Practices

Move the family's picture from a child who will not do as they are asked to a child whose capacity for holding themselves in place is genuinely limited. It is a change of category, not a softening.

The moral version has a quiet arrogance in it, the assumption that the child could manage if only they cared enough, and everyone in the house can…

Changing how the family understands the child comes before the medication, before the charts, before the meeting at school. It is step one, not a friendly introduction to the real work.

Skip it and the behaviour plan still gets written, but it gets delivered with an edge, applied on the good days and abandoned on the bad ones. When…

A ramp does nothing for someone's legs, and it gets them into the building. Timers, visible clocks, a shorter task list and a calendar somebody else keeps do the same job here.

Accommodations are not treatment and they are not pretending to be. What they do is take the parts of the work that live inside a person's head,…

Paediatric and psychiatric bodies have moved towards treating earlier than used to be usual. The reasoning is that the damage builds on itself.

A year of falling behind makes the next year harder, a reputation among classmates is quick to form and slow to shift, and a household that has been…

One social approach does have a real evidence base behind it, and what makes it different is who delivers it. Parents do the coaching, in the middle of actual play with actual friends.

In practice it looks small and ordinary. You set up a play date, you stay within earshot, you give a nudge before things tip over, and afterwards you…

Coaching for adult ADHD comes down mostly to one thing: a standing appointment with somebody who will ask how it went. That sounds thin until you have tried keeping a plan alive entirely on your own.

A coach is not a therapist and does not need to be. They hold the horizon you keep losing and the fortnight that has quietly gone by, and they make…

Mindfulness for adult ADHD is promising and thinly researched at the same time. If it helps you, that is worth having. It is simply not yet in the same bracket as medication or practical therapy.

There are only a handful of studies, mostly small, and few of them set mindfulness against another active treatment rather than against not much.…

A great many people are diagnosed and then left with a starting dose nobody ever revisited, no reading, no group, nothing else at all. If things have stalled, the first thing to check is whether the treatment was ever actually finished.

Optimising is unglamorous and often the quickest thing available. Was the dose ever adjusted upwards, and on what basis. Does the cover reach the…

If the prescriber, coach or therapist is not delivering much, say so and ask for someone else. Working around poor care quietly is the thing that convinces a couple this is simply as good as it gets.

A dose never revisited, or a therapist who has never worked with ADHD, sets a low ceiling. The trouble is that the ceiling gets read as the person:…

Sleep, food and movement will not cure anything, but they lengthen the fuse. Bad moments still arrive, and you handle them differently when your body is not already running on empty.

This matters more here than it sounds, because ADHD tends to wreck exactly these three and then the wreckage feeds back into the flare ups. Late…

When something feels unbearable to risk, follow it downwards. If that did happen, what would it mean, and what would happen after that?

Keep asking gently, and stop when you reach something that is a statement about the person rather than about the situation, such as it would prove I…

One psychiatrist took up a dance class in lockdown, three times a week, at something he was frankly not good at. Being bad at it was the reason it kept working.

A repetitive session on a machine asks very little of you once your body knows it. Something with steps to follow, in time with other people, keeps…

Some of the low, grey stretches are not depression. They are what happens when there has been nothing on the go for a while, and the colour comes back when a project starts.

It is a quieter thing than depression and it does not look like much from outside. Sleep is fine, you are still working, but the zest has gone out of…

Build your work around what your mind does well, novelty, hyperfocus, big-picture, not only around your gaps.

You will go further leaning on your strengths than endlessly sanding down your weaknesses.

If you have not been assessed because of money, waiting lists or simply getting to appointments, that is a barrier and not a lack of seriousness on your part.

The loop is unkind: the difficulties themselves make earning and organising harder, and that makes assessment and treatment harder to reach. Before…

Plenty of adults with ADHD grew up being called lazy, difficult or naughty, and some were punished in ways nobody would allow now. That history usually needs saying out loud, because it left a belief behind.

The belief tends to sound like: there is something wrong with me and people will find out. It shows up as bracing for criticism, or hearing an…

Making a child repeat a year rarely fixes what went wrong. The same lessons without different support tend to produce the same result, plus the sting of being the oldest in the room.

If a year has gone badly, the useful questions are what support was missing and whether something else, such as an unrecognised learning difficulty,…

ADHD is not only about focus. Physical health tends to drift down the list, and appointments, sleep, food and movement are exactly the sort of thing this condition makes hard to keep up with.

Pick one health task you have been putting off and make it small and dated: book the check-up, refill the prescription, put a walk in the diary with…

Work is one of the places ADHD does the most damage, and it is usually a question of fit rather than ability. Choose the job that suits how you actually run, not the one that would suit an improved version of you.

Variety, movement, visible deadlines and quick feedback tend to work. Long stretches of quiet paperwork with a deadline months away tend not to. If…

If work keeps going wrong in the same way, ask for the expectations in writing before the next thing goes wrong. What is obvious to a manager is often not obvious to you, and a written version can be checked.

It might be a list of what counts as done, agreed deadlines, or the safety rules that are not negotiable. Adjustments are worth asking for too:…