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…

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…

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…

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,…

When your child comes to you in a spin, the kind thing is to stay warm and steady rather than to promise that it will be fine. Reassurance settles the next ten minutes and feeds the asking.

It sounds cold and it is not. What your steadiness says is two things at once: this feeling is real, and I think you can carry it. Keep it short and…

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…

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…

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,…

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…

Skipping weekends, holidays and summers is a common suggestion and mostly it is the wrong call. The difficulty does not take a holiday when school does.

Unstructured time asks more of planning and self-regulation rather than less: whole days to fill, everyone at home, no timetable holding the shape of…

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…

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…

To find out whether treatment is helping, ask the people who live with the person. One parent who stopped her medication for a family holiday remembered a lovely trip, while her children remembered running it.

Two teenagers had packed for her, fetched what she forgot, and kept an eye on the airport clock. She had no idea any of it happened. There is no…

The old argument about medication against behaviour therapy was set down years ago. The useful question now is what each one covers.

They work by different routes and they reach different hours of the day, so putting them in a single contest was never going to tell anyone much.…

Adding psychosocial work to medication buys something extra, and less than people hope. The extra tends to arrive in the places medication was never going to reach.

Homework routines, the temperature of arguments at home, how a teacher speaks to a child, the hours after a dose has worn off: that is where the…

Doing the behavioural work alongside a medicine can mean managing on less of it. That matters most for the side effects that follow the size of the dose.

Appetite, sleep and irritability all tend to scale with how much is being taken. Where part of the load is carried by routines, by support at school,…

Stopping medication rises sharply in the early teenage years. If that is where you are, it helps to know this is the usual pattern rather than a sign that something has gone wrong with your child.

The pull is understandable: wanting to be in charge of your own body, hating being the one who is different, and a parent no longer standing over the…

With some sensory routines, the part doing the work may be a parent's steady hands and full attention rather than the technique itself. Worth knowing, because contact carries into the rest of the day and a protocol does not.

Views differ on this and the research has not sorted it out. What follows practically is that a family who cannot keep the exact routine going has…

Who pays the bill does give a household some say. That argument weakens every year a child gets older, and it runs out entirely once they are an adult sitting in front of you asking for help.

With a sixteen year old at home on the family plan, parents setting terms is reasonable and worth saying out loud. With an adult, the same move…

Ask your child to show you their feed and explain it to you. You are asking to be taught rather than to inspect, and from the other side those feel nothing like each other.

Something shifts when the young person is the one who knows more. They slow down, they explain who these people are, they tell you which bits are…

Pick one series and watch it together on the same evening each week. The point is not the programme. It is that something puts the two of you in the same room on purpose.

With an older teenager or a young adult, a set night can carry a relationship through stretches when talking is hard. Some weeks you will pause it…

Fasten a time you keep missing to another person. Go up when your partner goes up. Ask a colleague to knock for you on the way to the meeting.

A person moving is much easier to notice than a number changing. Ask for it as a favour and keep it small and specific, because a vague request to be…

When someone reminds you often enough, things do get done. But the sense of time doing the work is theirs, which is why it all collapses the moment they stop.

Worth naming out loud in a household, because the reminding costs the relationship something and never builds the missing part. A better arrangement…

Moving between lessons is where things fall apart, so plan the move out loud before it happens. What to bring, where to go, and who will be waiting.

Before the child leaves maths, walk them through what comes with them and tell them to check in with the next teacher on arrival. That teacher greets…

A lot of what people now know about ADHD came from a video. Some of it is genuinely good, some of it is not, and asking someone what they have been watching is a fair question to open with.

Creators who live with ADHD have done real good here. They have made people feel recognised and made asking for help less frightening, and some…

Long acting does not automatically suit everybody. Some people genuinely do better on shorter doses, and it is worth saying so rather than assuming the newer option must be right.

There is a folk belief that a person's own chemistry takes over in the afternoon once the medicine wears off, and the research does not support it.…