Practices

ADHD does not usually vanish at eighteen. The visible fidgeting often settles while the inattention stays, and the restlessness moves inwards where nobody can see it.

A teenager who has stopped bouncing off the walls can look much improved at exactly the point their workload has quadrupled, which is a poor moment…

You will see wildly different figures for how many children still have ADHD as adults. The range mostly reflects what is being counted: symptoms on a childhood list, or whether life is actually being made harder.

Counted by childhood symptom lists, many people look as though they grew out of it. Counted by whether it still gets in the way, far more have not.…

With ADHD, self-management usually runs a few years behind the birthday. Expecting a child to handle what other children their age handle sets you both up to fail.

A rough working guide many clinicians use is to expect around two thirds of the chronological age for this kind of self-regulation, so an eighteen…

Telling parents that their child's self-management is running behind their age usually brings relief rather than alarm. It names something they had already noticed and had been blaming somebody for.

Left unexplained, parents fill the gap with a story, and the story is almost always that the child is choosing this or that they have parented badly.…

Set jobs at the level the child can manage now, then build up. A task pitched at their age that ends in a row every week mainly teaches them they are hopeless at chores.

Break it down further than feels necessary: not tidy your room, but put the clothes in the basket. Stay nearby for the first few goes, since being in…

A child who is tall for their age gets treated as older, and with ADHD their self-management may be running years behind. Pitch what you expect to the skills in front of you rather than to the height.

This lands hardest at school, where a big ten year old who cannot sit still reads as defiant rather than young for his skills. It is worth saying…

Not knowing a child's family history is not evidence against ADHD. Where a child is adopted, a blank family history should keep the question open rather than close it.

Assessment leans a good deal on family history, and adoption often means that history is simply unavailable. An unknown gets read as a negative,…

Much of what matters most in an assessment never comes up unless you ask for it directly. Unplanned pregnancies, money trouble, sackings, near misses in the car: people very rarely volunteer these.

Put the questions on the form rather than waiting for a moment that feels right, since a questionnaire normalises them and takes the weight out of…

Many people who end up in trouble with the law have never had their ADHD recognised. Behaviour read as defiance can be the same difficulty with stopping and thinking ahead.

That is not a claim that ADHD explains crime, and most people with ADHD never go near a courtroom. It does mean that where impulsive trouble keeps…

Driving is one long attention task with a very high cost of failure, so it is worth deliberately giving yourself more margin than you think you need.

In practice: phone out of reach and silent, route set before you move off, nothing to eat at the wheel, and no long drives on short sleep. If a…

Some families make it a house rule that driving happens only on a day the medication has been taken. It works because it ties a privilege to safety rather than to obedience.

Set it with the young person rather than at them, and be clear it is about the road and not about whether you trust them. It also moves medication…

If a young person says they do not feel ready to drive, take that as information rather than something to talk them out of. Plenty of them know their own attention better than the adults around them do.

Waiting a year is not a failure, and there are other ways to get about. Do ask what sits behind it, because there is a difference between a sober…

In any quiet practice, dhikr, prayer, sitting still, your mind will go. The practice is not staying put. It is noticing you have gone and coming back, however many times that turns out to be.

Set the bar at a length you can actually manage, two or three minutes to begin with, rather than the twenty minutes somebody recommended. Counting on…

Plenty of adults with ADHD keep tripping over rules nobody ever stated: how long a turn in a conversation lasts, when a story has gone on too long, when a joke reads differently than you meant it.

You can learn these the way you would learn anything else you were not taught. Ask one person you trust to tell you plainly what they notice, since…

With children, practise the hard social moment rather than explaining it. Act out asking to join a game, or losing one, a few times at home where nothing is at stake.

Keep it light and short, let them play both parts, and be the one who gets it wrong sometimes so it does not feel like a test. Pick the situation…

Girls get diagnosed later, and a good deal of the reason is social. A boy who plays the fool gets laughed with, while a girl who does the same is corrected by her friends within a week, so she goes quiet and disappears from view.

Referral usually follows disruption rather than difficulty, so anything that keeps a child quiet also keeps her unassessed. The point it finally…

They are too clever to have ADHD is one of the more expensive mistakes in this field. Being able to understand something and being able to start it, order it and finish it are different abilities.

A very capable person can sit with a task they fully understand and be unable to begin, and then be judged for it far more harshly precisely because…

ADHD is not only about focus. Physical health tends to drift down the list, and appointments, sleep, food and movement are exactly the sort of thing this condition makes hard to keep up with.

Pick one health task you have been putting off and make it small and dated: book the check-up, refill the prescription, put a walk in the diary with…

Work is one of the places ADHD does the most damage, and it is usually a question of fit rather than ability. Choose the job that suits how you actually run, not the one that would suit an improved version of you.

Variety, movement, visible deadlines and quick feedback tend to work. Long stretches of quiet paperwork with a deadline months away tend not to. If…

If work keeps going wrong in the same way, ask for the expectations in writing before the next thing goes wrong. What is obvious to a manager is often not obvious to you, and a written version can be checked.

It might be a list of what counts as done, agreed deadlines, or the safety rules that are not negotiable. Adjustments are worth asking for too:…