Focus, starting, and ADHD

Waiting to see how they get on carries a cost that is easy to miss. Every year a child spends behind narrows what is available to them the year after.

Treatment does not settle a life. What happens is that school reports, friendships and confidence build on one another, so a stretch of doing better…

If the medication question is the one burning a hole in your pocket, try holding it until last on purpose. Heard after everything else, the answer lands differently.

Most people arrive wanting to know about tablets and nothing else, and the risk in that is a plan made only of tablets. Sleep, movement, the shape of…

There is no brain scan, EEG trace or blood test that can tell you whether someone has ADHD. Anything sold as an objective biological test for it is promising more than the science can give.

Group differences do exist, including in the theta to beta balance, but a difference that appears when you average hundreds of people cannot identify…

Balance difficulties do turn up more often in ADHD, by something like half again. That is a fact about company, not about cause, and it does not turn balance training into a treatment.

Plenty of things could sit behind a link like that. More falls and knocks, more risk taken, or genetics feeding both at once. Working on balance…

Protocols that spin a child in a chair or tip them backwards and forwards to train balance do not improve ADHD. What they mainly produce is a dizzy child.

There is a cost beyond the wasted afternoons. Something unpleasant that was introduced as treatment teaches a child what treatment feels like, and…

Neurofeedback rests on a tidy idea: in ADHD the slower theta rhythm shows up when the faster beta rhythm should be running, so the training rewards you for shifting the balance. Knowing the idea is worth a few minutes, because it is what the brochure is built on.

Electrodes sit on the scalp, a screen animates when the signal moves the wanted way, and the person practises staying in a state of relaxed…

Ask what happens after the course ends, not only what happens during it. A gain that fades once the sessions stop was probably never a change in the person.

Neurofeedback tends to look decent while it is being delivered and then drift back, and the studies that followed people afterwards did not find…

Before committing to a course that runs into thousands, set the same money next to the other things it could buy. Tutoring, a proper assessment, a medication review and a well tested psychosocial programme all sit in the same envelope.

Neurofeedback courses often run for a month or more, insurers rarely pay, and the training of whoever delivers it varies a great deal. The cost is…

When you read that a treatment worked, look for who judged the improvement and whether they knew what the child had been given. In much of this literature, they knew.

The design to look for is a sham condition, where everybody goes through the same routine and only some receive the active ingredient, with the…

Regulators let devices through by several different routes, and only some of them mean what a family assumes. A game cleared for further investigation has not passed the bar a medicine passes.

The word approval carries an authority that advertising borrows freely, and device pathways are shorter and lighter than the ones drugs travel. It is…

Programmes built on tones through headphones and balance drills have not been shown to help ADHD. If a child does seem steadier during them, the likeliest reason is that something is occupying the part of them that goes looking for stimulation.

That effect is real enough, and it is cheap to get elsewhere. A walk, a job with the hands, background sound they choose themselves, all of it…

Several professional bodies came together to say that vision therapy is not a treatment for ADHD. A joint statement like that is unusual, and it is worth quoting to a family word for word.

Convergence problems, where the eyes struggle to work together on something close up, are a little more common in ADHD and deserve treating in their…

If you are trying omega supplements, give them four to six weeks and then decide. Imaging work has picked up changes in how neurons communicate after around four weeks, which is fast as these things go.

Fixing the end point at the start protects you twice over. It takes the sting out of nothing happening by Thursday, and it stops an open ended habit…

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…

If you are thinking about a weighted blanket or vest for a child, let an occupational therapist set the weight. It is a specific number for a specific body, not something to guess at in a shop.

The pull to order one straight away is understandable, especially after months of bad nights. What an OT does is match the weight to the child's size…

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…

Not every reminder is the same kind of reminder. Call at three is a clock job, when I next see my manager is a person job, and that thing at the conference next year is a diary job.

Mixing them up is where a lot of honest intentions leak away. A note on the desk will not survive until next March, and an alarm cannot tell you your…

Some things can be done a day late with an apology, and others cannot: the ticket doubles, the window shuts, the form is simply gone. Sorting your obligations into those two piles tells you where the effort is worth spending.

Lateness tends to get treated as one big failing, which makes every missed thing feel equally awful and gives you nowhere to aim. Go through what is…

A sticky note is fine for something happening within the hour. Anything further out needs something that goes off by itself, because holding a plan in mind for three days is not a thing memory does.

