{ "schema_version": 1, "version": "2026-09-29", "language": "en", "name": "adhd100: 100 evidence-rated things for living with ADHD (English)", "description": "A curated compilation of 100 things people with ADHD and parents can do, with evidence grades, GRADE style certainty, the population the evidence comes from, source references, cautions, practical actions and transparent prioritization rules. Not patient data or a clinical model.", "url": "https://adhd100.jock.pl/data/", "publisher": { "name": "Pawel Jozefiak", "url": "https://jock.pl/" }, "license": { "name": "CC BY 4.0", "url": "https://creativecommons.org/licenses/by/4.0/" }, "clinical_review": "none", "disclaimer": "General information about ADHD, not a diagnosis or an individual treatment plan. Tailoring changes the order of suggestions; it does not assess you. Medication decisions belong with you and a qualified clinician.", "items": [ { "id": "discuss-methylphenidate-child", "canonical_url": "https://adhd100.jock.pl/discuss-methylphenidate-child/", "rank": 1, "title": "Discuss methylphenidate for your child", "summary": "This first medication option has strong evidence for reducing ADHD symptoms in school age children.", "why": "Methylphenidate changes brain signalling involved in attention and behaviour. EBI rates the evidence high certainty: clinicians scored symptoms in school age children and adolescents 0.762 SMD better than on placebo, a standardised score gap rather than a percentage. That covers about 12 weeks, or the end of the trial, so lasting benefit is not proven. Cochrane's 2025 review used different methods and rated its evidence very low certainty (teacher-rated SMD 0.74, 21 trials), so the high rating holds for the EBI analysis only.", "how": [ "Ask whether methylphenidate, which NICE recommends as the first medicine for children aged 5 and over, fits your child's needs.", "Bring one or two real examples of what your child wants treatment to help with.", "Talk through what it should help, the side effects, and how the clinician will check both.", "Settle how your child, your family and the school will report changes at follow-up." ], "category": "Medication", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "A", "certainty": "high", "adhd_specific": true, "basis": "EBI re-estimation: 6 trials, 1038 children and adolescents, short term; NICE NG87 1.7.7 first-line medicine", "ebi": { "intervention": "Methylphenidate", "age": "youth", "outcome": "Core ADHD symptoms", "rater": "clinician-rated", "timepoint": "short" } }, "impact": { "score": 92, "headline_stat": "Children and teens: medium symptom improvement vs placebo over about 12 weeks (SMD 0.762)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.762, "unit": "SMD", "outcome": "clinician-rated core ADHD symptom improvement in youth", "comparison": "vs placebo", "stat_source": 0, "ci_lo": 0.56, "ci_hi": 0.965, "n_studies": 6, "n": 1038 }, "sources": [ { "title": "EBI-ADHD: companion data to Gosling et al., BMJ 2025, commit 86eff22a9ffb", "publisher": "BMJ / Gosling et al.", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 }, { "title": "Common questions about methylphenidate for children", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/medicines/methylphenidate-children/common-questions-about-methylphenidate-for-children/", "tier": 1 }, { "title": "Methylphenidate for children and adolescents with attention deficit hyperactivity disorder", "publisher": "Cochrane", "year": 2025, "url": "https://www.cochrane.org/evidence/CD009885_methylphenidate-effective-treatment-children-and-adolescents-attention-deficit-hyperactivity", "tier": 1 } ], "caution": "Only a qualified prescriber can decide whether methylphenidate suits your child. The estimate is for school age children and does not apply to preschoolers.", "practice": { "examples": [ "A teacher's note on how your child takes part in lessons, plus your child's own goal in their words.", "Ask how appetite and sleep will be checked, not only whether symptoms improve." ], "pitfalls": [ "Looking calmer is not the only goal. Talk about how your child joins in and how they feel.", "A trial average cannot predict how your child will respond, so agree follow-up for them in particular." ], "do": { "1m": "Type one line in your phone notes: the difficulty your child would want treatment to help with.", "5m": "Write down one thing you hope it helps and one worry, to take to the prescriber.", "15m": "List the support your child already gets, their health conditions and medicines, and what you want to ask about monitoring.", "plan": { "title": "Prepare a medication discussion", "steps": [ "Agree the problems treatment should address.", "Discuss suitability and monitoring with the clinician.", "Bring feedback from your child and school to the planned review." ] } }, "guides": [ { "title": "Common questions about methylphenidate for children", "publisher": "NHS", "url": "https://www.nhs.uk/medicines/methylphenidate-children/common-questions-about-methylphenidate-for-children/", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 6, "age_max": 17 }, "boosts": [ { "when": { "focus_any": [ "attention", "impulsivity", "school" ] }, "delta": 8, "reason": "Trials found improvement in core ADHD symptoms." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "discuss-methylphenidate-adult", "canonical_url": "https://adhd100.jock.pl/discuss-methylphenidate-adult/", "rank": 2, "title": "Discuss methylphenidate as an adult", "summary": "A guideline medicine for adults, with evidence that it improves symptoms in the short term.", "why": "Methylphenidate acts on brain signalling involved in attention and behaviour. In EBI, adults rated their own symptoms 0.343 SMD better than on placebo, with high certainty, and the clinicians' ratings of improvement carry moderate certainty. The trials ran about 12 weeks or to their endpoint, so long term benefit is not established. NICE lists it with lisdexamfetamine as a first-line medicine for adults, yet more people left the trials because of adverse effects than on placebo, which is why the choice is a talk about benefits and harms.", "how": [ "Ask your ADHD clinician plainly whether methylphenidate suits you.", "Say which parts of work, study or home life you want treatment to improve.", "Go through your medical history, any other medicines, and what worries you about side effects.", "Before you leave, find out what to bring to follow-up and who to contact between appointments." ], "category": "Medication", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "A", "certainty": "high", "adhd_specific": true, "basis": "EBI re-estimation: 13 trials, 2944 adults, short term self-ratings; NICE NG87 1.7.11 first-line medicine", "ebi": { "intervention": "Methylphenidate", "age": "adult", "outcome": "Core ADHD symptoms", "rater": "self-rated", "timepoint": "short" } }, "impact": { "score": 89, "headline_stat": "Adults: small improvement in self-rated symptoms vs placebo over about 12 weeks (SMD 0.343)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.343, "unit": "SMD", "outcome": "self-rated core ADHD symptom improvement in adults", "comparison": "vs placebo", "stat_source": 0, "ci_lo": 0.261, "ci_hi": 0.425, "n_studies": 13, "n": 2944 }, "sources": [ { "title": "EBI-ADHD: companion data to Gosling et al., BMJ 2025, commit 86eff22a9ffb", "publisher": "BMJ / Gosling et al.", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 }, { "title": "Common questions about methylphenidate for adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/medicines/methylphenidate-adults/common-questions-about-methylphenidate-for-adults/", "tier": 1 } ], "caution": "Whether it suits you, and the prescribing, are decisions for a qualified clinician. Bring your health history and every medicine you take, including ones bought without a prescription.", "practice": { "examples": [ "Say whether your goal is getting essential work finished or keeping up with conversations.", "Ask how the review will look at unwanted effects as well as benefits." ], "pitfalls": [ "A bigger prescription is not the goal. Talk about how much it actually helps and how well you tolerate it.", "Short term symptom improvement does not guarantee every life difficulty will resolve; keep other support in the plan." ], "do": { "1m": "Jot down the moment in an ordinary day you would most like treatment to improve.", "5m": "Write a few treatment goals and your questions about side effects.", "15m": "Put your medicine list and medical history on one page for the prescribing appointment.", "plan": { "title": "Discuss an individual treatment trial", "steps": [ "Bring goals and relevant health information.", "Ask the clinician about suitability, alternatives and follow-up.", "Review changes in functioning and adverse effects together." ] } }, "guides": [ { "title": "Common questions about methylphenidate for adults", "publisher": "NHS", "url": "https://www.nhs.uk/medicines/methylphenidate-adults/common-questions-about-methylphenidate-for-adults/", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "attention", "impulsivity", "work" ] }, "delta": 8, "reason": "Adult trials found improvement in core ADHD symptoms." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "seek-child-adhd-assessment", "canonical_url": "https://adhd100.jock.pl/seek-child-adhd-assessment/", "rank": 3, "title": "Request your child's ADHD assessment", "summary": "An assessment across home and school helps identify ADHD and other reasons your child may be struggling.", "why": "A good child assessment pulls together your child's developmental history, their own experience, and reports from more than one setting. The AAP recommends evaluating children who have persistent attention or behaviour concerns and impairment, and checking for other possible causes along the way. No single test confirms ADHD, and support does not have to wait for the final diagnosis.", "how": [ "Contact your child's healthcare provider and name the specific learning or behaviour concerns.", "Ask a teacher or childcare worker to write down what they see in their setting.", "Bring the developmental history, plus any hearing, vision or learning assessments that bear on it.", "Find out how your child will be included, and what help can start while the assessment is pending." ], "category": "Assessment", "domain": "treatment-care", "effort": "high", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "AAP 2019 key action statements 1 and 2 (AAP evidence grade B, strong recommendation); AAP grades are not GRADE certainty" }, "impact": { "score": 88, "headline_stat": "Assess concerns using information from more than one setting", "stat_source": 0 }, "sources": [ { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents", "publisher": "American Academy of Pediatrics", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 }, { "title": "Diagnosing ADHD", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/diagnosis/index.html", "tier": 1 }, { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 } ], "caution": "A qualified clinician should tell ADHD apart from normal developmental variation and other conditions. Assessment routes differ between countries.", "practice": { "examples": [ "Describe what is hard at home, and ask a teacher for a separate account from school.", "Bring the school support report you already have instead of writing a new long document." ], "pitfalls": [ "A quiet clinic visit does not describe every setting; bring observations from everyday life.", "A school concern is useful information, but it should lead to a clinical assessment, not just a label." ], "do": { "1m": "Picture one recent moment when your child needed more support than they got. That is your opening example.", "5m": "Write a short request to your child's clinician that describes the main concern.", "15m": "Put the school feedback and developmental information you already have in one folder.", "plan": { "title": "Build a shared picture", "steps": [ "Describe concerns to your child's clinician.", "Gather input from school and include your child's perspective.", "Agree the assessment and interim support plan." ] } }, "guides": [ { "title": "Diagnosing ADHD", "publisher": "CDC", "url": "https://www.cdc.gov/adhd/diagnosis/index.html", "kind": "guide", "lang": "en" }, { "title": "ADHD in children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_max": 17, "age_min": 4 }, "boosts": [ { "when": { "diagnosed": [ "suspected" ] }, "delta": 12, "reason": "Assessment checks persistent symptoms and impairment across settings." