Loading practices
Loading practices
Areas › Focus, starting, and ADHD › Treatment and medication
Accommodations are not treatment and they are not pretending to be. What they do is take the parts of the work that live inside a person's head, holding time, holding rules, holding motivation, and put them out in the room where they can be seen. That is why they keep working in a way that training a skill often does not: nothing has to be remembered or generalised, the support is simply there. It is also usually the cheapest thing on the list.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
God wishes to lighten your burden; man was created weak (Quran 4:28). Lightening what is carried is described as mercy, with no suggestion that it is a lesser way to go on.
النساء
يُرِيدُ ٱللَّهُ أَن يُخَفِّفَ عَنكُمۡۚ وَخُلِقَ ٱلۡإِنسَٰنُ ضَعِيفࣰ ا
God wishes to lighten your burden; man was created weak
Qur’an 4:28read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
In a trial of 410 adults randomised to six months of atomoxetine or placebo, the main outcome was work productivity rather than a count of symptoms. It is a useful illustration of the distinction being drawn: how much someone gets done and how much of the disorder is present are two different measures. Accommodations aim squarely at the first of those, and that trial was of a drug rather than of accommodations.
Adler LA, Spencer TJ, Levine LR, Ramsey JL, Tamura R, Kelsey D, Ball SG, Allen AJ, Biederman J. (2008). Functional outcomes in the treatment of adults with ADHD.. Journal of attention disorders doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Putting time, rules and reminders out in the world means the person no longer has to hold them in a place that keeps dropping them.
After a working lifetime in this field, Barkley names the change in how a family sees the child as the most important step of all. Not the medication, not the charts.
Everything has side effects, including doing nothing. The only real question is whether what you gain outweighs what it costs you.
Move the family's picture from a child who will not do as they are asked to a child whose capacity for holding themselves in place is genuinely limited. It is a change of category, not a softening.