Practices

If you run a group for people with ADHD, keep it to about five or six, or bring in a second facilitator. Past that you spend the session keeping order instead of doing the work.

The limit is not really about behaviour. It is about how many people one person can genuinely track while also holding the thread of the session.…

Sitting in a room with other people who lose their keys, cry at nothing and hate themselves for both does something no explanation can. You find out you were never the only one.

Groups also do encouragement better than a therapist can. When someone with the same trouble asks whether you managed the homework, it does not land…

Connection does not have to be human. A dog will not judge how your week went, and it will get you out of the door twice a day whether you feel like it or not.

If people currently feel exhausting or risky, an animal is often the easiest place to begin. Part of the good is the company and part of it is the…

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…

If you are permanently behind, short of sleep and scrambling, that is not the backdrop to your short fuse. A good deal of the time it is the cause of it.

This is what makes the dull organisational work worth doing, because it buys you something you actually want. A morning that is not a panic leaves…

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…

If not knowing makes you itch, the work is learning to sit with the itch rather than making it go away. The plan can stay unfinished while you get on with today.

For some of us an unresolved question hums in the background until it is settled, and settling it becomes urgent even when nothing depends on it.…

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…

When a child truly does not mind losing the privilege, taking more away will not get you anywhere. That is the moment to change approach rather than raise the stakes, usually to a structured parent programme that works on the pattern between parent and child.

Star charts fail with these children because the reward was never the point of the behaviour. What helps is a proper course of parent management…

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…

If you are going to try a mindfulness course, give it the full eight weeks before deciding. Expect a real but moderate change rather than a different life.

Courses of this length help a good number of people and do very little for others, which is worth knowing at the start so that being in the second…

Attention problems often travel with anxiety or low mood, and those two eat working memory as well. Settling that layer can make everything else look quite different.

If you are anxious most of the day you will lose track of things, forget what you came into the room for and struggle to hold a plan, whether or not…

It does get better, but not by waiting for time to pass. The improvement comes from the walking, and the walking is small and unremarkable.

Every rep you did today changes almost nothing you can feel, which is the honest and irritating truth of it. Progress here shows up over months and…