Practices

Being able to disappear into something for six hours does not cancel the diagnosis out. Getting stuck on and getting stuck off are the same switch failing in two directions.

People often use their own absorption as evidence against themselves, or a family member uses it against them: if you can play that game all night,…

When you explain ADHD to someone who does not have it, describe the effort rather than the outcome. Not that the form is unfinished, but what twenty minutes of trying to fill it in actually took out of you.

Most people around you are judging the visible result, because that is all they can see. One concrete picture of the inside of an ordinary task…

If you reach the bottom of a page and nothing has stayed, reading it again more slowly usually will not fix it. Change something about how you are reading instead.

Read a paragraph and then say it back in your own words before moving on, or write one line per section, or read with a pen underlining as you go.…

ADHD tends to run in families, and the differences in reported rates between countries say more about how a country counts than about its people.

It is common to find, part way through your own assessment, that you are recognising a parent, a sibling or a child. That is not a coincidence and it…

Before you decide who in front of you looks like ADHD, notice the picture you are already carrying. The loud boy gets sent for assessment and the quiet, drifting girl often does not.

The research on how race affects who gets diagnosed is genuinely mixed, and it is more honest to read the studies than to adopt a position from a…

When you meet a confident claim about ADHD, look it up before passing it on. A search of recent papers, limited to the last few years, takes a couple of minutes and often changes the picture.

Free scholarly search engines will show you abstracts without an institutional login. Two habits do most of the work: filter by date so you are…

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…

Anything that gives a quick lift, a bet, a purchase, speed, a risk taken late at night, pulls harder when your brain is short of reward. The workable move is not more willpower, it is putting friction between you and the thing.

Friction is a delay you build while you are calm: the card left at home, the app deleted, a rule that anything over a set amount waits until…

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…

The same mistake costs far more when you have no money behind you. Legal trouble is not handed out evenly, and that sits on top of the earning difficulties ADHD already brings.

This is worth naming when somebody is carrying shame about a record: what happened was shaped by what they could afford at the time and not only by…

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…

Cognitive testing done on a day without medication can come out well below what a person can actually do. If a score is going to decide a school placement, make sure the conditions on the day are recorded.

The parts of these tests that are timed, or that ask you to hold numbers in your head, are exactly the parts untreated ADHD drags down, and they pull…

A lot of people with ADHD quietly believe they are not clever. Usually it comes from reading a page four times and taking nothing in, and concluding the obvious thing about themselves.

That belief does a great deal of damage. It keeps people out of courses and jobs they could do, and it makes them give up on any new strategy the…