Most reminder failures are this mismatch rather than a lack of trying. Someone uses a note where an alarm was needed, it fails, and they conclude…

Anything that comes round every month should be leaving your account without you. Direct debits and standing orders take the remembering out of the job altogether, which beats any reminder you could set.

It is worth an afternoon. List what recurs, automate what can be automated, and put one calendar note to check the statement each month instead of…

Every extra step in a task is another place to lose it. Three clicks and done beats a process with a form, an envelope and a walk to the postbox, even when the second one saves a little money.

Before you commit to a routine, count its steps, then take some out. Bin bags stored next to the bin, stamps kept with the envelopes, paying on the…

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…

Ask two questions and then sit with the difference. How much time on this would you like? And how much do you think is actually good for you?

Almost nobody gives the same answer twice, and the gap between the numbers is more persuasive than anything you could have told them, because they…

Nothing here does the job on its own. Medication if it suits you, a few practical systems, something for the low mood and shame that has built up, and the people you live with brought into it.

The practical layer is the easiest to describe and the first to fall over, because whether you use a system at all depends on how you feel about…

The timer you will actually use is the one that takes two seconds. A dial you twist beats an app with four taps, every time, whatever the app can do.

Keep a cheap kitchen timer where you work and another where you get ready. If speaking to a smart speaker is quicker for you, use that instead.…

The inner clock does more than one job. It tells you what time it is now, how long that took, how long things usually take, and it taps you on the shoulder when a particular time arrives.

Worth finding out which of those is weak for you, because they need different props. Someone who estimates badly needs a record of past attempts to…

A list on the back of an envelope, made before the day starts, beats holding the day in your head. It does not have to be neat and it does not have to survive contact with the morning.

Write what has to happen and roughly in what order, and keep it where you will see it. Two things come out of that. You have made one deliberate…

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 reading has always been slow and effortful, that is worth looking at in its own right. Dyslexia and ADHD turn up together far more often than chance would give, and they need different help.

Someone can do very well in a subject built on reading and still read slowly, and that is often the difficulty left over once everything else has…

Bad with time covers at least five different things: arriving late, missing deadlines, never planning ahead, always guessing the best case, and losing hours inside something absorbing. Each one has a different fix.

Write your own list and mark which ones actually apply to you. Someone who is never late but always guesses the best case needs a record of real…

A clock only counts if you can see it without doing anything. Behind you, in a pocket, behind a lock screen: that is not a clock, that is an errand.

Walk through the places where time actually disappears for you and put something visible in each one. The bathroom, the kitchen, the desk, the room…

When you are sure something takes ten minutes, do not argue with yourself. Write down the guess, start a timer, and look at both afterwards.

Do it for the handful of jobs that keep wrecking your mornings: the shower, the email, the tidy before guests. Keep the numbers somewhere you can…

If the internal clock is not there, put clocks in the room. Somewhere the child can see without turning round, a timer on the desk, one on the wall by where they work.

Think of it as a prop rather than a cure. The aim is not to train an ability into existence before the child is allowed to cope, it is to let them…

Take the Friday deadline and walk it backwards onto the days. What happens Monday, what happens Tuesday, written down where both of you can see it.

Children with this difficulty rarely generate the sequence themselves, and asking them to is asking for the thing that is hard. So supply it, on…

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.…

When you are choosing where to start, take the easy one rather than the important one. Direction matters more than size at the beginning, because these things gather speed whichever way they are pointing.

The loops that drag you down run in reverse as well. A week where two small things went right makes a third worth attempting, and the person you are…

Some people book their first assessment on the day they turn eighteen, because it is the first day they can consent without a parent. If you have been waiting like that, the waiting was not laziness.

Where a family or a community treats mental health care as shameful, a young person can spend a decade struggling with nobody's permission to ask for…

Think of a calendar as memory kept outside your head rather than as a test of discipline. Its whole job is to answer what you should be doing now, so that you do not have to work it out.

That framing matters if planners have ever felt like a judgement on you. Nobody expects anyone to hold a phone number in their head any more. The…

By your teens you need some way, any way, of answering one question: given that it is this time on this day, what should I be doing? A plain system that answers it beats a beautiful one that does not.

Paper, phone, whiteboard on the fridge, the format is not the point. If the answer depends on remembering, it depends on luck. Pick the thing you…