Focus, starting, and ADHD

Cutting sugar does not improve ADHD, and nor does stripping out additives. Both have been tested repeatedly, including under conditions where nobody knew which child had eaten what.

The belief survives because parties are where children eat sweets, and parties are also loud, crowded and thrilling. The sugar takes the blame for…

Megavitamins, antioxidant products such as pycnogenol and assorted trace minerals have not beaten placebo for ADHD. They stay popular on the strength of a good story about how they ought to work.

The gap between a mechanism and an outcome is the thing worth teaching, because it will still be useful when the next product appears. Ask what…

Chiropractic neurologic organisation training, the kind involving manipulation of the skull, has no credible theory behind it for ADHD. The main harm is not the treatment itself but the months and the money that go into it.

Families meet this because it is marketed at them at the exact moment they are most willing to try anything. Naming it plainly, once, is usually…

With EEG neurofeedback, the weaker the study, the better the results look. Six large trials using sham feedback, with parents and teachers kept unaware of who received what, found nothing beyond placebo.

That shrinking with rigour is itself the finding. Blinding matters especially here because the outcome is a rating made by adults who have watched…

Brain training makes you better at the game, and at things that resemble the game. It does not seem to reach the parts of life you bought it for.

Cogmed, the several hundred apps, the balance based programmes: they all hit the same wall when someone independent tests them with a proper control…

One senior researcher in this field is approached by ADHD app startups roughly once a month and no longer takes part, on the view that the companies are not seriously trying to build something that works.

You do not have to share his judgement to borrow the question. Before paying for a digital product, ask who tested it, whether those testers were…

Peripheral biofeedback, the sort that tracks skin conductance and heart rate rather than brainwaves, has more behind it than neurofeedback does. You practise letting the body drop into a calmer state while a monitor shows you it happening.

Once that state is familiar, pair it with a distinctive scent used only for this. After enough repetitions the smell starts pulling the state along…

If you are going to take supplements, it is worth paying a small subscription to a service that assays what is actually in them. ConsumerLab is one, at roughly sixty dollars a year.

The thing to check about any such service is who funds it, because a tester paid by manufacturers is a marketing department with a laboratory…

When omega levels are low, everything about ADHD tends to get louder: attention, mood swings, holding things in mind. Low omega does not cause ADHD, but it can be sitting on top of it.

Think of it as one more layer to lift off rather than the thing underneath. Specialist labs can measure levels if it seems worth checking, and…

One woman's ADHD symptoms climbed and her thinking slowed as each B12 injection wore off, then settled again after the next one. The deficiency came down one side of her family and the ADHD down the other.

The two lived in the same person without either causing the other. What made it findable was the timing, because difficulties that follow a cycle are…

Play therapy and insight based psychotherapy do not treat ADHD. There is no buried, unexpressed feeling driving it that talking will let out.

The difficulty sits in executive control and how it develops, not in hidden conflict. That said, a child with ADHD can also be anxious, grieving or…

The studies tying childhood screen hours to later attention problems are correlational. They cannot tell you which way the arrow points, and there is a very ordinary reading where it points the other way.

The child who cannot settle is the child most likely to be put in front of a screen so that dinner gets cooked. A parent who is scattered themselves…

Fast cuts, saturated colour, constant motion, a level that ticks over just as you were about to stop. Screens are not accidentally gripping for a distractible brain, and preferring them says something about how you are wired rather than about what has gone wrong with you.

There is a second use for knowing this. If those features are what holds attention, they are also the features worth stealing for the things that…

Ask a child how long they were on the tablet and the answer comes back low. Ask their parent and that answer comes back low too. Neither of them is exactly lying to you.

A child does not volunteer that they went over the limit, and a parent doing their best on every other front rounds their own household down. This…

If someone selling you a treatment for ADHD uses the word cure, that is your cue to leave. There is no cure. What good treatment offers is fewer symptoms, and that is a real and worthwhile thing.

A registered clinician is not allowed to promise you an outcome, because nobody can honestly guarantee one. So a provider who promises makes you a…

ADHD is managed rather than cured, across a whole life. Anything advertising a cure is telling you it is not working from the evidence.

Managed sounds like a disappointment until you look at what it means in practice: treatment that fits your life now, adjusted when the life changes,…

By response rate, extended release stimulants are among the most effective medicines in psychiatry, and most people tolerate them well. That is worth hearing plainly, particularly from people who are not generally keen on medication.

What the long acting form buys you is coverage. A dose that has faded by four in the afternoon leaves the evening bare, and the evening is where home…

Three things are worth noticing before you buy any treatment: whether the only research on it is their own, whether they will say plainly what it is meant to change, and whether you have to sign something.

Each one covers a different way of being caught out. Research a company funded and ran itself has never been checked by anyone with nothing to lose.…

Better usually means smaller, rarer, or shorter. Pick something you can count, like losing your keys twice a week instead of every day.

