Practices

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If a small child cannot swallow tablets, that is a solvable problem rather than a reason to give up on treatment. One methylphenidate preparation comes as a skin patch.

Children who cannot manage pills often will not say so in words. What you see instead is spitting, hiding, gagging, or a battle every morning. Ask…

Five minutesMedication and how it worksMedical and treatmentQur’an 5:6One line of research

Pill swallowing can be taught in a few short sessions with sweets. Start with the tiniest ones, give two to eat for every one swallowed whole, and work up in size across a week.

Keep each session short and cheerful and stop before anyone is upset, since one frightening attempt can set the whole thing back weeks. For capsules,…

Five minutesMedication and how it worksMedical and treatmentQur’an 2:185One line of research

Dry mouth, a later bedtime and a smaller appetite are the usual early complaints, and each has a workaround. Knowing about them in advance turns a nasty surprise into something you were already expecting.

Water and sugar free sweets for the mouth, an earlier dose for the sleep, food loaded into breakfast and dinner for the appetite. Most people who…

Five minutesMedication and how it worksMedical and treatmentQur’an 4:28One line of research

A child who barely touches lunch may still eat a normal amount across the day. Look at breakfast and dinner before concluding that they are not eating.

The usual pattern is a decent breakfast, very little at midday and a large dinner, with appetite returning as the dose wears off. So make the two…

Five minutesMedication and how it worksMedical and treatment

Looking for a whole subject rather than a single practice? Start from the nine areas.

Grounding and settling

Growing empathy

The cost of avoiding

Structure and routine

Food, caffeine and fuel

What worry does

Practising under provocation

Cool the body first

Emotions as signals

Treatment and medication

Making it stick

Breathing

What you are actually defending

Being seen and judged

Righteous anger and perfectionism

Shame and stigma

Breaking the worry loop

Feeling from the inside

When anger turns to harm

When you use something to cope

Reading, numbers and learning differences

Remembering to do it

Facing it a step at a time

Tolerate distress

Self-compassion

Anger, alcohol and the body

Use your strengths

Obsessions and compulsions

Posture and how you carry yourself

Living with uncertainty

Qur’an 20:81

One line of research

When a dose that was working seems to stop working in a growing child, check height and weight before you reach for the word tolerance. These medicines are dosed by body weight, and a child can simply have outgrown the dose.

It is the cheaper explanation and the more common one, and it takes a single appointment to test. Bring the growth chart and the dates when you…

Five minutesMedication and how it worksMedical and treatmentQur’an 16:43One line of research

A prescribed dose swallowed as a tablet is set to bring you into the ordinary range, not to make you high. The rise it produces is too slow and too small to be the sort of thing anybody chases.

Misuse in the research is concentrated among people who do not have ADHD and who take the medicine in ways it was never designed for, by crushing it,…

Five minutesMedication and how it worksMedical and treatmentQur’an 7:32One line of research

The realistic difficulty with this medicine is not misuse. It is forgetting, since part of what is being treated is the very ability to remember to do something later.

So put the reminder outside your head. A weekly pill organiser sitting on top of whatever you pick up every morning, an alarm with the name of the…

Five minutesMedication and how it worksMedical and treatmentQur’an 12:67One line of research

An untreated attention difficulty rarely stays a blank space. People tend to find something that steadies them, and what they find is not always kind.

Nicotine, coffee at strange hours, cannabis in the evening, a bit of somebody else's prescription: these are often attempts at self correction rather…

Five minutesMedication and how it worksMedical and treatmentQur’an 26:80One line of research

Conversations about alcohol and cannabis tend to be timed for the child you expect to have at fourteen. With an attention difficulty in the picture, start them earlier and keep them light.

Early does not mean heavy. It means the subject is already open, so the first offer is not the first mention. Keep the tone curious rather than…

Five minutesMedication and how it worksMedical and treatmentQur’an 16:43One line of research

Medication does not simply turn the brain up. On scans the regions that should be busy during a task get busier, and the ones that should stay quiet settle.

That detail matters more than it sounds. It says the trouble is one of aim rather than a shortage of effort, which is the opposite of what many…

Five minutesMedication and how it worksMedical and treatmentQur’an 16:69One line of research

Watch someone on a laboratory stop task and two things move together on medication: the fidgeting drops and the stopping gets more accurate.

Holding still and holding back turn out to run on the same machinery. That is why inhibition sits underneath so much else, from waiting your turn to…

Five minutesMedication and how it worksMedical and treatmentQur’an 4:28One line of research

In simulator work the biggest improvements on medication show up in the drivers who were worst without it: stopping properly, slowing for an amber, actually looking around.

That pattern is quietly reassuring. A drug that made everyone sharper would lift the good drivers as well, and this does not look like that. It looks…

Five minutesMedication and how it worksMedical and treatmentQur’an 55:8One line of research

When you are weighing up whether a teenager is ready for something, it helps to think in two thirds. A fifteen year old may be handling responsibility more like a twelve or thirteen year old.

This is not an insult and it should never be delivered as one. It is a way of explaining why a privilege arrives later here than for their friends,…

Five minutesMedication and how it worksMedical and treatmentQur’an 2:286One line of research

Offered ten pounds now or twenty in an hour, plenty of people with attention difficulties take the ten and know while they are doing it that it makes no sense. The pull towards now is not a flaw of character.

It shows up in a laboratory and it shows up on a bank statement. Naming it helps, because a thing with a name can be planned around: money moved by…

Five minutesMedication and how it worksMedical and treatmentQur’an 65:3One line of research

Before you explain anything about medication, ask what the person already believes about it. You cannot correct a worry that has never been said out loud.

Most people arrive carrying something: a cousin who could not sleep, a headline, a parent with a strong view. Lead with your own information and you…

Five minutesMedication and how it worksMedical and treatmentQur’an 42:38One line of research

None of the non-stimulants should be stopped suddenly. Guanfacine and clonidine began life as blood pressure medicines, and taking them away all at once can send blood pressure sharply back up.

Atomoxetine has its own unpleasant discontinuation effects, closer to those of an antidepressant. So a break because a prescription ran out, or…

Five minutesMedication and how it worksMedical and treatmentQur’an 16:43One line of research

In practice the non-stimulants turn up more often as an addition than on their own. A stimulant in the morning with guanfacine alongside it is a common shape.

The two act at different points of the same circuit, so they tend to complement rather than repeat each other, and the blood pressure effect of one…

Five minutesMedication and how it worksMedical and treatmentQur’an 42:38One line of research

When a dose wears off, things can feel worse than they ever did untreated. A good deal of that is contrast rather than the medicine leaving a debt behind.

You have spent the day at one level and then meet your own baseline without warning, late in the afternoon, usually with something still to do.…

Five minutesMedication and how it worksMedical and treatmentQur’an 55:8One line of research

A small short-acting dose in the afternoon, on top of the long-acting one, is ordinary practice rather than a special case. Homework and the evening drive often fall outside what the morning dose still reaches.

The hours when you most need to hold back are frequently the hours the medicine has stopped covering. Raising the morning dose to solve an early…

Five minutesMedication and how it worksMedical and treatmentQur’an 73:20One line of research

Skipping weekends, holidays and summers is a common suggestion and mostly it is the wrong call. The difficulty does not take a holiday when school does.

Unstructured time asks more of planning and self-regulation rather than less: whole days to fill, everyone at home, no timetable holding the shape of…

Five minutesMedication and how it worksMedical and treatmentQur’an 13:28One line of research