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "seek-adult-adhd-assessment", "canonical_url": "https://adhd100.jock.pl/seek-adult-adhd-assessment/", "rank": 4, "title": "Ask for an adult ADHD assessment", "summary": "A thorough assessment can explain persistent difficulties and open a route to suitable care.", "why": "ADHD assessment looks at how symptoms affect your life now and whether they were present in childhood. Interviews, health history and information from someone who knows you help distinguish ADHD from other explanations. NHS guidance supports seeking help when difficulties affect work, study or relationships, and NICE recommends specialist assessment when symptoms began in childhood, have persisted and cause at least moderate impairment. This is a care recommendation, not a measured percentage benefit.", "how": [ "Tell your primary care clinician which everyday difficulties made you seek help.", "Bring examples from your life now and from childhood, plus any school reports you already have.", "Note down sleep problems, mood symptoms, other health conditions and medicines for the assessor.", "Ask who assesses adult ADHD locally and what support you can get while you wait." ], "category": "Assessment", "domain": "treatment-care", "effort": "high", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "NICE NG87 1.2.10 recommends specialist assessment for adults meeting its criteria; NHS guidance agrees; no GRADE rating for the pathway" }, "impact": { "score": 86, "headline_stat": "Seek help when symptoms affect study, work or relationships", "stat_source": 0 }, "sources": [ { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 } ], "caution": "An online screener cannot confirm ADHD. A qualified clinician has to weigh your symptoms, impairment and other possible causes.", "practice": { "examples": [ "Bring one example from work and one from childhood, even if they are about different difficulties.", "Ask whether someone who knew you as a child can add what they remember." ], "pitfalls": [ "Waiting until your records are perfect can delay help. Bring what you have and talk about the gaps.", "A quiz score can start the conversation, but a clinical assessment has to look at your history." ], "do": { "1m": "Write the one difficulty you most want the assessor to understand as a single sentence.", "5m": "Write three examples of what you struggle with and roughly when each began.", "15m": "Draft a short appointment note: symptoms, childhood history, mood, sleep and current medicines.", "plan": { "title": "Prepare for assessment", "steps": [ "Identify the difficulties affecting your life.", "Request an assessment through your local care pathway.", "Bring available history and ask about next steps." ] } }, "guides": [ { "title": "ADHD in adults", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-adults/", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "diagnosed": [ "suspected" ] }, "delta": 12, "reason": "Persistent difficulties warrant a clinical assessment." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "plan-clinician-led-titration", "canonical_url": "https://adhd100.jock.pl/plan-clinician-led-titration/", "rank": 5, "title": "Plan titration with your clinician", "summary": "Planned check-ins on what is helping and which side effects show up let your clinician find treatment that fits.", "why": "Titration means your clinician adjusts treatment step by step while checking whether it helps and what unwanted effects appear. The AAP recommends aiming for the most useful benefit with adverse effects you can tolerate. NICE recommends recording symptoms, impairment and adverse effects at each dose change and reviewing progress regularly with a specialist. There is no universal best dose or fixed timetable, and these recommendations put no number on the benefit of keeping a symptom record.", "how": [ "Before the titration review, agree the main problems treatment should help with.", "Ask what the clinic wants to hear about symptoms and side effects, and use its form if it has one.", "Include what has changed in sleep, appetite, mood and how your days go.", "Confirm the next review date and how to reach the team if something goes wrong before then." ], "category": "Monitoring", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "AAP key action statement 6 (AAP evidence grade B, strong recommendation) and NICE NG87 1.7.26 to 1.7.27; no GRADE certainty for the process" }, "impact": { "score": 85, "headline_stat": "Titrate medication to useful benefit with tolerable adverse effects", "stat_source": 0 }, "sources": [ { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents", "publisher": "American Academy of Pediatrics", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 }, { "title": "Common questions about methylphenidate for adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/medicines/methylphenidate-adults/common-questions-about-methylphenidate-for-adults/", "tier": 1 } ], "caution": "The prescriber directs every medication change. Report worrying effects promptly instead of waiting for the next routine review.", "practice": { "examples": [ "Bring one change that helped and one unwanted effect to the next review.", "For a child, put their own experience next to a short teacher report when the clinic asks for one." ], "pitfalls": [ "If you only watch for better concentration, you can miss side effects. Report both.", "Forgot the form? The appointment still matters. Bring whatever information you have." ], "do": { "1m": "Add one change you've noticed, good or bad, to a note titled 'next review'.", "5m": "Write a few lines on attention, how your days are going, sleep, appetite and mood.", "15m": "Ask the clinic which feedback form they use, and write your questions for the next review.", "plan": { "title": "Make reviews informative", "steps": [ "Agree treatment goals and a simple way to report changes.", "Provide the requested feedback during clinician-led titration.", "Review benefit, adverse effects and the next monitoring plan." ] } }, "guides": [ { "title": "Common questions about methylphenidate for adults", "publisher": "NHS", "url": "https://www.nhs.uk/medicines/methylphenidate-adults/common-questions-about-methylphenidate-for-adults/", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": [ { "who": "self" }, { "who": "parent", "age_min": 5 } ], "boosts": [ { "when": { "medication": [ "current" ] }, "delta": 10, "reason": "Titration decisions depend on benefit and adverse effect feedback." }, { "when": { "medication": [ "never" ] }, "delta": -10, "reason": "Titration begins only once a prescriber starts medication." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "discuss-amphetamines-child", "canonical_url": "https://adhd100.jock.pl/discuss-amphetamines-child/", "rank": 6, "title": "Ask about amphetamine alternatives", "summary": "When the first stimulant has not helped enough, an amphetamine medicine is an option for some children.", "why": "Amphetamine medicines act on brain signalling involved in attention and impulse control. In children and adolescents, EBI found a large improvement in clinician-rated symptoms, 1.024 SMD versus placebo, with moderate certainty, over about 12 weeks or to trial endpoint. That does not make amphetamines the best choice for every child. NICE suggests considering lisdexamfetamine after a 6-week methylphenidate trial that did not help enough, and more children than on placebo stopped because of adverse effects, so tolerability belongs in the conversation.", "how": [ "Give the clinician a summary of what previous treatment did, good and bad.", "Ask whether the current treatment has been given a fair assessment before switching is discussed.", "Talk about why a different stimulant might suit your child better, and what the new monitoring would involve.", "Bring your child's own preferences and the school's feedback into the decision." ], "category": "Medication", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "A", "certainty": "moderate", "adhd_specific": true, "basis": "EBI re-estimation: 5 trials, 876 children and adolescents, short term; NICE NG87 1.7.8 second-line option", "ebi": { "intervention": "Amphetamines", "age": "youth", "outcome": "Core ADHD symptoms", "rater": "clinician-rated", "timepoint": "short" } }, "impact": { "score": 84, "headline_stat": "Children and teens: large symptom improvement vs placebo over about 12 weeks (SMD 1.024)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 1.024, "unit": "SMD", "outcome": "clinician-rated core ADHD symptom improvement in youth", "comparison": "vs placebo", "stat_source": 0, "ci_lo": 0.672, "ci_hi": 1.376, "n_studies": 5, "n": 876 }, "sources": [ { "title": "EBI-ADHD: companion data to Gosling et al., BMJ 2025, commit 86eff22a9ffb", "publisher": "BMJ / Gosling et al.", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 }, { "title": "Common questions about methylphenidate for children", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/medicines/methylphenidate-children/common-questions-about-methylphenidate-for-children/", "tier": 1 } ], "caution": "These are clinician-led alternatives, not interchangeable medicines. Appetite, sleep and cardiovascular effects need review; the youth estimate does not describe adult efficacy.", "practice": { "examples": [ "A few lines on what got better and what stayed hard on the earlier treatment.", "Ask whether the problem now is how long the benefit lasts, or the side effects." ], "pitfalls": [ "Effect sizes from separate trials cannot tell you which medicine is best for your child. Ask about how your child responds.", "One medicine not fitting does not close off the other options. Ask for a review." ], "do": { "1m": "Write down one thing that went well and one that didn't on your child's previous treatment.", "5m": "Write what helped, what did not, and what your child found uncomfortable.", "15m": "Pull together a summary of previous treatment to go through with the prescriber.", "plan": { "title": "Review the need for an alternative", "steps": [ "Summarise the current treatment experience.", "Ask the clinician whether a different stimulant is appropriate.", "Agree how the chosen plan will be monitored." ] } }, "guides": [ { "title": "Common questions about methylphenidate for children", "publisher": "NHS", "url": "https://www.nhs.uk/medicines/methylphenidate-children/common-questions-about-methylphenidate-for-children/", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 6, "age_max": 17 }, "boosts": [ { "when": { "medication": [ "current", "past" ] }, "delta": 6, "reason": "Guidance considers an alternative when the initial medicine is unsuitable or insufficient." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "discuss-atomoxetine-adult", "canonical_url": "https://adhd100.jock.pl/discuss-atomoxetine-adult/", "rank": 7, "title": "Ask about atomoxetine as an adult", "summary": "A nonstimulant with solid evidence behind it, for when stimulants don't suit you or haven't helped enough.", "why": "Atomoxetine is a nonstimulant medicine that affects noradrenaline signalling. EBI found a 0.368 SMD improvement in adults' self-rated symptoms versus placebo, with high certainty, but clinician-rated evidence was very low certainty. These findings concern about 12 weeks or trial endpoint, and do not establish long term benefit. NICE recommends it for adults who cannot tolerate, or have not been helped by, lisdexamfetamine and methylphenidate; more participants withdrew because of adverse effects than with placebo.", "how": [ "Ask whether a nonstimulant makes sense given your previous treatment and medical history.", "Bring a short account of what stimulants did for you, the side effects, or why they may not suit you.", "Ask how long the clinician expects it to take before you can judge whether it helps.", "Talk through possible unwanted effects and set up a review plan." ], "category": "Medication", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "A", "certainty": "high", "adhd_specific": true, "basis": "EBI re-estimation: 7 trials, 1734 adults; high certainty applies specifically to short term self-ratings; NICE NG87 1.7.15", "ebi": { "intervention": "Atomoxetine", "age": "adult", "outcome": "Core ADHD symptoms", "rater": "self-rated", "timepoint": "short" } }, "impact": { "score": 80, "headline_stat": "Adults: small improvement in self-rated symptoms vs placebo over about 12 weeks (SMD 0.368)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.368, "unit": "SMD", "outcome": "self-rated core ADHD symptom improvement in adults", "comparison": "vs placebo", "stat_source": 0, "ci_lo": 0.265, "ci_hi": 0.471, "n_studies": 7, "n": 1734 }, "sources": [ { "title": "EBI-ADHD: companion data to Gosling et al., BMJ 2025, commit 86eff22a9ffb", "publisher": "BMJ / Gosling et al.", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 } ], "caution": "A clinician should decide whether it suits you, check interactions and plan monitoring. This adult estimate cannot be assumed to apply to children or to every outcome.", "practice": { "examples": [ "Ask: 'What would count as enough benefit, and when would we review it?'", "Bring up your concerns about previous medicines, including effects that felt awkward to mention." ], "pitfalls": [ "Nonstimulant does not mean free of side effects. Ask how you'll be monitored.", "Self-ratings and clinician ratings got different certainty ratings. Talk about the benefits that matter in your own life." ], "do": { "1m": "Type the one question about nonstimulant treatment you most want answered.", "5m": "List what you want from an alternative and what made previous treatment hard.", "15m": "Write your questions about timing, side effects and the review appointment.", "plan": { "title": "Explore a nonstimulant option", "steps": [ "Review previous treatment and current needs.", "Ask about suitability and realistic expectations.", "Agree a clinician-led monitoring and review plan." ] } }, "guides": [ { "title": "ADHD in adults", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-adults/", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "medication": [ "current", "past" ] }, "delta": 6, "reason": "Guidance considers atomoxetine when stimulant treatment is unsuitable or insufficient." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "prepare-medication-baseline-review", "canonical_url": "https://adhd100.jock.pl/prepare-medication-baseline-review/", "rank": 8, "title": "Prepare a medication safety review", "summary": "Your full health and medicine history lets the prescriber choose and monitor ADHD treatment safely.", "why": "Whether a medicine suits you depends on more than the ADHD diagnosis. The AAP and NICE call for your medical history and physical checks before prescribing, including a heart assessment, and NICE says an ECG is needed only when specific heart features are present. Telling the prescriber about other medicines and other conditions helps catch interactions or anything that needs a closer look.", "how": [ "List every prescribed medicine, anything you buy without a prescription, and supplements.", "Tell the clinician about heart symptoms, fainting, and heart problems in your family.", "If they apply to you, mention other mental health conditions, worries about substance use, and plans for pregnancy.", "Ask which baseline measurements or extra assessments you need and who will arrange them." ], "category": "Assessment", "domain": "treatment-care", "effort": "low", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "NICE NG87 1.7.4 to 1.7.6 (committee consensus informed by very low to moderate quality safety evidence) and AAP medication safety guidance" }, "impact": { "score": 80, "headline_stat": "Full health and heart assessment before starting medication", "stat_source": 0 }, "sources": [ { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 }, { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents", "publisher": "American Academy of Pediatrics", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 }, { "title": "Attention-Deficit/Hyperactivity Disorder: What You Need to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-what-you-need-to-know", "tier": 1 } ], "caution": "A qualified prescriber decides whether treatment suits you and which tests are needed. A normal screening result does not replace follow-up, and new symptoms still need reporting.", "practice": { "examples": [ "Bring the names of your supplements, not just prescribed medicines.", "Mention any sudden death or inherited heart disease in the family at the assessment." ], "pitfalls": [ "'Natural' does not mean it can't interact. Put it on the medicine list.", "Not everyone needs an ECG. Ask which tests your own history and examination call for." ], "do": { "1m": "Open your notes and write the one health detail or medicine the prescriber must not miss.", "5m": "List every medicine and supplement you take right now for the appointment.", "15m": "Write down your own and your family's health history, and your questions about baseline checks.", "plan": { "title": "Prepare the safety information", "steps": [ "Gather medicines and relevant health history.", "Share the information at the clinician's assessment.", "Confirm required checks and the monitoring plan." ] } }, "guides": [ { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": [ { "who": "self" }, { "who": "parent", "age_min": 5 } ], "boosts": [ { "when": { "diagnosed": [ "yes" ], "medication": [ "never" ] }, "delta": 10, "reason": "Baseline health information helps assess medication suitability." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "book-regular-treatment-review", "canonical_url": "https://adhd100.jock.pl/book-regular-treatment-review/", "rank": 9, "title": "Book your treatment review", "summary": "Regular reviews keep your care in step with what you need now, what is working and what side effects appear.", "why": "ADHD treatment needs can change as school, work, health and responsibilities change. NICE recommends a medication review at least once a year, covering how well treatment works through the day, adverse effects, preferences and whether treatment is still needed; the NHS describes yearly check-ups. This is a minimum interval, not a reason to postpone help when treatment is causing problems.", "how": [ "Check when your last full medication review was and who is responsible for the next one.", "Bring a short account of what treatment helps with and what is still hard.", "Discuss new health conditions, life changes and any unwanted effects.", "Ask for a written plan identifying follow-up, monitoring and who will prescribe." ], "category": "Monitoring", "domain": "treatment-care", "effort": "low", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "NICE NG87 1.10.1 annual review recommendation; a care standard, not a rated treatment-effect estimate" }, "impact": { "score": 79, "headline_stat": "At least 1 ADHD medication review each year", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 1, "unit": "year", "outcome": "maximum routine interval between full medication reviews", "comparison": "NICE NG87 recommendation 1.10.1", "stat_source": 0, "bound": "at_most" }, "sources": [ { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 }, { "title": "Common questions about methylphenidate for adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/medicines/methylphenidate-adults/common-questions-about-methylphenidate-for-adults/", "tier": 1 } ], "caution": "New problems or side effects mean an earlier review, not a wait. Medication decisions belong with your prescriber.", "practice": { "examples": [ "Bring changes in work demands or school support that change what you want from treatment.", "Ask who will handle prescriptions and physical checks after the review." ], "pitfalls": [ "A prescription renewal is not necessarily a full review. Ask what was actually assessed.", "A yearly review does not replace earlier monitoring, or getting help with new side effects." ], "do": { "1m": "Start a note called 'treatment review' and put the first thing you want to raise in it.", "5m": "Find the date of your last review. If the next one is unclear, draft a request.", "15m": "Write one page on what helps, the unwanted effects and the support you need now.", "plan": { "title": "Keep care current", "steps": [ "Confirm who provides your full treatment review.", "Bring treatment feedback and changed circumstances.", "Record the agreed plan and next review date." ] } }, "guides": [ { "title": "Common questions about methylphenidate for adults", "publisher": "NHS", "url": "https://www.nhs.uk/medicines/methylphenidate-adults/common-questions-about-methylphenidate-for-adults/", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "medication": [ "current" ] }, "delta": 12, "reason": "Medication should receive at least an annual full review." }, { "when": { "medication": [ "never" ] }, "delta": -10, "reason": "The yearly review recommendation covers people taking ADHD medication." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "coordinate-anxiety-depression-care", "canonical_url": "https://adhd100.jock.pl/coordinate-anxiety-depression-care/", "rank": 10, "title": "Ask for anxiety and depression care", "summary": "Tell your clinician about persistent anxiety or depression, so your care plan covers more than ADHD.", "why": "Anxiety and depression can sit alongside ADHD, and they need their own assessment and treatment plan. The AAP recommends treating co-occurring conditions within the clinician's expertise or referring on, and NICE includes coexisting conditions in every ADHD assessment. NHS adult guidance adds that anxiety and depression can make ADHD symptoms worse. Better control of ADHD symptoms does not mean a separate mood or anxiety disorder has been treated.", "how": [ "Describe persistent worry, low mood or loss of interest, and what it does to your days or your child's.", "Say when these problems started and whether they line up with treatment changes or life events.", "Find out if you need a separate assessment or referral.", "Agree which clinician coordinates treatment and checks for interactions between medicines." ], "category": "Combined care", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "AAP key action statement 7 (AAP grade C recommendation), NICE NG87 1.3.4 and 1.4.13, NHS adult guidance; no combined-treatment effect or GRADE rating claimed" }, "impact": { "score": 78, "headline_stat": "Treat co-occurring conditions or refer for appropriate care", "stat_source": 0 }, "sources": [ { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents", "publisher": "American Academy of Pediatrics", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 }, { "title": "Attention-Deficit/Hyperactivity Disorder: What You Need to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-what-you-need-to-know", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 } ], "caution": "If you or your child has thoughts of suicide or is in immediate danger, help is available now: contact local emergency services or a crisis line. New severe mood changes need prompt clinical assessment, including review of current medicines.", "practice": { "examples": [ "Tell the clinician if low mood hangs on even when attention gets better.", "Ask whether the ADHD team and your anxiety therapist can share notes and coordinate, with your consent." ], "pitfalls": [ "If you put everything down to ADHD, a separate condition can go unnoticed. Name the mood and the worry out loud.", "With several services involved, nobody may own the plan. Ask who coordinates it." ], "do": { "1m": "Write down the mood or anxiety worry you want your clinician to hear about.", "5m": "Write when it started, how often it happens and what it stops you doing.", "15m": "Put your symptom history and current medicine list together for an appointment about combined care.", "plan": { "title": "Connect the care plans", "steps": [ "Raise persistent mood or anxiety symptoms.", "Ask for assessment, treatment or an appropriate referral.", "Agree who coordinates care and how progress will be reviewed." ] } }, "guides": [ { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" }, { "title": "ADHD in adults", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-adults/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "cooccurring_any": [ "anxiety", "depression" ] }, "delta": 15, "reason": "Co-occurring anxiety and depression need assessment within the care plan." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "discuss-alpha2-child", "canonical_url": "https://adhd100.jock.pl/discuss-alpha2-child/", "rank": 11, "title": "Ask about alpha-2 nonstimulant options", "summary": "A nonstimulant option for children, usually after stimulants. The rules for guanfacine and clonidine differ by country.", "why": "Guanfacine and clonidine act on alpha-2 adrenergic receptors. EBI pooled the two and found clinician-rated symptoms in children and adolescents 0.635 SMD better than on placebo, with high certainty, but that rating covers only this youth result over about 12 weeks or to trial endpoint, and the adult evidence for the class is very low certainty. Pooling them does not make them interchangeable: NICE recommends guanfacine for children when stimulants were not tolerated or did not help, and clonidine only on specialist tertiary advice, while the AAP lists extended-release forms of both. The AAP names sleepiness, low blood pressure and a slow heart rate among the possible adverse effects.", "how": [ "Given how previous treatment went, ask your child's clinician whether an alpha-2 medicine fits.", "Pin down which medicine and which formulation you are talking about, and whether it is licensed for this use where you live.", "Ask who will check alertness, pulse and blood pressure, and how.", "Check how it would sit alongside any other medicine your child is prescribed." ], "category": "Medication", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "A", "certainty": "high", "adhd_specific": true, "basis": "EBI re-estimation: pooled alpha-2 class, 8 trials, 1497 children and adolescents, short term clinician ratings; adult class evidence very low certainty; NICE NG87 1.7.10 and 1.7.17", "ebi": { "intervention": "Alpha-2 agonists (guanfacine / clonidine)", "age": "youth", "outcome": "Core ADHD symptoms", "rater": "clinician-rated", "timepoint": "short" } }, "impact": { "score": 78, "headline_stat": "Children and teens: medium symptom improvement vs placebo over about 12 weeks (SMD 0.635)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.635, "unit": "SMD", "outcome": "clinician-rated core ADHD symptom improvement in youth", "comparison": "vs placebo", "stat_source": 0, "ci_lo": 0.479, "ci_hi": 0.79, "n_studies": 8, "n": 1497 }, "sources": [ { "title": "EBI-ADHD: companion data to Gosling et al., BMJ 2025, commit 86eff22a9ffb", "publisher": "BMJ / Gosling et al.", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents", "publisher": "American Academy of Pediatrics", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 } ], "caution": "A specialist must choose and supervise the medicine, and in the UK clonidine is used only on tertiary specialist advice. Plan any change, stopping included, with the prescriber, because stopping suddenly can raise blood pressure.", "practice": { "examples": [ "Ask how the clinic checks for daytime sleepiness or dizziness.", "Bring a list of every medicine your child takes, so the clinician can check the combinations." ], "pitfalls": [ "A pooled result for the class does not make the medicines interchangeable. Ask about the specific one on offer.", "Sleepiness can be a side effect, not ADHD getting better. Report how your child is actually getting on." ], "do": { "1m": "Write down the one concern about a nonstimulant you want the clinician to answer.", "5m": "Write down your child's current medicines and any history of fainting or marked sleepiness.", "15m": "Write your questions about the proposed medicine, whether it is licensed locally, and monitoring.", "plan": { "title": "Compare the option with your child's needs", "steps": [ "Summarise previous treatment and relevant health history.", "Discuss the specific medicine and monitoring with the specialist.", "Agree how your child will report benefits and adverse effects." ] } }, "guides": [ { "title": "ADHD in children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 6, "age_max": 17 }, "boosts": [ { "when": { "medication": [ "current", "past" ] }, "delta": 6, "reason": "Nonstimulant options may be considered when stimulant treatment is unsuitable." