Practices

When nobody has checked whether a benefit lasts, that is not the same as finding out it does not. Following people up for a year costs money that most studies never had.

Two mistakes sit either side of this. One is reading a gap in the evidence as bad news. The other is assuming something lasts because a trial…

Speech has a beat inside it. When a child cannot hold a steady rhythm, that often sits alongside difficulty with reading and with the flow of talking, so time spent clapping or tapping a beat together is doing something real.

You need nothing for this. Clap a slow pattern, ask them to clap it back, then keep it running while you both count or walk in time to it.…

Start the movement slow enough that it is almost boring. Speed it up once it has gone smooth, and only then add the thinking part.

Throwing a beanbag back and forth, bouncing a ball, drumming on the table: pick something plain and let it become automatic before you make it…

When somebody does not take up the movement you suggested, ask what got in the way before deciding they did not want to. Usually it is money, childcare, transport or time.

Cost, an awkward class time, nobody to watch the children, a room full of people you would have to make conversation with. None of that is…

If you are the therapist, you do not need to become the movement teacher as well. Sending somebody to a person trained for it is the better version of helping.

The evidence is for movement alongside therapy, not for therapy with a few stretches added by someone who picked them up from a video. Handing it…

Pulling back makes you harder to reach, which makes people give up on reaching, which looks like proof that nobody was coming. The loop closes itself.

Being told to open up rarely breaks it, because opening up in one go is exactly the risk the whole strategy exists to prevent. What breaks it is…

Offer choices rather than instructions. With a problem that runs on control, being told what to do gives that control somewhere to dig in.

Two or three real options, the trade-offs said plainly, and then the pick is genuinely theirs. That holds for the big decisions too, like moving to a…

When a parent is set on something that will not hold, one honest story often lands better than a pile of studies. A family finished the better part of a year of neurofeedback and watched their child slide back to where he started within weeks.

Told plainly, with no note of triumph in it, a story like that raises durability without telling a parent they were foolish. They were not foolish.…

Saying that something does not work leaves a parent holding the same worry that sent them looking in the first place. Say what the time and money would buy instead, and put exercise at the top of the list.

The energy behind an unevidenced treatment is usually love with nowhere to go, and if it is not given somewhere to go it moves on to the next…

Ask which direction a person's sensory difficulty runs before offering anything. Someone who is under responsive needs more input and someone who is over responsive needs less, and the wrong one makes the day harder.

The under responsive child is the one climbing, chewing, pressing into things, hunting for sensation in order to feel settled. The over responsive…

Keep something to eat and drink within reach for hard conversations. Handing someone a biscuit and a glass of water often settles a room faster than any instruction does.

Part of why it works is that nobody has to be told how. A person too wound up to follow a breathing exercise can still take a sip and chew. Sharing…

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…

Benzodiazepines turn the volume down. They do not change the setting the volume keeps returning to, and it is worth saying that plainly before someone starts one.

They work by strengthening the braking system the brain already runs, which is why they act quickly and why they need that braking chemistry to be…