Vague goals cannot be reviewed, so a few months later nobody can say whether anything changed and you are left going on mood alone. Choose two or…

You are going to look things up anyway, so start somewhere with proper review behind it. CHADD and Understood both have professionals checking what goes on the page.

Telling anyone to stop searching online has never worked and only means they search without saying so. Better to hand over two or three places worth…

Part of why so many adults are coming forward now is that well known people have said out loud that they have this. Seeing someone capable say it makes the asking cost less.

The old picture of ADHD was a careless child and a lazy adult, and that picture kept a great many people from ever mentioning it. An athlete at the…

Brain training and therapeutic games raise one question above all others. Does the improvement show up anywhere except inside the game, and does it last once you stop playing?

People do get better at what they practise, and the scores go up, which makes for a persuasive chart on a website. The harder question is whether…

Supplements are not checked before they go on sale, so what is in the bottle may not match the label. Look for a third party mark such as USP or NSF before you buy.

This is not about whether a given supplement helps. It is about the plainer question of whether you are getting the dose written on the front, since…

CBT has more research behind it than most other therapies, and part of that is because it is easy to count. Its steps and its outcomes can be scored, so it gets studied more often.

That is worth saying because a thin research base is not the same as a therapy that fails. Approaches that work through relationship, imagery or the…

Two things happening together is not one causing the other. Learn that once and you have a reply to most of the claims you will meet.

Children with ADHD may use more screens, and screens may not be the reason. The same shape turns up with sugar, with additives, with organic food and…

Untreated ADHD is not free. It turns up in appointments, in repeat trips to A and E, in school reports and in lost work, and the bill lands on the family either way.

So when the cost of treatment is the reason for waiting, it is worth adding up what is already going out, in money and in hours and in the things…

Play based programmes that build executive skills in young children have done reasonably well with children at risk of struggling at school. None has yet been tested in children actually diagnosed with ADHD, and that is a real difference rather than a technicality.

Results found in a broad at risk group tend to shrink, sometimes to nothing, when the same thing is tried with clinically diagnosed children, where…

Showing a teenager live pictures of activity in one targeted part of their own brain has been tried once, in a small trial, and it looked encouraging. That was around a dozen young people, and nobody has repeated it yet.

This is worth knowing about mainly so you can tell it apart from the neurofeedback that is widely sold. The clinic version reads surface brain…

There is a headband worn at night that stimulates a nerve in the face, cleared by regulators and tested against a dummy version in a single trial. Some children improved. Some felt sick or slept badly and stopped.

Regulatory clearance answers whether a device is safe enough to be sold, not whether it beats what you are already doing. One trial, funded by the…

Magnetic stimulation of the brain has been tried for ADHD and has not yet shown anything. The studies are small, often single cases, and not built in a way that could give a trustworthy answer.

Small uncontrolled studies are generous places. Hope, attention and the freedom to report only the good parts all push results upwards. That does not…

Programmes built on crossing the midline or on balance and inner ear work do not appear to beat ordinary exercise. If movement is what you are after, movement is available free.

These packages come with a theory about why they work, and the theory is usually where the confidence comes from rather than from the results. What…

Massage may well leave you calmer, and calmer is worth having. It is not a treatment for ADHD, and the two are worth keeping in separate boxes.

Living with ADHD is stressful in a measurable way, so anything that genuinely lowers that load is doing real good and deserves a place. The error is…

Rather than memorising which treatments to avoid, keep a few questions you can put to any of them. New products arrive faster than anyone can keep a list.

Ask how it was tested and by whom, and whether anyone independent of the company has looked at it. Ask what it costs, whether insurance touches it,…

Roughly, the order runs like this. Stimulant medication does the most, the non stimulants help but come second, and after that exercise, omega oils, accommodations and therapy are the ones worth your time.

Decent sleep, ordinary good food and keeping screens within reason sit underneath all of it as support rather than treatment, and a sleep study is…

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…

The diet evidence has drifted away from cutting particular things out and towards eating decently overall. That is easier on everyone at the table.

Removing additives or colourings helps a small number of children, and the trouble is that you cannot tell in advance who they are, so most families…

Think of ADHD as sitting at the centre of an onion. Poor sleep, sleep apnoea, low vitamin levels, allergy, ongoing pain, untreated anxiety or low mood all sit in layers around it, and each one makes the centre look worse than it is.

This explains something that otherwise looks strange: treatments that do nothing whatever for ADHD can still make a real difference, because they…

When a child with ADHD and a parent get stuck in daily rows, the rows themselves start doing damage. Getting the ADHD properly managed early takes some heat out of those exchanges before defiance settles in as a habit.

The chain people worry about runs from constant friction at home to entrenched defiance, and from there to difficulties in the teenage years that are…