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "request-school-support-plan", "canonical_url": "https://adhd100.jock.pl/request-school-support-plan/", "rank": 12, "title": "Request a school support plan", "summary": "A written plan can coordinate support between your child, school and clinicians.", "why": "The AAP says educational interventions and individual school supports should be part of ADHD treatment. A support plan names the barriers, the changes agreed and who provides the help. US IEP and 504 plans are one version, other countries run different systems, and the evidence for each single accommodation is limited, so review what actually helps your child.", "how": [ "Find out who at school coordinates support for pupils with additional needs.", "Describe what gets in the way of learning or taking part, including how your child sees it.", "Request an assessment of support needs and a written record of the help agreed.", "Agree who provides each support and when the plan gets reviewed." ], "category": "School care", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "AAP key action statements 5b and 5c (AAP grade A); CDC notes limited evidence for specific accommodations" }, "impact": { "score": 78, "headline_stat": "Individualised school supports are a necessary part of treatment", "stat_source": 0 }, "sources": [ { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents", "publisher": "American Academy of Pediatrics", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 }, { "title": "ADHD in the Classroom", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/treatment/classroom.html", "tier": 1 }, { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 } ], "caution": "Eligibility and legal procedures vary by country and school system. An ADHD diagnosis does not automatically decide which plan or adjustments a child gets.", "practice": { "examples": [ "Ask for a meeting with the school's support coordinator and bring one classroom concern.", "If a quieter room for tests is offered, ask for it to be written down with a review date." ], "pitfalls": [ "A list of possible adjustments is not a plan for your child. Match each one to the barrier it deals with.", "More accommodations are not always better. Ask your child and the staff which ones are earning their place." ], "do": { "1m": "Write the single school barrier you want the support meeting to tackle.", "5m": "Draft an email asking the school for a support meeting or a needs assessment.", "15m": "Make a short list for the meeting: the barriers, the help already in place, and what your child thinks.", "plan": { "title": "Agree support that can be reviewed", "steps": [ "Request a meeting or assessment through the school's process.", "Agree specific help and who will provide it.", "Review whether the support improves access and participation." ] } }, "guides": [ { "title": "ADHD in the Classroom", "publisher": "CDC", "url": "https://www.cdc.gov/adhd/treatment/classroom.html", "kind": "guide", "lang": "en" }, { "title": "ADHD in children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 6, "age_max": 17 }, "boosts": [ { "when": { "focus_any": [ "school" ] }, "delta": 12, "reason": "Guidelines include school support in ADHD treatment." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "seek-adult-adhd-cbt", "canonical_url": "https://adhd100.jock.pl/seek-adult-adhd-cbt/", "rank": 13, "title": "Ask about CBT adapted for adult ADHD", "summary": "Structured CBT can help adults manage ADHD symptoms, including when problems remain despite other treatment.", "why": "CBT built for ADHD mixes structured skills practice with work on unhelpful thoughts and habits. EBI found clinician-rated adult symptoms 0.528 SMD better than with passive controls, with moderate certainty, while self-rated results were very low certainty and most evidence was short term, about 12 weeks or to trial endpoint. NICE suggests considering it when medication is not wanted, not tolerated or only partly helps, and longer lasting benefits are less certain.", "how": [ "Look for a therapist who has delivered structured CBT for adults with ADHD before.", "Explain what you want therapy to help with and what treatment you already have.", "Ask how sessions are structured, what practice happens between them, the cost, and what happens when you miss a task.", "Agree with the therapist how you'll both judge progress." ], "category": "Therapy", "domain": "treatment-care", "effort": "high", "evidence": { "grade": "A", "certainty": "moderate", "adhd_specific": true, "basis": "EBI re-estimation: 5 trials and 265 adults; moderate certainty is specific to short term clinician ratings; NICE NG87 1.5.16 to 1.5.18", "ebi": { "intervention": "Cognitive Behavioral Therapy (CBT)", "age": "adult", "outcome": "Core ADHD symptoms", "rater": "clinician-rated", "timepoint": "short" } }, "impact": { "score": 77, "headline_stat": "Adults: medium improvement in clinician-rated symptoms vs a waiting list or similar (SMD 0.528)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.528, "unit": "SMD", "outcome": "clinician-rated core ADHD symptom improvement in adults", "comparison": "vs passive control, such as waiting list", "stat_source": 0, "ci_lo": 0.286, "ci_hi": 0.771, "n_studies": 5, "n": 265 }, "sources": [ { "title": "EBI-ADHD: companion data to Gosling et al., BMJ 2025, commit 86eff22a9ffb", "publisher": "BMJ / Gosling et al.", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 } ], "caution": "Choose a qualified therapist and keep therapy connected to the rest of your care. CBT does not require you to change medication yourself.", "practice": { "examples": [ "Ask whether the therapist adjusts the between-session practice when remembering tasks is the hard part.", "Bring one concrete goal, like following through on essential work." ], "pitfalls": [ "Supportive talking is not necessarily ADHD-focused CBT. Ask what approach they use.", "Struggling to do the practice is useful information for the therapist, so work out together how to make it simpler." ], "do": { "1m": "Finish the sentence 'I'd want an ADHD therapist to help me with...' in your notes.", "5m": "Write three questions for a therapist: their ADHD experience, the format, the cost.", "15m": "Draft a therapy enquiry: your goals, your current care, and what might make attending hard.", "plan": { "title": "Find an appropriate therapy fit", "steps": [ "Ask for ADHD-focused CBT options.", "Discuss goals, format and practical barriers with the therapist.", "Review whether sessions and practice are helping your chosen goals." ] } }, "guides": [ { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "organisation", "time", "attention" ] }, "delta": 10, "reason": "ADHD-focused CBT addresses everyday skills alongside symptoms." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "check-pulse-blood-pressure", "canonical_url": "https://adhd100.jock.pl/check-pulse-blood-pressure/", "rank": 14, "title": "Arrange pulse and blood pressure checks", "summary": "Routine cardiovascular monitoring helps your clinician spot medication effects that symptoms alone may miss.", "why": "ADHD medicines can change heart rate and blood pressure, sometimes in different directions. NICE recommends checking both before treatment, before and after each dose change, and every 6 months, though its own evidence review calls that schedule committee consensus, because most trials were short. Monitoring does not mean everyone needs an ECG, and one odd reading does not prove a medicine is unsuitable.", "how": [ "Find out who is responsible for your pulse and blood pressure checks.", "Make sure the checks around any recent changes your clinician made have been done.", "Tell the clinician about fainting, palpitations, or heart problems in you or your family.", "Ask how the results reach the prescriber and when the next check is due." ], "category": "Monitoring", "domain": "treatment-care", "effort": "low", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "NICE NG87 1.7.4 and 1.8.9; evidence review D: consensus schedule, safety evidence mostly very low to moderate quality" }, "impact": { "score": 76, "headline_stat": "Check pulse and blood pressure every 6 months", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 6, "unit": "months", "outcome": "routine pulse and blood pressure monitoring interval", "comparison": "NICE NG87 1.8.9, plus checks before and after each dose change", "stat_source": 0, "bound": "every" }, "sources": [ { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 }, { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents", "publisher": "American Academy of Pediatrics", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 }, { "title": "ADHD evidence review D: pharmacological safety (NG87)", "publisher": "NICE", "year": 2018, "url": "https://www.nice.org.uk/guidance/ng87/evidence/d-pharmacological-safety-pdf-4783686304", "tier": 1 } ], "caution": "New chest pain, fainting or significant palpitations need prompt medical assessment. A clinician should interpret readings and decide whether further tests are needed.", "practice": { "examples": [ "Ask whether your primary care team or the ADHD clinic is doing the next check.", "Bring up any fainting or family heart problems at the monitoring appointment." ], "pitfalls": [ "Feeling fine does not replace the scheduled checks. Confirm when yours are due.", "One reading needs a clinician to interpret it, so share it instead of changing treatment yourself." ], "do": { "1m": "Check your calendar: do you know when your next pulse and blood pressure check is?", "5m": "Look at your appointment record, and if the next check isn't clear, contact the service in charge.", "15m": "Write a short note for your clinician on heart symptoms, family history and recent treatment changes.", "plan": { "title": "Keep monitoring connected to prescribing", "steps": [ "Confirm the monitoring service and schedule.", "Attend the arranged checks and report relevant symptoms.", "Make sure the prescriber receives the results." ] } }, "guides": [ { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "medication": [ "current" ] }, "delta": 15, "reason": "ADHD medication requires cardiovascular monitoring." }, { "when": { "medication": [ "never" ] }, "delta": -15, "reason": "Six-monthly checks apply while taking ADHD medication." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "screen-child-cooccurring-conditions", "canonical_url": "https://adhd100.jock.pl/screen-child-cooccurring-conditions/", "rank": 15, "title": "Ask about coexisting conditions", "summary": "A targeted check can pick up learning, language, autism or tic-related needs that sit alongside ADHD.", "why": "An ADHD diagnosis does not explain every learning, communication or movement difficulty a child has. The AAP recommends screening for co-occurring developmental and physical conditions, including learning and language disorders, autism and tics. Finding extra needs can change the treatment and the school support plan, and a screen is a first check, not a second diagnosis.", "how": [ "Tell the clinician about reading, language, communication or movement worries that keep coming back.", "Bring the school assessments or observations you have and let the clinician interpret them.", "Ask which concerns need a proper assessment and which can be watched for now.", "If extra needs are confirmed, ask for them to be written into the care plan and the school support plan." ], "category": "Assessment", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "AAP key action statement 3 (AAP evidence grade B, strong recommendation) and CDC diagnostic guidance; no GRADE certainty assigned to the pathway" }, "impact": { "score": 76, "headline_stat": "Screen for developmental and physical conditions alongside ADHD", "stat_source": 0 }, "sources": [ { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents", "publisher": "American Academy of Pediatrics", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 }, { "title": "Diagnosing ADHD", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/diagnosis/index.html", "tier": 1 }, { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 } ], "caution": "Screening results need a clinician to interpret them. ADHD, autism, learning conditions and tics can occur together, and none of them should be diagnosed or ruled out from a checklist alone.", "practice": { "examples": [ "Bring a school report showing reading is still hard even with attention support in place.", "Mention movements or sounds that keep recurring and ask whether they need looking at." ], "pitfalls": [ "A screening result is not a confirmed diagnosis. Ask what the next assessment step is.", "Not every school difficulty comes from attention. Raise specific learning or language concerns by name." ], "do": { "1m": "Write down the learning, communication or movement concern you want to mention.", "5m": "Write the concern and one example of it from home or school.", "15m": "Collect the reports you already have and write your questions about further assessment.", "plan": { "title": "Check the whole picture", "steps": [ "Describe concerns beyond core ADHD symptoms.", "Ask which screening or assessment is appropriate.", "Include confirmed needs in the shared support plan." ] } }, "guides": [ { "title": "Diagnosing ADHD", "publisher": "CDC", "url": "https://www.cdc.gov/adhd/diagnosis/index.html", "kind": "guide", "lang": "en" }, { "title": "ADHD in children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 4, "age_max": 17 }, "boosts": [ { "when": { "cooccurring_any": [ "autism", "learning", "tics" ] }, "delta": 12, "reason": "These conditions are included in the AAP's ADHD assessment recommendations." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "smoking-support-review", "canonical_url": "https://adhd100.jock.pl/smoking-support-review/", "rank": 16, "title": "Ask for support with smoking", "summary": "Plan a supported quit conversation that takes your ADHD and past attempts into account.", "why": "In the general population, stopping smoking cuts cardiovascular, lung and cancer risks, and CDC reports it can add up to 10 years to life expectancy. ADHD is associated with more smoking and substance-related problems, so support that's easy to reach matters more. Counselling and medication together are effective general quit support, with your own choices made together with a clinician.", "how": [ "Tell a clinician or stop-smoking adviser about your smoking and past quit attempts.", "Say when cravings hit hardest and what made earlier attempts hard.", "Ask which support and treatments suit your health, your medicines and what you prefer." ], "category": "Tobacco", "domain": "body-health", "effort": "high", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "CDC smoking-cessation evidence and guidance with ADHD smoking-risk reviews; no source-specific GRADE rating for this action." }, "impact": { "score": 75, "headline_stat": "Quitting smoking can add up to 10 years to life expectancy", "stat_source": 0 }, "effect": { "kind": "years", "value": 10, "unit": "years", "outcome": "potential life-expectancy gain, up to this amount", "comparison": "quitting smoking vs continuing", "stat_source": 0 }, "sources": [ { "title": "Benefits of Quitting Smoking", "publisher": "CDC", "year": 2024, "url": "https://www.cdc.gov/tobacco/about/benefits-of-quitting.html", "tier": 1 }, { "title": "How to Quit Smoking", "publisher": "CDC", "year": 2024, "url": "https://www.cdc.gov/tobacco/about/how-to-quit.html", "tier": 1 }, { "title": "The impacts associated with having ADHD: an umbrella review", "publisher": "Frontiers in Psychiatry", "year": 2024, "url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1343314/full", "tier": 2 } ], "caution": "Ask a clinician or pharmacist to go through treatment options and your medicines with you, including if you are pregnant.", "practice": { "examples": [ "Tell an adviser that remembering a complex plan was difficult during your previous attempt.", "Ask for a clear plan for cravings and a way to get follow-up support." ], "pitfalls": [ "Calling a past attempt a failure can put you off getting support. Bring what you learned from it.", "Guessing at a quit-smoking medicine can miss safety issues. Go through the options with a professional." ], "do": { "1m": "Name the smoking moment you'd most want help with.", "5m": "List your strongest cravings, previous attempts and questions for an adviser.", "15m": "Find a local stop-smoking service or ask your clinician for a support appointment." }, "guides": [ { "title": "How to Quit Smoking", "publisher": "CDC", "url": "https://www.cdc.gov/tobacco/about/how-to-quit.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18, "smoker": [ "current" ] }, "boosts": [ { "when": { "smoker": [ "current" ] }, "delta": 15, "reason": "Stopping smoking offers substantial health benefits." }, { "when": { "cooccurring_any": [ "substance" ] }, "delta": 8, "reason": "Substance problems make tailored cessation support relevant." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "monitor-child-growth-on-medication", "canonical_url": "https://adhd100.jock.pl/monitor-child-growth-on-medication/", "rank": 17, "title": "Arrange your child's growth checks", "summary": "Regular height, weight and appetite checks let the prescriber notice growth changes during medication treatment.", "why": "Some ADHD medicines can reduce appetite and affect growth, so the trend on the chart matters as well as how your child feels. NICE recommends measuring height every 6 months and plotting height and weight on a growth chart. Weight is checked more often in children 10 and under and early in treatment, so ask for your child's own schedule rather than assuming all checks are twice yearly.", "how": [ "Ask the prescriber who will measure your child's height and weight and plot them.", "Confirm the schedule for weight checks, including the more frequent ones for younger children.", "Tell the clinician about changes in appetite or any worries about growth.", "Bring any measurements you already have and ask what the trend means." ], "category": "Monitoring", "domain": "treatment-care", "effort": "low", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "NICE NG87 1.8.5 growth monitoring recommendation (committee consensus), NHS medicine guidance and AAP adverse-effect discussion" }, "impact": { "score": 74, "headline_stat": "Measure children's height every 6 months", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 6, "unit": "months", "outcome": "height monitoring interval for children taking ADHD medication", "comparison": "NICE NG87 recommendation 1.8.5", "stat_source": 0, "bound": "every" }, "sources": [ { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 }, { "title": "Common questions about methylphenidate for children", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/medicines/methylphenidate-children/common-questions-about-methylphenidate-for-children/", "tier": 1 }, { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents", "publisher": "American Academy of Pediatrics", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 } ], "caution": "A clinician should read the growth chart and decide how treatment responds to it. Raise appetite or growth worries without changing the medication yourself.", "practice": { "examples": [ "Ask whether the latest measurements have gone onto your child's growth chart.", "Tell the clinic about appetite changes even when school says things are going well." ], "pitfalls": [ "One weight on one day says little about growth. Ask to see the trend.", "A height check does not cover the more frequent weight checks some children need. Confirm both dates." ], "do": { "1m": "Think of any change in your child's appetite that you want to report.", "5m": "Check when height and weight were last measured, and book the next appointment if it's due.", "15m": "Gather the measurements you have and write your questions about appetite or growth for the review.", "plan": { "title": "Follow the growth trend", "steps": [ "Confirm the measurement schedule with the prescriber.", "Bring measurements and appetite concerns to review.", "Ask the clinician to explain the growth chart and next steps." ] } }, "guides": [ { "title": "Common questions about methylphenidate for children", "publisher": "NHS", "url": "https://www.nhs.uk/medicines/methylphenidate-children/common-questions-about-methylphenidate-for-children/", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_max": 17 }, "boosts": [ { "when": { "medication": [ "current" ] }, "delta": 15, "reason": "Children taking ADHD medicines need growth monitoring." }, { "when": { "medication": [ "never" ] }, "delta": -20, "reason": "This growth schedule applies while a child takes ADHD medication." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "review-medication-pregnancy", "canonical_url": "https://adhd100.jock.pl/review-medication-pregnancy/", "rank": 18, "title": "Plan a pregnancy medication review", "summary": "A planned conversation weighs what ADHD treatment does for you against the pregnancy unknowns of each specific medicine.", "why": "Pregnancy safety evidence comes mainly from observational studies of medicine exposure, rather than trials of ADHD care in pregnancy. The decision matters with ADHD because treatment may support daily functioning, and NHS guidance says those benefits should be weighed against possible risks. Methylphenidate information cannot be assumed to apply to every ADHD medicine, and no single choice suits everyone.", "how": [ "Tell your prescriber if you are planning a pregnancy or are pregnant.", "Ask for a review that includes your ADHD clinician and, where it makes sense, the maternity team.", "Bring all your current medicines and describe what treatment helps you do.", "Ask what the evidence says for your particular medicine, and what support and monitoring you'll have." ], "category": "Medication", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "NHS and UKTIS pregnancy safety guidance based on medicine-exposure evidence, not an ADHD pregnancy treatment trial" }, "impact": { "score": 74, "headline_stat": "Discuss medication risks and benefits when pregnant or planning pregnancy", "stat_source": 0 }, "sources": [ { "title": "Pregnancy, breastfeeding and fertility while taking methylphenidate for adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/medicines/methylphenidate-adults/pregnancy-breastfeeding-and-fertility-while-taking-methylphenidate-for-adults/", "tier": 1 }, { "title": "Methylphenidate", "publisher": "UK Teratology Information Service, BUMPS", "year": 2023, "url": "https://www.medicinesinpregnancy.org/leaflets-a-z/methylphenidate/", "tier": 3 } ], "caution": "Contact your prescriber promptly about pregnancy or plans for one. Medication decisions need a review of your own situation, and nothing here tells you to change treatment.", "practice": { "examples": [ "Ask both teams who will coordinate the medication decision during pregnancy.", "Describe what treatment concretely does for you, alongside your worries about pregnancy risks." ], "pitfalls": [ "Do not assume every ADHD medicine has the same pregnancy evidence; ask about the exact medicine.", "Focusing only on possible medicine harms misses the effect of impaired functioning; discuss both with the clinician." ], "do": { "1m": "Write down the question about pregnancy and your current treatment that worries you most.", "5m": "Draft a request for a medication review that mentions pregnancy or your plans for it.", "15m": "Write your medicine list and a few lines on how treatment affects your everyday life.", "plan": { "title": "Make a coordinated pregnancy plan", "steps": [ "Tell the prescriber about pregnancy plans or pregnancy.", "Review medicine-specific evidence and your support needs.", "Agree which team coordinates treatment and monitoring." ] } }, "guides": [ { "title": "Pregnancy, breastfeeding and fertility while taking methylphenidate for adults", "publisher": "NHS", "url": "https://www.nhs.uk/medicines/methylphenidate-adults/pregnancy-breastfeeding-and-fertility-while-taking-methylphenidate-for-adults/", "kind": "guide", "lang": "en" }, { "title": "Methylphenidate", "publisher": "UK Teratology Information Service, BUMPS", "url": "https://www.medicinesinpregnancy.org/leaflets-a-z/methylphenidate/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "sex": "female", "age_min": 15, "age_max": 50 }, "boosts": [ { "when": { "pregnant": true }, "delta": 18, "reason": "Pregnancy needs an individual review of medicine benefits and risks." }, { "when": { "pregnant": true, "medication": [ "current" ] }, "delta": 10, "reason": "Current medication makes a coordinated pregnancy review especially relevant." