Practices

Choosing the app, picking the colours, setting up the tags: that is the task avoiding you. It is interesting, it feels like preparation, and by bedtime nothing has been done.

New systems are enjoyable in a way the actual work never is, which is exactly why the evening goes that way. A useful test is whether anything on…

When something does not get written down, go back to that exact moment with curiosity rather than a telling off. What was in your hands, where were you, what did you tell yourself?

The useful information is all in the specifics: the request came in the corridor, the phone was in your other hand, you were already late. That is a…

We all keep a few small stories that let us take the easier option in the moment. Not lies to other people, just the ones we tell ourselves and half believe.

They are not a sign of a bad character. Everybody has a set, and what you have been through shapes which ones you specialise in. The reason to know…

You are allowed to decide not to write things down. What you cannot do is choose that and then be upset with yourself when you forget.

Straddling is the expensive bit: taking the easy option in the moment and the guilt afterwards. Pick one honestly. Either the note gets written, or…

Put the thing you are avoiding early in the day. Anything you place late gets pushed out by whatever the day turns into.

Early has two advantages at once. It is less likely to be shunted, because the day has not yet piled up behind it, and if it does slip it only slips…

Email is the easiest place to hide. It answers back, it never runs out, and by five o'clock it feels like you worked.

What makes it such a good stand-in for real work is that the rewards come in small unpredictable bursts and almost none of it asks much of you. Your…

Turn a vague plan into an if-then: when I sit down after lunch, I will open the one file.

Deciding in advance exactly when and where you will start removes the moment of friction where you usually stall.

An ADHD diagnosis usually arrives with two extra words attached: which presentation it is, and how severe. Both are descriptions of what gets in your way, not a grade you were awarded.

Inattentive, hyperactive and impulsive, or the two together, and then mild, moderate or severe. Mild means you met the threshold and the effect on…

Hyperactivity and impulsiveness almost never turn up alone. When restlessness appears with no attention difficulty beside it, that is a reason to ask what else might be going on.

In practice the two run together, and over the years the visible restlessness tends to settle while the attention side stays. So a picture that is…

The diagnostic manual is a document people sat in rooms and argued over. That is no reason to dismiss it, and it is a good reason not to treat it as the last word on you.

Committees weigh how reliably clinicians can agree on a criterion, what the field trials show, what a particular wording will do out in the world.…

The checklists were built around the loud version of this, and girls are more often the quiet version. If she is struggling and nobody has ever suggested an assessment, that is worth pressing on.

Defiance in girls can look like refusal, withdrawal or a long-running argument about friendships rather than the disruption a teacher would report.…

Most autistic people also meet the criteria for ADHD. The other direction is much thinner: only a small minority of people with ADHD meet the criteria for autism.

That is mostly arithmetic rather than mystery. ADHD is the more common of the two, so one overlap looks large from one side and small from the other.…

Autism and ADHD share some surface features and are still two different things. The social difficulty in each arrives by a different road.

With ADHD it tends to be impulsiveness and missing what was going on: the interruption, the thing said too fast, the friend never rung back. With…

A reward that comes every time is easy to walk away from. A reward that turns up unpredictably is the one you cannot put down, and that is exactly how your phone is built.

Sometimes there is something good in the notifications and usually there is not, and it is that uncertainty which keeps you checking. Willpower is…

When you read that some proportion of people with ADHD have a particular problem, the number tells you nothing until you know the figure for everybody else.

Twenty percent sounds alarming until you learn what the rate is in the general population. What matters is the multiple, how many times more likely,…

Hypervigilance after trauma and ADHD scanning look much alike from outside. Often the honest answer is that both are present, and the real question is how much of each.

Watching that comes from threat is aimed at something and tends to switch on in particular situations. ADHD distraction is not fussy about where it…

Damage to the front of the brain can produce something that looks a great deal like ADHD: poor impulse control, blunted judgement, a person their family says has changed.

The nineteenth century railway worker who survived an iron rod through the frontal lobes is the standard illustration, and what altered in him was…

Check the licensing before assuming you cannot afford a good instrument. Some come with permission to photocopy once you have bought the manual.

That detail matters most to the clinicians least likely to have a budget, which usually means the services seeing the families with fewest options. A…

There is more than one decent instrument, and which you use often comes down to what you were trained on. If you have never used one, say so rather than having a view about it.

Several rating scales are in wide circulation for children and for adults, validated by different groups for slightly different purposes. Picking one…

Home DNA tests turn up relatives nobody expected. If someone is thinking of taking one to fill in a blank family history, it is worth saying out loud that it may hand them more than they asked for.

People find half siblings. Sometimes they find that the story they were told about their birth was not the story. That is a great deal to receive by…