivered and then drift back, and the studies that followed people afterwards did not find…

Before committing to a course that runs into thousands, set the same money next to the other things it could buy. Tutoring, a proper assessment, a medication review and a well tested psychosocial programme all sit in the same envelope.

Neurofeedback courses often run for a month or more, insurers rarely pay, and the training of whoever delivers it varies a great deal. The cost is…

When you read that a treatment worked, look for who judged the improvement and whether they knew what the child had been given. In much of this literature, they knew.

The design to look for is a sham condition, where everybody goes through the same routine and only some receive the active ingredient, with the…

Regulators let devices through by several different routes, and only some of them mean what a family assumes. A game cleared for further investigation has not passed the bar a medicine passes.

The word approval carries an authority that advertising borrows freely, and device pathways are shorter and lighter than the ones drugs travel. It is…

Programmes built on tones through headphones and balance drills have not been shown to help ADHD. If a child does seem steadier during them, the likeliest reason is that something is occupying the part of them that goes looking for stimulation.

That effect is real enough, and it is cheap to get elsewhere. A walk, a job with the hands, background sound they choose themselves, all of it…