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "adult-aerobic-movement", "canonical_url": "https://adhd100.jock.pl/adult-aerobic-movement/", "rank": 19, "title": "Build activity you enjoy", "summary": "Move in amounts you can manage, for your heart and your health overall.", "why": "Regular activity has established health benefits in the general population, including better cardiovascular health. The NHS page on adult ADHD suggests making time for activity you enjoy. In observational research ADHD is associated with more obesity and cardiovascular disease, which makes prevention matter more. The adult activity target is general health advice, not an ADHD symptom-treatment dose.", "how": [ "Pick walking, cycling, swimming or anything else you enjoy and can do safely.", "Build up from an amount that feels comfortable, in short bouts if long sessions are hard.", "Work toward the adult weekly guideline at your own pace, adapting where you need to." ], "category": "Movement", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General adult physical activity guidance and NHS adult ADHD self-care advice, with ADHD-specific observational health-risk evidence; EBI-ADHD has no adult physical-training row, so no ADHD symptom effect is claimed." }, "impact": { "score": 73, "headline_stat": "Adults need 150 minutes of moderate activity a week", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 150, "unit": "min/week", "outcome": "moderate-intensity aerobic activity target", "comparison": "general adult health guidance", "stat_source": 0, "bound": "at_least" }, "sources": [ { "title": "Adult Activity: An Overview", "publisher": "CDC", "year": 2023, "url": "https://www.cdc.gov/physical-activity-basics/guidelines/adults.html", "tier": 1 }, { "title": "Adding Physical Activity as an Adult", "publisher": "CDC", "year": 2025, "url": "https://www.cdc.gov/physical-activity-basics/adding-adults/index.html", "tier": 1 }, { "title": "The impacts associated with having ADHD: an umbrella review", "publisher": "Frontiers in Psychiatry", "year": 2024, "url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1343314/full", "tier": 2 }, { "title": "Attention-deficit/hyperactivity disorder is associated with increased risk of cardiovascular diseases: A systematic review and meta-analysis", "publisher": "JCPP Advances", "year": 2023, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10501695/", "tier": 2 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 } ], "caution": "If a condition, pain or disability affects exercise, ask a clinician how to adapt it.", "practice": { "examples": [ "Use a short walk as part of a journey you already make.", "Choose swimming or adapted activity if that fits your abilities better." ], "pitfalls": [ "An all-or-nothing target can make starting harder, so count small amounts of activity.", "Going too hard can make activity miserable. Add time and effort gradually." ], "do": { "1m": "Pick one kind of movement you enjoy and could actually repeat.", "5m": "If it is safe for you, take a comfortable short walk or use an adapted movement you already know.", "15m": "Try a manageable activity session, or use the time to find an accessible option.", "30m": "Take a longer comfortable activity session if it fits your ability; shorter bouts still count.", "plan": { "title": "Build from what works", "steps": [ "Choose a manageable starting activity.", "Repeat it on days that fit your life.", "Gradually add time toward the weekly recommendation." ] } }, "guides": [ { "title": "Adding Physical Activity as an Adult", "publisher": "CDC", "url": "https://www.cdc.gov/physical-activity-basics/adding-adults/index.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "activity": [ "low" ] }, "delta": 12, "reason": "Building up activity offers general health benefits." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "alcohol-health-discussion", "canonical_url": "https://adhd100.jock.pl/alcohol-health-discussion/", "rank": 20, "title": "Bring alcohol into your health review", "summary": "Get support with drinking before it gets harder to manage.", "why": "General health guidance says to get support when alcohol feels hard to control or causes problems. ADHD reviews find higher rates of alcohol and substance problems, though the size of the link varies. A factual talk about your drinking can point to the right support, and it doesn't assume everyone with ADHD has a drinking problem.", "how": [ "Say how often you drink, how much, and what happens afterwards.", "Mention cravings, trouble controlling your drinking, or symptoms when the alcohol wears off.", "Ask a clinician or alcohol service what support fits your situation." ], "category": "Alcohol", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General NHS alcohol-support guidance and ADHD substance-risk reviews; no rated trial evidence for this appointment action." }, "impact": { "score": 73, "headline_stat": "A GP is a good place to start if drinking causes problems", "stat_source": 0 }, "sources": [ { "title": "Alcohol support", "publisher": "NHS", "year": 2026, "url": "https://www.nhs.uk/live-well/alcohol-advice/alcohol-support/", "tier": 1 }, { "title": "The impacts associated with having ADHD: an umbrella review", "publisher": "Frontiers in Psychiatry", "year": 2024, "url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1343314/full", "tier": 2 } ], "caution": "Alcohol withdrawal can be dangerous. If you may be dependent, get medical advice before changing your drinking. Seizures or hallucinations need emergency help.", "practice": { "examples": [ "Tell the clinician if alcohol has become your usual way to get to sleep.", "Mention morning shaking or nausea rather than trying to handle it alone." ], "pitfalls": [ "Playing down the amount makes the assessment less useful. Give your best honest estimate.", "If you're dependent, a sudden change without support can be dangerous. Ask for a medically supported plan." ], "do": { "1m": "Name one effect of drinking you'd like to talk about, without judging yourself.", "5m": "Write a short account of your drinking pattern and any problems or withdrawal symptoms.", "15m": "Contact primary care or a local alcohol service and prepare the points you want to cover." }, "guides": [ { "title": "Alcohol support", "publisher": "NHS", "url": "https://www.nhs.uk/live-well/alcohol-advice/alcohol-support/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "alcohol": [ "heavy" ] }, "delta": 15, "reason": "Heavier drinking makes an alcohol health review more relevant." }, { "when": { "cooccurring_any": [ "substance" ] }, "delta": 12, "reason": "Existing substance problems warrant tailored support." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "take-suicide-talk-seriously", "canonical_url": "https://adhd100.jock.pl/take-suicide-talk-seriously/", "rank": 21, "title": "Take talk of suicide seriously", "summary": "Know how to ask straight out, how to listen, and how to get someone to urgent support.", "why": "In a meta-analysis of 9 longitudinal studies, children and teenagers with ADHD had about 3.3 times the odds of later suicidal thoughts or behaviour, with large differences between studies. This association cannot predict any one person's future, and it does not make suicide inevitable. NIMH's advice is to ask directly, listen without judging and help the person connect with support. Studies show that asking does not increase suicidal thoughts.", "how": [ "If you're worried, ask plainly and calmly whether they are thinking about suicide.", "Take the answer seriously and keep listening. Then help them reach a crisis service or a professional they trust.", "If there is immediate danger, call emergency services and stay with them if it is safe to.", "If these feelings are yours, tell someone directly and get help now. Don't carry it alone." ], "category": "Safety", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "Longitudinal observational meta-analysis in ADHD (Tier 2) for risk; NIMH general suicide-prevention guidance for actions, with no ADHD-specific intervention estimate." }, "impact": { "score": 72, "headline_stat": "Asking about suicide does not increase suicidal thoughts", "stat_source": 0 }, "sources": [ { "title": "5 Action Steps to Help Someone Having Thoughts of Suicide", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/5-action-steps-to-help-someone-having-thoughts-of-suicide", "tier": 1 }, { "title": "Longitudinal Suicide Risk in Children and Adolescents With Attention Deficit and Hyperactivity Disorder: A Systematic Review and Meta-Analysis", "publisher": "Brain and Behavior", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12177204/", "tier": 2 } ], "caution": "If you or someone else may act on suicidal thoughts, call your local emergency number now, or contact a crisis line or suicide prevention helpline in your country. Do not wait for a scheduled appointment.", "practice": { "examples": [ "'Are you thinking about suicide?' is clearer than 'You would not do anything silly, would you?'", "'I am not feeling safe and need help now' is enough to start asking for support." ], "pitfalls": [ "Don't promise secrecy. Keeping that door open lets you bring in urgent support when safety is at risk.", "Don't use ADHD statistics to predict one person's risk. Respond to what they say and what is happening now." ], "do": { "1m": "Practise saying it out loud: 'I am struggling and need someone to stay with me while I get help.'", "5m": "Identify your local crisis service and a trusted person you could contact; do not delay urgent help to do this.", "15m": "Read NIMH's action steps with a trusted person and discuss how you would help each other reach support." }, "guides": [ { "title": "5 Action Steps to Help Someone Having Thoughts of Suicide", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/5-action-steps-to-help-someone-having-thoughts-of-suicide", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "cooccurring_any": [ "depression" ] }, "delta": 10, "reason": "The ADHD suicide review cites major depression as a stronger risk factor for suicidal thoughts than ADHD." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "plan-transition-adult-care", "canonical_url": "https://adhd100.jock.pl/plan-transition-adult-care/", "rank": 22, "title": "Plan the move to adult ADHD care", "summary": "An early handover plan can clarify who will provide treatment and support as your child becomes an adult.", "why": "ADHD needs often continue beyond childhood even when the symptoms change. The AAP recommends introducing transition planning around age 14 and focusing on it as school completion approaches, and NICE recommends reassessment at school-leaving age with a planned handover to adult services. This is a continuity-of-care recommendation, not evidence for a measured symptom reduction from a handover checklist.", "how": [ "Ask the current team when transition planning should start and which adult service might take over.", "Include what the young person wants, their preferences, and how involved they want the family to be.", "Request a written summary of the assessment, current treatment, the support that helps and the monitoring needed.", "Confirm the receiving service, where the referral stands, and who stays responsible until the handover happens." ], "category": "Care planning", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "AAP 2019 transition guidance (narrative text, not a key action statement) and NICE NG87 1.1.4 to 1.1.6; no GRADE effect rating" }, "impact": { "score": 71, "headline_stat": "Introduce transition planning at about age 14", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 14, "unit": "years of age", "outcome": "age to introduce transition planning", "comparison": "AAP recommendation for adolescent ADHD care", "stat_source": 0, "bound": "about" }, "sources": [ { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents", "publisher": "American Academy of Pediatrics", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 }, { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 } ], "caution": "Referral rules and ages differ by service and country. Confirm with the clinical teams who carries on prescribing and monitoring.", "practice": { "examples": [ "Ask for the adult service's name and whether it has accepted the referral.", "Ask the young person which parts of family involvement they want to keep." ], "pitfalls": [ "A referral does not necessarily mean the handover is done. Ask who owns the care plan right now.", "If planning starts only after child care ends, nobody may know who is responsible. Raise the transition early." ], "do": { "1m": "Write down the handover detail you most need someone to clear up.", "5m": "Write a message asking the current team what the transition plan is.", "15m": "List current treatments, monitoring and support to go through at the handover meeting.", "plan": { "title": "Prepare a connected handover", "steps": [ "Raise transition planning with the current team.", "Include the young person's goals and prepare the care summary.", "Confirm the receiving service and ongoing responsibilities." ] } }, "guides": [ { "title": "ADHD in children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "kind": "guide", "lang": "en" }, { "title": "ADHD in adults", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-adults/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": [ { "who": "parent", "age_min": 14, "age_max": 17 }, { "who": "self", "age_min": 14, "age_max": 25 } ], "boosts": [ { "when": { "age_min": 16, "age_max": 18 }, "delta": 10, "reason": "The approaching move out of child services needs an agreed handover." