Practices

Everything has side effects, including doing nothing. The only real question is whether what you gain outweighs what it costs you.

The conversation about medication often gets set up as a risky drug against a safe natural alternative, and that is not the choice anyone is actually…

Long acting does not automatically suit everybody. Some people genuinely do better on shorter doses, and it is worth saying so rather than assuming the newer option must be right.

There is a folk belief that a person's own chemistry takes over in the afternoon once the medicine wears off, and the research does not support it.…

What a person expects from a treatment genuinely changes what they get from it. That is not a trick to be exploited, and it is not nothing either.

In some trials the dummy treatment helps around half the people who receive it, and there is work showing benefit even when people were told outright…

The point of treatment is not a tidier score on a questionnaire. It is fewer accidents, a finished course, work that holds, relationships that survive, a longer and better life.

Symptoms are worth reducing because of what they do downstream, and that is where the goal should be set. It changes what you review, too. Instead of…

After a working lifetime in this field, Barkley names the change in how a family sees the child as the most important step of all. Not the medication, not the charts.

The reason is practical rather than sentimental. Every other part of treatment asks parents to keep going for weeks with very little to show for it,…

The point of explaining ADHD to a parent is to produce a particular kind of parent: one who is kind about it, quick to forgive the day's failures, and willing to make a nuisance of themselves at school.

Those three are results, not manners. Harsh days breed pushing back, pushing back breeds harsher days, and that loop is the main road from ADHD to a…

Being told ADHD is largely inherited can sound like being told nothing can be done. It does not follow, and the two questions are separate ones.

How much of something a person shows, day to day, moves a good deal with what is around them, even when the underlying trait is strongly heritable.…

A child can be almost trouble free with a grandparent who has all afternoon for them, and impossible in a class of twenty five. Same child, same condition, very different demand.

What a setting asks for is the ratio between the self control a person has to supply and the structure being supplied for them. One adult, close…

Treatment is not only about school reports. Lower rates of accidental injury and of other serious harms are reasons in their own right, even for a child whose marks are perfectly fine.

This is the answer to the question about the bright child who is coping academically and whose impulsivity worries you in traffic, on a bike, or…

Untreated ADHD is not free. It turns up in appointments, in repeat trips to A and E, in school reports and in lost work, and the bill lands on the family either way.

So when the cost of treatment is the reason for waiting, it is worth adding up what is already going out, in money and in hours and in the things…

Gathering disruptive children into one room to learn social skills leaves about a quarter of them worse than before. They pick things up from each other far faster than from the adult at the front.

This is not a reason to give up on helping a child socially. It is a reason to look hard at who else is in the group before you accept a place in it.…

The warning about group social skills work is about loud, disruptive children. A quiet, anxious child who simply has not had much practice with other children is a different case, and a gentle group may be exactly right.

So the question is not whether groups work, but which child is sitting in front of you. If the difficulty really is inexperience, a group offers…

If therapy for ADHD did little for your thirteen year old, that is not a sign they were not trying. The self monitoring it leans on is still being built at that age, and it builds later in ADHD than in most.

The practical reading is about timing rather than willingness. Younger teenagers usually do better when the adults around them change the setup at…

Play based programmes that build executive skills in young children have done reasonably well with children at risk of struggling at school. None has yet been tested in children actually diagnosed with ADHD, and that is a real difference rather than a technicality.

Results found in a broad at risk group tend to shrink, sometimes to nothing, when the same thing is tried with clinically diagnosed children, where…

Showing a teenager live pictures of activity in one targeted part of their own brain has been tried once, in a small trial, and it looked encouraging. That was around a dozen young people, and nobody has repeated it yet.

This is worth knowing about mainly so you can tell it apart from the neurofeedback that is widely sold. The clinic version reads surface brain…

There is a headband worn at night that stimulates a nerve in the face, cleared by regulators and tested against a dummy version in a single trial. Some children improved. Some felt sick or slept badly and stopped.

Regulatory clearance answers whether a device is safe enough to be sold, not whether it beats what you are already doing. One trial, funded by the…

Magnetic stimulation of the brain has been tried for ADHD and has not yet shown anything. The studies are small, often single cases, and not built in a way that could give a trustworthy answer.

Small uncontrolled studies are generous places. Hope, attention and the freedom to report only the good parts all push results upwards. That does not…

Two ideas will let you judge most claims for yourself. In a good trial nobody involved knows who got the real treatment, and a study of five people can be swung by one of them having a good month.

Researchers want their treatment to work, and that hope leaks into how they rate what they see, which is why the person handing out the pill and the…

Programmes built on crossing the midline or on balance and inner ear work do not appear to beat ordinary exercise. If movement is what you are after, movement is available free.

These packages come with a theory about why they work, and the theory is usually where the confidence comes from rather than from the results. What…

Massage may well leave you calmer, and calmer is worth having. It is not a treatment for ADHD, and the two are worth keeping in separate boxes.

Living with ADHD is stressful in a measurable way, so anything that genuinely lowers that load is doing real good and deserves a place. The error is…