Practices

When obsessions start early and dig in deep, ask gently what anxiety looks like elsewhere in the family. Often there is an undiagnosed parent, and often that parent is helping in ways that keep the whole thing running.

None of this is about blame. A parent who checks the locks for their child, answers the same question fifteen times, or arranges the evening around a…

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…

Try swapping the word picky for particular. A fair number of people with ADHD have more densely packed taste buds, so the bitterness in a sprout arrives at full volume.

That changes what is going on at the table. A child is not refusing in order to be difficult, they are tasting something stronger than you are.…

The amount in a capsule can vary from bottle to bottle, and sometimes between capsules in the same bottle. Undeclared fillers have been found in them too.

This matters most when you are trying to work out whether something helps you. A good month followed by a flat one may be two different products…

Kava can damage the liver at a high enough dose, badly enough that some countries have banned it. Herbal is not a synonym for gentle.

The unnerving part is how quiet liver damage is. Someone self medicating anxiety with kava can be accumulating harm and feel nothing at all until it…

Vitamin C cannot really be stockpiled, since the excess leaves in your urine. A, D, E and K are stored in fat, so a large daily dose keeps adding to itself.

Vitamin D is where this bites at the moment, after a lot of people started taking big amounts on their own during the pandemic years. If you are…

Omega supplements thin the blood, so they usually do not belong alongside warfarin. Bruising easily is often the first thing anyone notices.

One clinician worked out that her husband's bruising came from taking omegas on top of his Coumadin, and it settled once his doctor told him to stop.…

If fish oil gives you those horrible repeats all afternoon, that is a fixable problem rather than a reason to stop. Keep the capsules in the freezer, ask about an enteric coated version, or try a flavoured liquid.

Sticking with something usually fails for small unglamorous reasons like this. Someone with a sensitive palate will not last four weeks with an…

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…

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.…

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…

Brain training games make you better at the game. Sadly, that improvement tends to stay inside the game.

Sorting shapes faster or planning a conveyor belt more smoothly comes from learning the task, not from stretching a capacity, so the classroom and…