Practices

The scales worth using are the ones that ask about situations rather than symptoms alone. Home, school, work, and what actually happens in each.

A questionnaire counting how often somebody loses their keys will label half the population. What a diagnosis needs is evidence that the difficulty…

Executive function scales ask how the week actually went. That is often more use than an afternoon of testing in a quiet room.

Office testing happens in the best conditions a person will ever meet: no interruptions, someone sitting with them, a clear finish line in sight.…

Ask about the family properly: parents, brothers and sisters, children, then aunts, uncles and grandparents. Include drinking and drug use, in them as well as in the person sitting with you.

This tends to be the highest yield few minutes of an assessment, because the condition runs strongly in families. Relatives who were never assessed…

The family history is not the warm up before the real assessment. Give it proper time and it will often tell you more than any single rating scale in the folder.

Walk through the family rather than asking one summary question about it. Who struggled at school, who could never sit through a meal, who changed…

Note who is a first degree relative and who is a second, instead of writing 'runs in the family'. Parents, children and siblings sit in one ring. Grandparents, aunts, uncles and cousins sit in the next.

A simple grid helps: names down the side, then relation, what they were like, what was ever diagnosed, what was ever treated. The picture comes out…

Ask whether anyone kept the old school reports. The same lines turn up generation after generation: not working to potential, talks too much, never has the right books with him.

They were written by teachers who had never heard of ADHD, about children nobody was going to assess, and that is exactly what makes them worth…

'I am disorganised' cannot be treated. 'The post piles up on the hall table until something ends up with a debt collector' can. Spend the time getting the problem down to something that specific.

Push for the particulars: which task, which moment, what was happening just before, what they did instead. Where you can, ask someone who was there…

For the child who flies off the handle at noise, labels and crowded rooms, with no autism diagnosis in the picture, a free parent completed sensitivity questionnaire will tell you more than another behaviour chart.

It gives you a structured way to describe the reactivity without reaching for a diagnosis the child may not have, and it points at what to change:…

Run the assessment yourself and watch while they work. Under real effort you will see the small movements, the tics and the overflow that never appear in ordinary conversation, and none of it reaches you if a technician or an app does the testing.

Sit where you can see hands and face. Note what happens as the task gets harder: the tongue that comes out, the leg that starts going, the free hand…

If sitting still with your eyes closed has never worked, do it moving. Walking, washing up, gardening: the exercise is the same, and there is something to hold on to.

Sitting meditation asks for the hardest possible version of the task, sustained inward attention with nothing outside to grip. Attach attention to…

If your child is learning to settle, learn it alongside them rather than supervising. Parents who practise report less stress of their own and less flying off the handle.

Attention difficulties run in families, so the adult in the room is often working with much the same wiring at the end of a longer day. Practising…

If your imagination runs away with you, use it rather than fight it. Guided imagery gives a vivid mind somewhere to go.

Being able to disappear into a scene is a real ability, even when it has mostly got you into trouble at school and in meetings. A recording that…

Left, right, left, right. Walking, swimming, drumming and rowing all give the body the same steady side to side rhythm that the seated techniques are copying.

If tapping your own shoulders feels odd, or you would rather not do anything that looks like a technique, go for a walk instead and let the rhythm do…

Choose one good thing the person did and carry it forward in your own life this week.

A habit of theirs kept alive, a kindness they showed passed on, keeps their good present in the world.

Knowing something calmly and feeling it are two separate achievements, and the second takes longer. If you can say the reasonable thing but it does not touch how you feel, you are partway, not failing.

The gap does not close by arguing with yourself harder. It closes by living it: doing the practice in real situations, in your body, while the…

Pick the news channel you cannot stand and watch ten minutes of it on purpose. The only job is to notice what rises in you and let it go by.

Real provocation turns up when you are least ready for it. This gives you the feeling with nothing at stake: the indignation, the tightening, the…

When something is genuinely alive for the person in front of you, work with that. Whatever you had planned to cover keeps until a quieter week.

Teaching over the top of live feeling does not land, and it tells the other person that your agenda outranks their week. When there is heat, follow…

Tell your spouse about a raw spot, an old tender place that still gets touched.

When you go quiet I feel abandoned, like I did as a child. Name the ache, not the blame.

Ask one open question about their inner world tonight, and just listen to the whole answer.

What are you hoping for lately, what are you dreading. Questions with no single answer.

Ask your spouse about a moment from their childhood that shaped them, and listen closely.

What comfort felt like then, what they longed for. It still lives in how they love now.