Practices

More clinicians now raise supplements themselves, and more of them will suggest something like omegas. The shift matters less for what gets recommended and more for what it does to disclosure.

People hide what they expect to be laughed at. Someone braced for an eye roll simply does not mention the four bottles in the kitchen cupboard, and…

Omega supplementation for ADHD began with encouraging results, including a Swedish study where about a quarter of inattentive children seemed to improve. Blinded, placebo controlled work did not reproduce it, and a Cochrane meta-analysis found no effect.

The manufacturers themselves largely moved on to other conditions, which tells you something. None of this makes omegas worthless, and levels do run…

Cutting sugar does not improve ADHD, and nor does stripping out additives. Both have been tested repeatedly, including under conditions where nobody knew which child had eaten what.

The belief survives because parties are where children eat sweets, and parties are also loud, crowded and thrilling. The sugar takes the blame for…

Megavitamins, antioxidant products such as pycnogenol and assorted trace minerals have not beaten placebo for ADHD. They stay popular on the strength of a good story about how they ought to work.

The gap between a mechanism and an outcome is the thing worth teaching, because it will still be useful when the next product appears. Ask what…

Sensory integration training is popular and it does not help ADHD. Whatever value it has elsewhere, the capacity it works on is not the one that is impaired here.

What is impaired in ADHD is holding back a response and steering your own behaviour over time. Sensory modulation is a different thing altogether.…

Chiropractic neurologic organisation training, the kind involving manipulation of the skull, has no credible theory behind it for ADHD. The main harm is not the treatment itself but the months and the money that go into it.

Families meet this because it is marketed at them at the exact moment they are most willing to try anything. Naming it plainly, once, is usually…

A child can learn a self control routine beautifully in the therapy room and not use it once all week at school. Knowing the steps and performing them under pressure are two different skills.

This is why supports that sit in the moment tend to beat supports that sit in the mind. A prompt at the point of need, a changed seat, a rule the…

With EEG neurofeedback, the weaker the study, the better the results look. Six large trials using sham feedback, with parents and teachers kept unaware of who received what, found nothing beyond placebo.

That shrinking with rigour is itself the finding. Blinding matters especially here because the outcome is a rating made by adults who have watched…

Brain training makes you better at the game, and at things that resemble the game. It does not seem to reach the parts of life you bought it for.

Cogmed, the several hundred apps, the balance based programmes: they all hit the same wall when someone independent tests them with a proper control…

One senior researcher in this field is approached by ADHD app startups roughly once a month and no longer takes part, on the view that the companies are not seriously trying to build something that works.

You do not have to share his judgement to borrow the question. Before paying for a digital product, ask who tested it, whether those testers were…

Peripheral biofeedback, the sort that tracks skin conductance and heart rate rather than brainwaves, has more behind it than neurofeedback does. You practise letting the body drop into a calmer state while a monitor shows you it happening.

Once that state is familiar, pair it with a distinctive scent used only for this. After enough repetitions the smell starts pulling the state along…

Headsets have become cheap enough to sit in an ordinary consulting room, and the use with the best backing is graded exposure. You can set the intensity exactly and repeat it as often as the person needs.

The value is in the control. A feared situation can be dialled up in small steps, run again the moment it stops being frightening, and ended without…

A weighted vest seems to do its work in roughly the first quarter of an hour. Twenty minutes did not beat fifteen, so longer is not more help.

Use it as a tool for a moment rather than a garment for the day: on before the piece of work that needs the most sitting still, off once that is…

If you are thinking about a weighted blanket or vest for a child, let an occupational therapist set the weight. It is a specific number for a specific body, not something to guess at in a shop.

The pull to order one straight away is understandable, especially after months of bad nights. What an OT does is match the weight to the child's size…

With some sensory routines, the part doing the work may be a parent's steady hands and full attention rather than the technique itself. Worth knowing, because contact carries into the rest of the day and a protocol does not.

Views differ on this and the research has not sorted it out. What follows practically is that a family who cannot keep the exact routine going has…

When a test trips a child on something it was never meant to measure, change how they answer rather than what is asked. A spelling test spoken aloud is still a spelling test.

One girl saw letters as solid three dimensional shapes that would not sit together on a page, so writing them was a perceptual problem rather than a…