Focus, starting, and ADHD

Ask what someone takes that is not food, rather than asking what medications they are on. People do not file their supplements under drugs, so the usual question comes back empty.

There is a case worth carrying around for this. A liver transplant patient kept rejecting the organ, and it turned out he was quietly taking…

More clinicians now raise supplements themselves, and more of them will suggest something like omegas. The shift matters less for what gets recommended and more for what it does to disclosure.

People hide what they expect to be laughed at. Someone braced for an eye roll simply does not mention the four bottles in the kitchen cupboard, and…

Sensory integration training is popular and it does not help ADHD. Whatever value it has elsewhere, the capacity it works on is not the one that is impaired here.

What is impaired in ADHD is holding back a response and steering your own behaviour over time. Sensory modulation is a different thing altogether.…

A child can learn a self control routine beautifully in the therapy room and not use it once all week at school. Knowing the steps and performing them under pressure are two different skills.

This is why supports that sit in the moment tend to beat supports that sit in the mind. A prompt at the point of need, a changed seat, a rule the…

You can mean something completely, drive most of the way there with it in your head, and still turn left instead of right. Meaning it and doing it are two separate events, and only one of them is visible to anyone else.

To a partner, the missed errand looks like a verdict on where they come in your order of things. It helps to say out loud, at a calm moment rather…

Saying it is done when it is not is a common next step, and it makes more sense than it looks. The lie is rarely about the parcel, it is a way out of the look on somebody's face.

It also makes everything worse, because being found out turns a forgotten task into a trust problem, and that is a much longer repair. If this is…

Somebody should ask the boring question: is there a list at all, anywhere? It gets skipped for being too obvious to ask, which is how a person can go years with nothing.

The format does not matter: Outlook, a notes app, the back of an envelope kept in one place. What matters is that intentions live somewhere outside…

If you are going to ask someone to remind you, tie it to something they want as well. Reminding you to book the car in is much easier when it is also their car.

Asked as a favour it becomes a job they never applied for, and resentment collects quietly on both sides. Asked as a shared arrangement it lasts. Be…

You will still forget things. What decides how much damage a missed task does is usually the ten minutes after you notice, not the miss itself.

Two moves reliably make it worse: sinking into shame until you cannot look at the person, and defending yourself as though nothing had been dropped.…

The standard was never that you drop nothing. It is that the effort is steady and visible, and the misses that remain get some grace.

This matters as much for the person waiting on you as it does for you. Perfection gives them nothing to notice and gives you nothing to reach, so…

If the screen limit in your house is only your preference, every evening turns into a negotiation about your preference. Borrowing a published figure, roughly two hours a day of leisure screen time for a child over two, moves the argument off you.

The carve-outs matter as much as the number. A video call with a grandparent is a conversation, and a laptop open for homework is schoolwork, so…

For a child who finds face to face conversation frightening, a game where they talk to friends while doing something else may be the only place they socialise at all. Worth noticing before you count the hours.

Talking through a headset takes out most of what makes conversation hard: no eye contact to hold, no faces to read in real time, no silence to fill.…

It is a genuine relief to hear that what someone did online may not reflect who they are. Say that gently, and say the other half in the same breath: the people who saw it will judge it as though it does.

Both halves are true and they need each other. Offer only the first and you have handed over a reason for nothing to change. Offer only the second…

More hours on social media goes with more anxiety and low mood. That is a reason to aim at fewer hours, a conversation you can actually have, rather than at none, which usually ends the conversation.

Pick a number genuinely below the current one and low enough to notice, then look at what has changed in a fortnight. Sleep and mood are the things…

Some of what circulates makes being unwell look good. Drugs filmed like a party, low mood styled into something delicate and photogenic, until the illness starts to feel like a personality.

This is worth spotting because of what it does to recovery. If sadness has become part of how someone is known, getting better means losing something…

Real footage of people dying circulates without any warning, sometimes buried inside a video that starts off looking harmless. Young people rarely raise this themselves, so it is worth asking.

Ask plainly what they have come across that they wish they had not seen, and how often it happens. There is no preparation before it and nothing…

The quietest damage comes from a young person deciding that feeling like this is simply how it is, because everyone around them feels it too.

Once distress counts as ordinary it stops being reported. Nobody mentions it at home, nobody brings it to an appointment, and years can pass with…

Ask everybody, at the start, what they use and how it goes for them there. Not only the ones who arrive with an obvious phone problem.

Two questions do most of the work: which platforms are you on, and what is it like for you on them. Asked early, without any warning tone, it makes…

A young person on the sofa with their phone looks like nothing is happening. From the inside it is often the first hour all day that has asked nothing of them.

Both readings are true, and the argument is usually about which one gets said out loud. Naming the second one to a parent takes a surprising amount…

Before a phone gets taken away, it is worth asking what else goes with it. For a lot of young people the group chat is where their friendships actually live, and losing it leaves them alone at the moment they most need someone.

