Practices

Some of what feels like a flaw in your character is really a job that can be handed to something outside your head: a calendar, a list on the wall, a person who helps you lay out the week.

Coaching for attention difficulties is mostly this, and nothing more mysterious. Someone sits with you, builds the week, works out what comes first,…

Medication can make the learning possible. It does not do the learning. If no tools get built while things are steadier, there is nothing standing there when the dose wears off.

A common disappointment runs like this: the medication helps, then it seems not to be enough, then it gets stopped. Often what happened is that…

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…

You can be connected to a thing as well as to a person. A cause, a project, something you are making. On the days people feel like too much, it is still there.

This works best when it asks something of you regularly: a rehearsal, a shift, a chapter a week. The obligation is the useful part, more than the…

If you tell people that company is part of their treatment, it is worth noticing whether it is part of yours. Sitting in a training room with colleagues is the same medicine, taken by you.

There is a quiet loss of credibility in prescribing connection from a life that has none in it. It also flattens something that ought to be flat. You…

There is a difference between being calm because your partner manages you and being able to steady yourself. The first works right up until the person is not there.

Plenty of adults with ADHD have got by on outside regulation without ever noticing it: a spouse who makes the difficult phone calls, a deadline that…

Sleep, food and moving your body will not cure ADHD, and they do change how much of yourself you have available. Aim for good enough here rather than excellent.

The gain shows up in the margin more than in the symptoms. Rested, you have a bit of room before you snap. Short of sleep, you arrive at the evening…

You cannot ask anyone to work harder on your difficulty than you are working on it yourself. That is the condition attached to every adjustment you ask for.

It is what keeps help from curdling into supervision. If your partner is holding the calendar, softening the tone and steering round your worst…

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…

The parts of this that look like lifestyle, meaning sleep, driving, drinking, appointments that get missed, are the parts carrying the most risk across a lifetime. They are also the most changeable parts.

You may have met a striking figure quoted about untreated ADHD and years of life lost. Take the point underneath rather than the number: risk from…

Getting your ordinary life a bit calmer is worth doing for its own sake. More sleep, a little more structure, food that is not all improvised. Not perfect, just good enough to work with.

It will not give you more capacity than you have. What it does is let you use more of what you already have, more of the time, which is usually the…

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.…

Think of it the way you would think about diabetes. Something to manage with several things at once, most days, for as long as it is there.

That frame does a lot of quiet work. It says the treatment is ongoing rather than a course you finish, it explains why things slide back when…

The stack goes: understand it, medicate where that is right, change what the adults do, change what the day asks, and keep arguing the child's corner. Each layer does a job the others cannot.

None of them stands in for another, which is why swapping one out leaves a gap rather than a smaller plan. Medication does not reorganise a…

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.…

The trouble now is not that nothing works. It is that the things which work are spread unevenly, and whether a family gets any of them depends heavily on where they happen to live.

Medication travels reasonably well, since a prescriber can be found in most places. The psychological and behavioural work travels badly, because it…

Look for something genuinely hard that sits on top of something you are already good at. Too easy and your attention wanders off. Too far beyond you and it just becomes another thing you failed at.

The narrow band in between is where you stay engaged without noticing you are trying. It is usually a bit further up than feels comfortable when you…

For a lot of people with ADHD, making things is not a hobby but closer to an appetite. The itch to start something is always there, and when nothing is being made it does not go quietly.

Read that way, the restlessness that arrives when you have no project on is information rather than a character flaw. The same drive that gets called…