Practices

When a bright, talkative autistic child arrives looking mainly behavioural, look underneath for a coordination or reading difficulty. Once the first label is in place, whatever comes after tends to get filed under it and never assessed on its own.

Watch for the child who does well in conversation and badly on paper, or who is fine in class and miserable at PE. Those gaps are usually a second…

Expect more anxiety, low mood, drinking and drug use in the young people coming through now. And expect the boys to say less about it, so go looking for irritability, trouble and substances instead of waiting to be told.

Ask parents what they are seeing rather than only what they have been told, and ask the young person directly and privately. Screening that rests on…

Parents with one affected child often ask what they might do differently before the next one. Answer honestly: there are lists of suggestions in circulation, the evidence behind most of them is thin, and the question underneath is usually about blame.

Take the question seriously and take the guilt seriously alongside it. Give what is genuinely known, say plainly where recommendations run ahead of…

Keep the tasks short, a couple of minutes each, with results back the same day. A long test given to a child who cannot sustain attention measures how long they can last, not the thing you were trying to measure.

Brevity is not a convenience you are allowing yourself. It is what keeps the data honest, and it keeps the child willing for whatever you ask next.…

Choose the subtests that answer the question you were actually asked, and read whatever reports the family already has before adding anything of your own. Children arrive with thick folders, and they also arrive with nothing at all.

Where occupational therapy, speech and language or neuropsychology have already covered ground, do not cover it again for the sake of a complete…

When you explain executive function to parents and teachers, four words will do: attention, reasoning, speed, memory. Each one can be worked on, and four is a number people can still repeat at the school gate a week later.

The academic models have a dozen headings and nobody outside the field retains them. A short list gives parents something to hang observations on, so…

Two referrals turn up again and again. A young child being asked to leave a school for behaviour, with no developmental or cognitive information anywhere in the file. And a parent saying something is wrong while the school says everything is fine. Both are describing adult frustration rather than a formulation.

In each case the first job is the same: get some data. Not another opinion, not another meeting, but something measured about how this child thinks…

For the child who flies off the handle at noise, labels and crowded rooms, with no autism diagnosis in the picture, a free parent completed sensitivity questionnaire will tell you more than another behaviour chart.

It gives you a structured way to describe the reactivity without reaching for a diagnosis the child may not have, and it points at what to change:…

Run the assessment yourself and watch while they work. Under real effort you will see the small movements, the tics and the overflow that never appear in ordinary conversation, and none of it reaches you if a technician or an app does the testing.

Sit where you can see hands and face. Note what happens as the task gets harder: the tongue that comes out, the leg that starts going, the free hand…

Before intensive work ends, turn what you have learned about a child's thinking into things a teacher can actually do on a Tuesday morning. That translation is what decides whether any of the gains survive going back to school.

A profile written for clinicians is no use in a classroom of thirty. Give three or four concrete actions instead: where this child sits, how…

A clinician trained thoroughly in autism and ADHD may know almost nothing about coordination or reading difficulties, and can spend years working above foundations nobody ever checked. Ask yourself which of those categories your own training left out.

Go back over a handful of old cases rather than only reading about it. Where a child made less progress than you expected, ask what you never…

Assessing a child's thinking used to mean a referral, a waiting list and a report some months later. Brief cognitive tools an ordinary clinician can run have changed that, and the gap between noticing something and having a plan can now be a session rather than a season.

Learn one of them properly instead of dabbling in three. Know what it measures, what it does not, and how to talk about a score without turning it…

Processing speed is the stubborn one. It shifts a little with repeated, rhythmically paced practice and hardly at all with explanation, so say that to a family at the start rather than when they are disappointed.

Teaching a strategy will not make a slow processor quick, and telling a child to hurry up only makes the work more unpleasant. Graded practice with…

Assess, make a plan, do the work, and then keep measuring while you do it. Without that last part you have no way of knowing whether to push harder, change direction or stop.

Use more than one stream: your own measures, what parents notice at home, what school reports, and what the child says about it. Children will tell…

Telling someone they have changed their brain lands harder than telling them they have changed their mind. That is worth knowing, and worth handling carefully.

Brain language feels solid and permanent, so a person can lean on it. That same weight is why it should not be stretched: promising rewiring you…

Your brain is less a single organ than a crowd of billions of cells working out what to do next. The angry pull you feel is one voice in that crowd, not the whole of you.

This matters most in the second when an impulse arrives sounding completely certain. You can hear it, treat it as one contribution, and still not act…

You do not have to believe the calmer sentence yet. Say it anyway, on purpose, often, and belief tends to arrive behind the repetition rather than in front of it.

Pick one line you would want ready in your mouth, something like: he is not doing this at me. Repeat it in quiet moments, not only in hot ones. It…

A new practice needs somewhere to live. Hook it to something you already do a few times a day, like sitting down to eat.

Vague plans to practise more collapse without anyone noticing. Name the moment instead: when I put my plate down, I take three slow breaths before…

One move to interrupt, one to settle. Open your hand, then take the slow breaths: the first buys you the gap and the second gives you something to do with it.

An interrupt on its own leaves you standing there, aware and still flooded. A settling practice on its own never gets going, because the moment goes…

Sometimes you can feel the whole exchange lined up before it starts: your line, then theirs, then the door. Leaving your line out is enough to stop the sequence that once.

Nothing impressive is required. You sit there, you say nothing, you let the moment go past unfilled and you find out that it can. Some scripts do…