Practices

Before drilling number facts, check whether the child has any feel for how much a number is. Which pile is bigger, is eight nearer to ten or to two, give me three of those.

A child with no sense of quantity can still learn to recite that seven and eight make fifteen, and it will be a string of sounds attached to nothing.…

Patterns sit underneath both reading and arithmetic. Blue, red, green, blue, red, green: making a sequence, copying it, then breaking it on purpose builds the ordering that words and numbers both run on.

Use blocks, beads, claps, a drum, anything with an order to it. Ask the child to make the same pattern, then to spoil it deliberately and tell you…

A child who cannot bear the noise, the lights and the scratchy jumper all day will be hard to be around by the afternoon. That child usually gets described as badly behaved rather than as overwhelmed.

Once a child is understood to be choosing it, everything that follows is punishment, the arousal climbs, and the sensory difficulty gets worse. That…

Find something the child already loves, a team, an orchestra, a game, and lay their results over it. These players are strong, these ones need coaching, and none of it means the team is no good.

Feedback lands very differently when the low scores are players who need training rather than facts about who someone is. Do it with their own…

Ask a struggling ten year old what division actually is and you will often get a blank, or a method with no meaning under it. Going back to what each operation does is usually worth more than another go at this term's work.

Division is sharing out, or taking the same amount away again and again until nothing is left. Multiplication is that same amount repeated. Children…

If sleep has gone since starting, look at what time the dose is being taken before deciding the medicine is the problem. A long acting dose swallowed at one in the afternoon is still working at bedtime.

Extended release preparations are built to cover eight to twelve hours from whenever they are taken, so a late start pushes the whole thing into the…

Count good days, not unbroken runs. Whatever yesterday was, brilliant or a write off, the only live question is what can be done with today.

Streaks make one slip cost everything, so the missed night turns into a missed week and then the whole effort gets quietly dropped. Aiming for more…

Debt, impulsive spending, an account that never quite recovers: this belongs in the conversation about attention rather than in a separate drawer marked shame.

People hide this part longer than anything else, which means it is usually the last thing to get any help. If you are the one struggling, saying it…

Where anxiety sits alongside the attention difficulty, a non-stimulant is sometimes the better first choice. Stimulants sharpen anxiety in some people, and that is a hard trade to live with.

The same holds when blood pressure rises on a stimulant that is otherwise working, since adding an alpha-2 agent can make it possible to keep the…

The stimulant shortage is not your pharmacy being disorganised. Regulators set a fixed annual quota of the raw material, and the ceiling has been too low to cover the prescriptions being written.

Knowing that changes what you do with your energy. Ringing round twenty chemists is exhausting and it creates no supply, so spend the effort on…

When a prescription cannot be filled, you can report it to the medicines regulator's shortage inbox, naming the medication and the pharmacy. Nobody writes back, and people often find their prescription turns up soon afterwards.

The value of this is partly practical and partly in not being stuck. Being told no at a counter, month after month, is what makes people quietly…

Waking your child at six to give the tablet so it has taken hold by breakfast, then letting them fall back to sleep, is not a strange thing you invented because you are failing. It is a reasonable answer to a real gap in how the medicine works.

Families quietly carry a lot of these. The early alarm, the switch to a faster product, the parent who does the whole morning alone because it goes…

Doing badly on one long acting product does not mean the medicine inside it was wrong for you. The same molecule in a different capsule can behave differently enough to be worth trying before anyone gives up on it.

What gets described as the medicine not working is often the shape of the day being wrong: too slow to start, too abrupt at the end, strongest at the…

People usually stop for one of three reasons: the side effects are not worth it, the price is too high, or the dose was never raised far enough to do anything. The last one is the saddest, because it makes a workable medicine look useless.

If a trial ended with the words nothing happened, it is worth going back over what dose was actually reached and for how long it was held there. A…

Before anyone concludes that medication does not work for you, check what dose was actually reached. Doses in general practice often stay lower than a specialist would use, and a fair share of so called non responders respond once the dose goes up.

You are allowed to ask this, gently and without any accusation in it: what was the highest dose tried, and how long did it stay there? A trial that…

If one family of stimulant did nothing, or felt awful, that tells you very little about the other. Methylphenidate and amphetamine work in overlapping but different ways, and plenty of people who do badly on one do well on the other.

Stopping after a single class is one of the commonest routes to believing that nothing helps. Trying the second one is a normal next step rather than…

A medicine can give you back some energy. It cannot turn a bad situation into a good one, and it helps to be clear which of the two you are hoping for.

If home has been miserable for two years, feeling steadier may just mean you notice the misery more sharply. People often read that as the medicine…

For someone who cannot swallow tablets, or whose mornings fall apart long before the tablet gets taken, patches exist that release medicine slowly through the skin over hours.

Going through the skin skips the first pass through the liver and smooths out the peak, which changes the timing and sometimes how well it is…

Much of the progress in these medicines over the past twenty years has been in how the drug is delivered rather than in new molecules. So if one version did not suit you, another form of the same drug can still be worth a try.

People often conclude that a whole class has failed them when what failed was one release pattern: too sharp, too short, too much at once. That is a…

A pharmacy refusing a valid prescription is often working from a made-up rule or a plain mistake. It can usually be escalated, and it usually resolves fast.

People have been turned away for having a prescriber in the next county, or told the shop does not stock narcotics for a medicine that is not one.…