Focus, starting, and ADHD

Feeling bad about being late is a consequence you can talk yourself out of in about four seconds. Telling a friend you are buying dinner if you are late is not.

Pick something small and real, and pick a person who will hold you to it without being unkind about it. Dinner, the coffees, the taxi fare. The size…

Put the stake outside your own head. Tell a colleague that if you are late to the meeting, lunch is on you.

The link between being late and buying lunch is arbitrary, and that does not matter at all. What matters is that it is real, it happens soon, and…

Say the plan out loud to somebody. A manager, a colleague, your wife, a coach. Hearing yourself explain it does something that turning it over privately does not.

The listener does not need to be an expert in any of it. Talking forces you to put things in order, and the gaps tend to announce themselves halfway…

Once a week, both calendars open on the table. Who is doing scouts, who has football, what is happening on Thursday. Twice a week if the house is busy.

The point is finding the collisions while there is still time to sort them out, rather than at eight on Thursday morning with coats half on. Keep it…

Choose one person and tell them you will send the finished thing by a set time. Not a conversation about how it is going, just the file, the photo, or the word done.

The sending is the whole mechanism, so keep it small and exact: what, and by when. It does not have to be someone qualified to judge the work, and it…

Let the child score themselves on the same sheet the teacher scores. Two columns, filled in separately, then looked at together.

At first the two columns can be miles apart, and that is the useful bit rather than a problem. Nobody is being caught out. Over the weeks the gap…

Good help leaves you more able to do it yourself next time. If the whole thing only works while the other person is in the room, something has gone sideways.

There is a real difference between someone building your schedule for you and someone sitting beside you while you build it. The second is slower and…

If a course has no fixed time, give it one. Write down which day and which hour you will watch it, put that in the calendar as though somebody else set it, and tell one person.

Five minutes every Sunday: when am I watching this, and when am I doing the work that comes after it. Then one short message midweek to whoever is…

When you agree to something, agree who follows up. Do you tell them if it slips, or do they check in with you?

Most of the hurt around late work comes from nobody having said. You assume they will ask, they assume you will speak up, and the silence in between…

Difficult things come out more easily when your hands are occupied and you are not looking straight at the other person. Walk side by side, drive somewhere, wash up together, keep the sewing going.

If you are the one listening, offer it first. Most people assume that picking something up would look rude or half interested, so they sit still and…

Some things only happen when another person is there, even if they are doing something entirely different. Ring a friend and clean your two kitchens together with the phone on the counter.

This works for studying, tidying, paperwork and the weekly shop, because what you are borrowing is presence rather than help. Agree a start time and…

If you keep it all in your head, it is worth asking who else is keeping it. Very often somebody nearby is doing the remembering, and neither of you has ever said so out loud.

This matters because from outside it looks like coping, right up until that person is away, unwell or worn out by it. Ask the plain question at home:…

A behaviour agreement needs six things in it: the goal, exactly what the child does, what they earn, what happens if they do not, signatures from everyone, and an adult who sticks to it.

Most of these fall apart over what was meant rather than over what was done, so write the specifics down to the level of what counts as finished. The…

Work the deal out with the child instead of handing it to them. Much the same rules, an entirely different feeling.

Let them argue for a bit longer on the console, or for Friday off, and give ground where you honestly can. The terms tend to land in roughly the same…

Some of what feels like a flaw in your character is really a job that can be handed to something outside your head: a calendar, a list on the wall, a person who helps you lay out the week.

Coaching for attention difficulties is mostly this, and nothing more mysterious. Someone sits with you, builds the week, works out what comes first,…

Sorting goes better fast than carefully. If every item stalls you, ask someone to sit in the room while you work, not to help but to keep the pace up.

A person nearby changes what the hour feels like, and they can be reading their own book the whole time. What they supply is momentum, which is…

If someone close to you has become the person who chases you, that arrangement is wearing you both down, even on the days it works. It is worth naming out loud and changing on purpose.

Once a partner or a manager supplies all the pressure, nothing inside you ever needs to. They end up tired and resentful, you end up handled like a…

Try not to ask why. If the person knew why, they would probably have sorted it out already, and the question tends to land like an accusation.

Ask what happened just before instead. What was going on, what they felt, what came after, what sort of day it had been. Those answers can be worked…

You can screen for a processing difficulty with no test at all. Just notice, in ordinary conversation, whether the child is answering what you actually said.