This is not an argument against limits. It is an argument for knowing what you are cutting. If the same device carries the friendships, the homework…

A screen is a privilege, not something a person is owed. Food, clothes, a warm home, medical care, school, being loved: those are owed, and a phone is not on that list.

Saying this plainly gives a household something firmer than mood to stand on when limits are set. It also keeps two things apart. The care and the…

When someone misuses a device, sending explicit messages or piling on to someone or going where they should not, the useful read is that they were not ready for that much freedom yet. Not that they are a bad person.

Readiness gives you somewhere to go. You can name the skill that was missing, hand back a smaller amount of access, and set out what would show they…

Tell someone their phone is wrecking their sleep and you have handed them something to argue with. Ask instead what they notice on the mornings after a late scroll, and let them say it.

This is the difference between a conclusion arriving from outside and one a person reaches themselves, which they then have to take seriously because…

People rarely stop at you are late. They move on to what sort of person is late, and then it is about respect and reliability rather than about time. You have probably taken that account on board yourself.

Naming the jump out loud helps, at home and at work: this is a difficulty with timing, here is what I am putting in place, and it is not a comment on…

A child who is blind to time is not ignoring the deadline. They are living in whatever is happening right now, with no sense that the bell is close or that Friday's test has anything to do with today.

It shows up as reacting to each moment rather than moving through a day with a shape. Adults read that as not caring, and the child usually cannot…

The pattern usually ends the same way. Nothing feels urgent, then the deadline lands all at once, and the child panics and produces something poor or nothing at all.

Once you can see the sequence, you can step in near the beginning instead of managing the wreckage at the end. Say it out loud with the child,…

If the test is on Friday and it is Monday, Friday is doing almost no work. Put something today on the end of today's revision, however small.

This is not spoiling a child. It is matching the reward to the timescale they can actually feel, which is roughly the one they are living in. Half an…

If the only real feedback a child gets arrives every ten weeks, it will not shape a single Tuesday. A report at the end of term is a record, not a motivator.

This is worth saying gently to teachers and to parents who feel that grades ought to be motivation enough. For this child they are not, and no amount…

For younger children, make the reward small, concrete and soon. Stickers, points, a smiley face, five minutes of something good, handed over the same hour rather than at the end of the week.

Points that build towards something bigger work well, as long as the point itself arrives immediately. Hourly is not too often for a young child, and…

Keep consequences for the sake of honesty, but let praise and reward do most of the work. Punishment can tell a child what to stop and it cannot tell them what to do instead.

Children with this difficulty collect an extraordinary amount of correction over a childhood, from teachers, from parents, from other children.…

Go looking for the moment the child does the thing you have been asking for, and say so while it is still happening. Most of us watch for the problem and only notice the good behaviour when we have run out of trouble.

It helps to decide in advance what you are hunting for, so that starting the homework without being asked, or waiting a turn, actually registers…

Before you explain anything about ADHD to someone, ask what they already think it is. What they tell you decides what your explanation can land on.

People arrive with family stories, cultural rules about mental health and firm views about medication, and none of it shows up unless you invite it.…

By the time somebody comes for an assessment, the poor opinion of themselves is usually decades old. Assume it is there even when the person in front of you is visibly doing well.

It rarely arrives as a complaint. It shows up as apologising for taking up your time, as brushing off achievements, as a joke about being useless…

If a young person hears your suggestion of a planner as one more instruction, they will refuse it, and the refusal is about who is in charge rather than about diaries. Hand over the choice of format and the choice of what goes in.

It helps to be plain that this is theirs and not a monitoring device. That means not reading it over their shoulder and not producing it as evidence…

Anything with more than one step gets written down, and the child does the writing. Ten problems, check them against the answers, correct what is wrong: three lines in their own hand.

A handout would carry the same words, but writing it themselves does two extra things. It puts the sequence somewhere they can look again when step…

Put the rules up on the wall where everyone can see them, and put the child's own version on a card on their desk.

A rule that lives only in memory is not there in the second it is needed, which is the second something more interesting has just walked past. A card…

Some children need to move, and the choice is whether that movement is allowed for or whether it arrives as a disruption later on.

A ball chair, a standing desk, a seat near the front, or permission to walk to the back and return with a nod and nothing said: any of these let the…

Decide at the start what you are actually aiming at. Eight difficulties down to six, then to four, then perhaps to two. Never zero, because zero was never on offer.

Everybody has some of these traits, and ADHD is largely inherited, so a life with none of it was never a realistic target for anyone. Naming a number…

Hear this before you start rather than after: change here is gradual. Habits built over twenty years do not come apart in three weeks.

Waiting is genuinely harder with ADHD, and a treatment whose reward is months away is exactly the sort of thing that gets dropped in week five.…

Everything has side effects, including doing nothing. The only real question is whether what you gain outweighs what it costs you.

The conversation about medication often gets set up as a risky drug against a safe natural alternative, and that is not the choice anyone is actually…