Practices

If someone was adopted, or simply does not know their family history, say early and plainly that this is not a problem. It helps to have and it is not needed.

Otherwise the question lands as one more reminder of what is missing, and some people will spend the rest of the appointment feeling they brought the…

The age by which symptoms have to have shown up is a number people agreed on, not a line in nature. It moved from seven to twelve when the manual was revised.

That matters if you are an adult wondering whether you would even qualify. The old cut-off was itself a compromise between studies pointing in…

You do not need clinical language at an assessment. Some of the wording in the manual came straight from how families described it in the first place.

Phrases about being permanently on the go are in there because people kept saying them. So use yours: that your head is like a browser with forty…

Not all distraction comes from outside. Some of it is a thought that will not leave, circling while you read the same paragraph four times.

That difference matters at an assessment. Being pulled away by everything in the room, and being held in place by an intrusive thought you cannot put…

Eating that runs away from you, and eating you cannot stop once it has started, turn up alongside ADHD more than people expect. Usually it is doing a job rather than proving a weakness.

The pattern leans towards bingeing rather than restricting, which fits: it belongs with the difficulty of stopping something already in motion. Often…

Trouble with eating, and with how your body looks, gets missed far more often in men. The questionnaires and the expectations behind them were built around women.

In men it runs more towards size and muscle than towards thinness, and towards fixing on one part of the body that everybody else says looks…

Disruptive mood dysregulation disorder was built partly to keep the bipolar label off children whose future nobody can yet see. Worth remembering when that word lands on a family's paperwork: it describes now, and it does not settle later.

Use it the way it was meant to be used. Review it as the child grows instead of filing it as a fixed fact about their brain, and think about how you…

Strategies for ADHD are visible. A timer on the table, a list on the wall, an alarm going off in a meeting. If someone has not yet made peace with having ADHD, each of those is an announcement, and it will quietly get dropped.

So ask, before handing over another tool: how do you feel about the diagnosis itself? Sometimes the honest answer is that they still half hope it was…

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…

If you cannot remember much about being six, you are in the majority. Early childhood comes back poorly for most adults, while the teenage years are far easier to describe.

So do not sit in an assessment feeling you have failed a test because the early years are a blur. Bring what you can find instead: old school…

A list of symptoms on its own does not make a diagnosis. What counts is that they cost you something real in at least two areas of ordinary life.

That means work or school, money, home, friendships, driving, getting through the week. Almost everyone loses keys and drifts off in meetings, so the…

Much of the symptom wording was written with children in mind. If a question sounds like it is about someone climbing the furniture, translate it into your adult life rather than answering no.

Restlessness at forty is rarely running about. It is being unable to sit through a film, the leg going under the table, two jobs left out of boredom.…

If someone is about to send off a saliva kit to fill in the family history they never had, have a conversation first. These tests hand back more than health information, and they hand it back with nobody in the room.

A father who is not the father, a sibling nobody mentioned, a donor conception no one planned to explain: these arrive by email on an ordinary…

Say it plainly whenever you teach anything: the way I am showing you this is not the way it has to be done. Change it until it works for you.

Anyone who has failed at the standard version of something several times will not try again unless they are told clearly that adapting it is allowed.…

Before you walk into a room with someone, ask what you are carrying in with you, and what you are likely to leave behind when you go.

State travels ahead of words. A hard conversation an hour ago, a bad night, a piece of news you have not dealt with: any of it will be in the room…

Whenever you offer a standing practice, offer the seated version in the same breath, and mean it. Say plainly that people should look after their own bodies and change anything that does not suit them.

Say it before you begin, not afterwards, so that nobody has to interrupt to ask. If you cannot see the people you are guiding, say that too, and say…

Offer any movement in three sizes: small, medium and full. Let people take the one that fits today, and let them change their mind halfway through.

For a twist that might be a simple reach, or a reach with the other hand placed behind, or loose swinging arms. The three sizes do quiet work. They…

Start with a couple of minutes of movement before any of the difficult talking. Not a warm up for its own sake: a body that has moved is easier to think in.

Two or three minutes is enough. Roll the shoulders, round and lengthen the spine, turn gently side to side. It also says something without anyone…

To someone in grief, a short gentle word beats advice or fixing. Say something kind, and mean it.

You do not need to solve their loss. A soft, sincere word lands better than any counsel.

With someone grieving, offer your presence more than your words. Sit with them; let silence be enough.

You do not need the right thing to say. Being there, quietly and again and again, is the help.