Focus, executive function, and routines that actually stick.

ADHD is the diagnosis families feel most confident describing and most uncertain treating. The signs are familiar — a child who cannot stay seated, who loses three pencils a week, who melts down at the third instruction of the morning routine. The plan is less obvious. Schools recommend medication. Articles online recommend supplements. Grandparents recommend more discipline. Within a month a family has been handed five reasonable, incomplete plans.

Our programme picks one defensible spine and works from it: a structured, evidence-supported behavioural model, supplemented by direct child-coaching on executive function, and school coordination if the family wants it. Medication, where indicated, is a tool we discuss; not our default first move.

What we work on, in order

Sleep, regulation, and the morning routine come first. A sleep-deprived child looks identical to a child with worse ADHD; getting the sleep structure right pulls daytime symptoms down by a noticeable margin within two weeks. The morning routine is the second easiest lever — predictable order, visual checklist, no novel choices before school.

The next layer is the antecedent: what happens in the five minutes before the meltdown, the three seconds before the impulse, the six instructions that preceded the refusal. A surprising amount of ADHD-pattern behaviour can be prevented at the antecedent rather than corrected after.

Most families come to us asking for fewer meltdowns. What they get, by month four, is a set of tools they themselves can deploy without us in the room — which is, in the end, the point.

The third layer is the child themselves. From around seven years onward, children can use externalised executive-function scaffolds — visible plans, time estimation worksheets, transition rituals — that compensate for the working-memory and time-perception challenges ADHD makes harder.

When we suggest paediatric medication

When the executive-function load is heavy enough that behavioural strategies aren’t closing the gap, when school is at risk, when self-esteem is starting to erode, we will say so and recommend a conversation with a paediatrician. We have one on staff. We will not steer you toward medication, and we will not steer you away from it. The choice is yours — and the data we have collected gives you the substrate to make it well.