A child who drifts off topic, answers a slightly different question, or needs things said twice may not be avoiding you or daydreaming. The words may…

Clapping games, skipping rhymes and silly verses are worth doing. They are good for the ear and they cost nothing, but they will not on their own repair a reading difficulty, and it is kinder to say so early.

Play the games, and separately get the structured teaching that a child with a real decoding problem needs. Families are often told that rhyming…

Invent words together. Say a made up word, pull it apart into its sounds, put it back, then take one sound out and hear what is left. The nonsense is the point, because there is nothing for memory to fall back on.

With a real word, a child who cannot work with sounds can often get by on memory, and you learn nothing about what they can actually do. A made up…

Plenty of children read the equals sign as put the answer here. Write it the other way round sometimes, eight equals three plus five, so they meet the idea that both sides are simply the same amount.

Move the sign about. Leave the gap in the middle, four plus something equals two plus five, and watch what the child does with it. If they add…

The word one does several jobs at once: a digit, a number, a single object, a whole set. A child who has not sorted those out will put figures in the wrong columns and later read a third as a number instead of a part of something.

When digits land in the wrong place, check whether the child knows what is being counted before calling it carelessness. Say the unit out loud: one…

Phonological awareness is not one skill. Telling sounds apart, rhyming, breaking a word into its sounds and blending them back are separate jobs, and a child can be fine at one and stuck at another.

Before agreeing that a child needs phonics, find out which piece is missing. Ask them to say the sounds in cat, then to join up sounds you give them,…

A display organised by sound rather than by alphabet gives a child more to hold on to. Let them feel where each sound is made, lips, tongue, teeth, and match that to the letters that spell it.

Reading is learned from speech towards print, so a border running A, B, C tells a child very little about what they are actually doing. Grouping by…

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.…

Build numbers and break them up again. Seven is five and two, and also six and one, and a child who can see that has the thing mental arithmetic is made of.

Blocks, buttons, coins, anything you can push into two piles and back together. Ask which numbers fit inside other numbers and let the child show you…

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…

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…

Pill swallowing can be taught in a few short sessions with sweets. Start with the tiniest ones, give two to eat for every one swallowed whole, and work up in size across a week.

Keep each session short and cheerful and stop before anyone is upset, since one frightening attempt can set the whole thing back weeks. For capsules,…

Being given a medicine that holds no licence for your condition can feel like being experimented on. Usually it means the evidence is decent but thinner than a licence demands.

Bupropion is the common case. It helps some people with attention difficulties, often alongside a stimulant, and it never gained the indication, so…

Before you explain anything about medication, ask what the person already believes about it. You cannot correct a worry that has never been said out loud.

Most people arrive carrying something: a cousin who could not sleep, a headline, a parent with a strong view. Lead with your own information and you…

In practice the non-stimulants turn up more often as an addition than on their own. A stimulant in the morning with guanfacine alongside it is a common shape.

The two act at different points of the same circuit, so they tend to complement rather than repeat each other, and the blood pressure effect of one…

A small short-acting dose in the afternoon, on top of the long-acting one, is ordinary practice rather than a special case. Homework and the evening drive often fall outside what the morning dose still reaches.

The hours when you most need to hold back are frequently the hours the medicine has stopped covering. Raising the morning dose to solve an early…

These are among the best studied medicines in psychiatry, in use for decades. Most of the hesitancy around them traces back to how they get covered in the press rather than to the safety record.

Saying that is not the same as saying there is nothing to watch. Heart rate and blood pressure shift a little, appetite and sleep often need…

For a family stuck on whether to medicate at all, the comparison with diabetes often unlocks something. Nobody manages diabetes on diet alone, and nobody calls insulin a moral failure.

Offered gently it moves the question from what kind of parent am I towards what does this condition need. Played as a trump card it makes people…

Methylphenidate and amphetamine are not two names for the same thing. One mainly blocks dopamine from being taken back up, and the other does that and pushes more of it out as well.

That extra step is why the amphetamines tend to produce somewhat larger average effects, and why somebody who got nothing from one can do well on the…

The potential for misuse belongs to one of the three families rather than to ADHD medicines generally. The stimulants reach the reward circuitry and the others do not.

That gives a clear answer where there is a substance history in the house, or a worry about tablets going missing at school. Say plainly that a…

Plenty of children on a stimulant are taking something else as well, most often an antidepressant. That second medicine is usually there for a second problem rather than for the attention itself.

It is a useful lens when a regimen has grown complicated. Ask what each item is for, and the list generally resolves into a treatment for the…