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "child-poisoning-prevention", "canonical_url": "https://adhd100.jock.pl/child-poisoning-prevention/", "rank": 23, "title": "Put medicines out of children's reach", "summary": "Make medicines and supplements harder for children to get at, including the ones in visitors' bags.", "why": "General medicine-storage guidance cuts the chances of someone swallowing a medicine by accident. ADHD poisoning research found higher risk in young people with ADHD, but the pooled estimates mixed different kinds of poisoning and don't measure what a storage change achieves. Keeping medicines out of reach and sight is a practical prevention step, alongside the right supervision.", "how": [ "Put medicines and supplements back in a secure place, out of children's reach and sight.", "Check safety caps are fully closed after use.", "Ask visitors to keep bags with medicines in them out of reach too.", "Ask a pharmacist about storage that keeps children safe and still lets you take medicines as prescribed." ], "category": "Injury prevention", "domain": "body-health", "effort": "low", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General CDC storage guidance plus an ADHD poisoning meta-analysis; no formal rating for this household prevention action." }, "impact": { "score": 70, "headline_stat": "Keep medicines where young children cannot reach or see", "stat_source": 0 }, "sources": [ { "title": "Medication Safety and Your Health", "publisher": "CDC", "year": 2024, "url": "https://www.cdc.gov/medication-safety/about/index.html", "tier": 1 }, { "title": "Risk of poisoning in children and adolescents with ADHD: a systematic review and meta-analysis", "publisher": "Scientific Reports", "year": 2018, "url": "https://www.nature.com/articles/s41598-018-25893-9", "tier": 2 } ], "caution": "If you suspect poisoning, get advice quickly from your local poison service or emergency care. Changing where you store medicines does not change the instructions for taking them.", "practice": { "examples": [ "Check a bedside table for loose medicines and put them in their proper safe storage.", "Ask a visitor to put a medicine-containing handbag where children cannot access it." ], "pitfalls": [ "A safety cap is only useful when secured, so check it after each use.", "Leaving pills in view as a reminder can put them within reach. Ask about reminders that keep storage safe." ], "do": { "1m": "Look around for one spot at home where a child could reach medicines or supplements.", "5m": "Check that place and return any medicines to appropriate safe storage out of reach and sight.", "15m": "Review medicine storage with other adults at home, including what happens when visitors arrive." }, "guides": [ { "title": "Medication Safety and Your Health", "publisher": "CDC", "url": "https://www.cdc.gov/medication-safety/about/index.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_max": 17 }, "boosts": [ { "when": { "medication": [ "current" ] }, "delta": 8, "reason": "CDC storage advice covers every medicine kept at home." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "sleep-breathing-check", "canonical_url": "https://adhd100.jock.pl/sleep-breathing-check/", "rank": 24, "title": "Mention your child's snoring", "summary": "Tell your child's clinician about snoring or pauses in breathing during sleep, so they can be checked.", "why": "The American Academy of Pediatrics guideline says an ADHD evaluation should at least screen for physical conditions such as sleep apnea. Reviews find breathing problems in sleep are more common in children with ADHD, and the NHS notes children can get sleep apnoea too. Checking doesn't mean the ADHD diagnosis was a mistake. It makes sure a treatable sleep problem isn't missed.", "how": [ "Note any loud snoring, pauses in breathing or gasping you've noticed while your child sleeps.", "Describe how your child seems during the day, including tiredness that a full night in bed doesn't fix.", "Ask the clinician whether your child's breathing in sleep should be checked." ], "category": "Sleep", "domain": "body-health", "effort": "low", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "AAP 2019 ADHD guideline key action statement 3 (Grade B: strong recommendation) to screen for comorbid physical conditions including sleep apnea, plus ADHD sleep-disordered breathing reviews and NHS sleep apnoea guidance." }, "impact": { "score": 70, "headline_stat": "ADHD evaluation should screen for sleep apnea", "stat_source": 0 }, "sources": [ { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents", "publisher": "American Academy of Pediatrics (Pediatrics)", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 }, { "title": "Sleep apnoea", "publisher": "NHS", "year": 2026, "url": "https://www.nhs.uk/conditions/sleep-apnoea/", "tier": 1 }, { "title": "The impacts associated with having ADHD: an umbrella review", "publisher": "Frontiers in Psychiatry", "year": 2024, "url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1343314/full", "tier": 2 } ], "caution": "Snoring alone does not diagnose sleep apnoea. A clinician needs to assess it, and breathing pauses with marked daytime sleepiness need prompt review.", "practice": { "examples": [ "Tell the clinician that your child snores most nights and still seems tired despite a full night in bed.", "Mention that you have heard your child gasp or pause while breathing in sleep." ], "pitfalls": [ "Snoring alone can't diagnose sleep apnoea. Ask for an assessment instead of guessing.", "Blaming all daytime tiredness on ADHD can hide a sleep problem. Describe both." ], "do": { "1m": "Recall whether you have noticed your child snoring, gasping or pausing while breathing in sleep.", "5m": "Write down the breathing signs and how your child seems during the day.", "15m": "Listen at your child's door for a few minutes after they fall asleep, then note what you heard for the clinician." }, "guides": [ { "title": "Sleep apnoea", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/sleep-apnoea/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 4, "age_max": 17 }, "boosts": [ { "when": { "focus_any": [ "sleep" ] }, "delta": 10, "reason": "Sleep difficulties make this directly relevant." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "medication-appetite-plan", "canonical_url": "https://adhd100.jock.pl/medication-appetite-plan/", "rank": 25, "title": "Ask for an appetite eating plan", "summary": "Tell your child's clinician about a smaller appetite or weight loss, and plan food around what your child needs.", "why": "ADHD medicines can reduce appetite, and NHS trust guidance describes how low intake can affect a child's growth and nutrition. A clinician or dietitian can help you pick smaller meals, snacks or more nourishing foods when they fit. This is practical help with a medicine-related eating problem, not evidence that a particular food treats ADHD.", "how": [ "Tell the prescriber about eating less or a weight change now, instead of waiting for the next routine review.", "Bring examples of meals your child manages, and the times when eating goes better.", "Ask whether a dietitian can help plan meals and snacks that suit your child.", "Leave medicine decisions with the prescriber." ], "category": "Food", "domain": "body-health", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "NHS clinical nutrition advice for appetite problems in ADHD; no measured effect of the food-support plan or matching EBI row." }, "impact": { "score": 69, "headline_stat": "An NHS trust: a dietician can give tailored advice if weight is a concern", "stat_source": 0 }, "sources": [ { "title": "Managing low weight and weight loss", "publisher": "Tees, Esk and Wear Valleys NHS Foundation Trust", "year": 2024, "url": "https://www.tewv.nhs.uk/about-your-care/practical-guide/adhd/weight-loss/", "tier": 1 }, { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 } ], "caution": "Weight loss or growth worries need a clinical review. Any change to medicines or their timing must be agreed with the prescriber.", "practice": { "examples": [ "Tell the clinician that lunch often comes home untouched while supper is easier.", "Ask whether small portions of nourishing foods would fit your child's needs." ], "pitfalls": [ "Bigger portions can feel like too much. Talk about smaller, nourishing options.", "Pressure or punishment around food can make meals feel bad. Keep mealtimes supportive and ask for help." ], "do": { "1m": "Name one meal your child manages well and one they struggle with.", "5m": "List recent eating changes and the foods your child currently accepts.", "15m": "Prepare a message for the prescriber or dietitian about appetite, eating times and weight concerns.", "plan": { "title": "Prepare a food review", "steps": [ "Describe the appetite change and foods currently accepted.", "Agree a tailored eating plan with the care team.", "Review whether intake and growth concerns improve." ] } }, "guides": [ { "title": "Managing low weight and weight loss", "publisher": "Tees, Esk and Wear Valleys NHS Foundation Trust", "url": "https://www.tewv.nhs.uk/about-your-care/practical-guide/adhd/weight-loss/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_max": 17, "medication": [ "current" ] }, "boosts": [ { "when": { "medication": [ "current" ] }, "delta": 8, "reason": "Appetite loss can occur with ADHD medicines." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "child-sleep-opportunity", "canonical_url": "https://adhd100.jock.pl/child-sleep-opportunity/", "rank": 26, "title": "Protect your child's sleep time", "summary": "Leave enough time for the sleep your child's age needs, and don't treat bedtime struggles as misbehaviour.", "why": "Recommended sleep hours come from children in general, not from ADHD treatment trials. Reviews show children with ADHD often have trouble at bedtime and broken sleep. Protecting enough time for sleep supports health and how the day goes, but time in bed is not the same as time asleep.", "how": [ "Look up your child's age in the CDC sleep table.", "Count back from the time they have to wake, and don't count settling down as sleep.", "Ask for help if your child has enough time in bed but still can't sleep, or is very sleepy during the day." ], "category": "Sleep", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General paediatric sleep consensus with ADHD-specific sleep-risk reviews; no GRADE rating for this action." }, "impact": { "score": 68, "headline_stat": "Children 6 to 12 need 9 to 12 hours of sleep, teens 8 to 10", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 8, "unit": "hours/night", "outcome": "lower end of recommended sleep: 9 hours at ages 6 to 12, 8 hours at 13 to 17", "comparison": "age-based guidance, not an ADHD treatment effect", "stat_source": 0, "bound": "at_least" }, "sources": [ { "title": "About Sleep", "publisher": "CDC", "year": 2024, "url": "https://www.cdc.gov/sleep/about/index.html", "tier": 1 }, { "title": "The impacts associated with having ADHD: an umbrella review", "publisher": "Frontiers in Psychiatry", "year": 2024, "url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1343314/full", "tier": 2 }, { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 } ], "practice": { "examples": [ "For a child aged 6 to 12, allow for 9 to 12 hours of actual sleep; for a teen, 8 to 10.", "If bedtime takes a long time, include that settling time when reviewing the evening." ], "pitfalls": [ "An adult sleep target can leave a child short. Check the recommendation for their age.", "A long bedtime struggle needs support, not blame. Describe it to your child's clinician." ], "do": { "1m": "Think back: does your child usually wake refreshed, or still very tired?", "5m": "Check the CDC age table and compare it with your child's usual time asleep.", "15m": "Review bedtime, estimated sleep onset and waking with your child, then note any daytime sleepiness." }, "guides": [ { "title": "About Sleep", "publisher": "CDC", "url": "https://www.cdc.gov/sleep/about/index.html", "kind": "guide", "lang": "en" }, { "title": "ADHD in children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 6, "age_max": 17 }, "boosts": [ { "when": { "focus_any": [ "sleep" ] }, "delta": 10, "reason": "Sleep difficulties make this directly relevant." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "physical-health-risk-review", "canonical_url": "https://adhd100.jock.pl/physical-health-risk-review/", "rank": 27, "title": "Ask which health checks are due", "summary": "Keep heart and metabolic health on the list alongside your ADHD care.", "why": "Guidance on assessing and preventing heart risk comes from the general population. Observational research links ADHD with obesity and cardiovascular disease, although one large registry study found no link with cardiovascular disease in adults, and these associations don't show that ADHD causes either condition. Ask which checks fit your age, symptoms and other risks, and don't assume ADHD on its own calls for extra tests.", "how": [ "Bring your family history and any blood pressure, cholesterol or blood sugar results you have.", "Ask which cardiovascular or diabetes checks are appropriate under your local guidance.", "Talk about food, movement, smoking or weight, without making weight the only measure of health.", "Agree how you'll get results and what follow-up you need." ], "category": "Physical health", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General NHS cardiovascular-risk assessment guidance plus ADHD obesity and cardiovascular observational reviews; no GRADE rating for this action." }, "impact": { "score": 67, "headline_stat": "A health check reviews cardiovascular risk and how to reduce it", "stat_source": 0 }, "sources": [ { "title": "NHS Health Check", "publisher": "NHS", "year": 2023, "url": "https://www.nhs.uk/tests-and-treatments/nhs-health-check/", "tier": 1 }, { "title": "Attention-deficit/hyperactivity disorder is associated with increased risk of cardiovascular diseases: A systematic review and meta-analysis", "publisher": "JCPP Advances", "year": 2023, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10501695/", "tier": 2 }, { "title": "The impacts associated with having ADHD: an umbrella review", "publisher": "Frontiers in Psychiatry", "year": 2024, "url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1343314/full", "tier": 2 } ], "caution": "Who gets tested, and how often, varies by country and by personal risk. New symptoms need a clinical assessment, not a wait for the routine check.", "practice": { "examples": [ "Ask whether you are due a cholesterol check given your age and family history.", "If weight has changed, describe the change alongside eating, activity and other symptoms." ], "pitfalls": [ "A general health check is not an ADHD-specific screening schedule. Follow local eligibility and clinical advice.", "Looking only at body weight can miss other risks. Ask about the whole cardiovascular picture." ], "do": { "1m": "Name one health check or result you're not sure is up to date.", "5m": "List known family history, existing conditions and any past results you can easily find.", "15m": "Prepare a primary-care appointment request asking which preventive checks are appropriate." }, "guides": [ { "title": "NHS Health Check", "publisher": "NHS", "url": "https://www.nhs.uk/tests-and-treatments/nhs-health-check/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "age_min": 40, "age_max": 74 }, "delta": 10, "reason": "The NHS Health Check invites people aged 40 to 74." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "request-adult-sleep-assessment", "canonical_url": "https://adhd100.jock.pl/request-adult-sleep-assessment/", "rank": 28, "title": "Ask for a sleep problem assessment", "summary": "Sleep problems that won't go away deserve an assessment, including for possible sleep disorders and medication effects.", "why": "NIMH reports sleep problems in up to 70% of adults with ADHD, so sleep deserves its own place in your care. An assessment can look at trouble sleeping, daytime sleepiness, breathing symptoms and possible medicine effects. NHS sleep apnoea advice is written for the general population, but it applies when an adult with ADHD also snores, gasps or is very sleepy in the day, and those symptoms should not just be put down to ADHD.", "how": [ "Tell your clinician what the sleep problem is and what it does to your days.", "Mention loud snoring, gasping, pauses in breathing or severe daytime sleepiness.", "Bring a short account of sleep timing and any relationship to prescribed treatment.", "Ask whether a medication review, a sleep assessment or a specialist referral is the right next step." ], "category": "Assessment", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "NIMH ADHD-specific prevalence summary and NHS clinical assessment advice; no effect of assessment quantified" }, "impact": { "score": 67, "headline_stat": "Sleep problems affect up to 70% of adults with ADHD", "stat_source": 0 }, "effect": { "kind": "share_of_people", "value": 70, "unit": "%", "outcome": "adults with ADHD reported to have sleep problems, up to this proportion", "comparison": "prevalence estimate, not a treatment effect", "stat_source": 0 }, "sources": [ { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 }, { "title": "Sleep apnoea", "publisher": "NHS", "year": 2026, "url": "https://www.nhs.uk/conditions/sleep-apnoea/", "tier": 1 }, { "title": "Common questions about methylphenidate for adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/medicines/methylphenidate-adults/common-questions-about-methylphenidate-for-adults/", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 } ], "caution": "Ongoing sleepiness, pauses in breathing or gasping need medical assessment. If sleepiness makes driving unsafe, do not drive, and get clinical advice.", "practice": { "examples": [ "Tell the clinician if someone has noticed you stop breathing for moments in your sleep.", "Describe your daytime sleepiness in a few lines, including when it hits." ], "pitfalls": [ "Put every sleep problem down to ADHD and you can miss a treatable disorder. Describe the symptoms.", "A medicine may affect sleep, but the prescriber should judge that and decide on any change." ], "do": { "1m": "Write down the sleep symptom you most want looked at.", "5m": "Write when the problem happens, and whether anyone has noticed snoring or pauses in your breathing.", "15m": "Write a short sleep history and your medicine list to go through with your clinician.", "plan": { "title": "Arrange the right sleep assessment", "steps": [ "Describe sleep and daytime symptoms.", "Ask about medicine effects and signs of a separate sleep disorder.", "Follow the agreed assessment or referral pathway." ] } }, "guides": [ { "title": "Sleep apnoea", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/sleep-apnoea/", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "sleep" ] }, "delta": 15, "reason": "Sleep problems are common in adults with ADHD and can need separate assessment." }, { "when": { "medication": [ "current" ] }, "delta": 5, "reason": "NICE recommends monitoring sleep changes during ADHD medication treatment." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "steady-sleep-timing", "canonical_url": "https://adhd100.jock.pl/steady-sleep-timing/", "rank": 29, "title": "Keep a steady sleep window", "summary": "Give sleep a predictable place in your day, and get help if the timing stays hard.", "why": "General sleep guidance backs regular sleep and wake times over repeatedly cutting sleep short. The NHS page on adult ADHD says a regular bedtime can help. Adults with ADHD report more sleep difficulties than adults without ADHD, though objective sleep findings are less consistent. A steady schedule can support sleep, but it is not a proven treatment for core ADHD symptoms or a cure for a delayed body clock.", "how": [ "Pick a wake time you can usually keep that still leaves enough time for sleep.", "Keep the bedroom quiet and dark, and go to bed when you're sleepy.", "If falling asleep or waking stays hard, take your sleep pattern to a clinician." ], "category": "Sleep", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "NHS general sleep guidance, NHS adult ADHD self-care advice and a meta-analysis of sleep in adults with ADHD; no formal certainty rating for this habit." }, "impact": { "score": 67, "headline_stat": "Wake up at the same time each day", "stat_source": 0 }, "sources": [ { "title": "Insomnia", "publisher": "NHS", "year": 2024, "url": "https://www.nhs.uk/conditions/insomnia/", "tier": 1 }, { "title": "Sleep in adults with ADHD: Systematic review and meta-analysis of subjective and objective studies", "publisher": "Neuroscience and Biobehavioral Reviews", "year": 2018, "url": "https://pubmed.ncbi.nlm.nih.gov/29477617/", "tier": 2 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 } ], "caution": "If sleep problems persist or affect daily life, get assessed. Medication changes belong with your prescriber.", "practice": { "examples": [ "Use a similar wake time on workdays and free days.", "If you lie awake despite allowing enough sleep time, tell your clinician what happens." ], "pitfalls": [ "Going to bed earlier may not make you sleepy. Get advice if your body clock keeps running late.", "A bad night is no reason to cut sleep further. Go back to a sleep window that works." ], "do": { "1m": "Pick a wake time that works most days of your week without cutting your sleep short.", "5m": "Compare your workday and free-day sleep times and identify the biggest mismatch.", "15m": "Write a brief account of when you feel sleepy, fall asleep and wake, including the effect on your day.", "plan": { "title": "Make sleep timing workable", "steps": [ "Choose a realistic sleep window.", "Try keeping the timing similar across the week.", "Bring persistent difficulty to a clinician." ] } }, "guides": [ { "title": "Insomnia", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/insomnia/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "sleep" ] }, "delta": 10, "reason": "Sleep difficulties make this directly relevant." }, { "when": { "sleep_max": 6.9 }, "delta": 12, "reason": "NHS says most adults need 7 to 9 hours of sleep." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "cannabis-health-review", "canonical_url": "https://adhd100.jock.pl/cannabis-health-review/", "rank": 30, "title": "Discuss cannabis use openly", "summary": "Bring cannabis use into your health review, especially if you use it for ADHD or sleep.", "why": "General-population evidence shows recent cannabis use can impair attention, memory and coordination. A meta-analysis also found cannabis use disorder was more common in people with ADHD, though estimates varied a lot between settings. That's reason enough to talk it through with a clinician, but it doesn't prove cannabis permanently worsens ADHD in every person, or that feeling calmer shows it's treating ADHD.", "how": [ "Say how often you use cannabis, in what form, and what you hope it helps with.", "Mention memory problems, broken sleep or trouble controlling your use.", "Ask a clinician or drug-support service to assess you and talk through support options." ], "category": "Cannabis", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General CDC acute cognitive-effects guidance, ADHD cannabis-use-disorder meta-analysis and NHS support guidance; no GRADE rating." }, "impact": { "score": 66, "headline_stat": "A GP can discuss drug problems and refer you to a local service", "stat_source": 0 }, "sources": [ { "title": "Drug addiction: getting help", "publisher": "NHS", "year": 2023, "url": "https://www.nhs.uk/live-well/addiction-support/drug-addiction-getting-help/", "tier": 1 }, { "title": "Cannabis and Brain Health", "publisher": "CDC", "year": 2024, "url": "https://www.cdc.gov/cannabis/health-effects/brain-health.html", "tier": 1 }, { "title": "The prevalence of cannabis use disorder in attention-deficit hyperactivity disorder: A clinical epidemiological meta-analysis", "publisher": "Journal of Psychiatric Research", "year": 2024, "url": "https://pubmed.ncbi.nlm.nih.gov/38452637/", "tier": 2 } ], "caution": "Talk about cannabis alongside your prescribed medicines and other substances. This item does not recommend cannabis for ADHD and is not a plan for stopping without supervision.", "practice": { "examples": [ "Tell the clinician if you use cannabis at night because you struggle to settle.", "Mention using more than you intended even if you also feel that it helps you relax." ], "pitfalls": [ "Feeling calmer and doing better are different outcomes. Tell the clinician about both.", "Fear of being judged can mean leaving things out. Ask for a confidential conversation about your use." ], "do": { "1m": "Name what you hope cannabis helps with, and one worry you'd like to raise.", "5m": "Write a brief account of your use and its effects on sleep, attention and daily life.", "15m": "Prepare an appointment request with a clinician or local drug-support service." }, "guides": [ { "title": "Drug addiction: getting help", "publisher": "NHS", "url": "https://www.nhs.uk/live-well/addiction-support/drug-addiction-getting-help/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "cooccurring_any": [ "substance" ] }, "delta": 12, "reason": "Substance-related problems warrant an individual assessment." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "ask-about-bullying", "canonical_url": "https://adhd100.jock.pl/ask-about-bullying/", "rank": 31, "title": "Ask about bullying and exclusion", "summary": "Make it easier for your child to tell you when other kids hurt them or leave them out.", "why": "In a US parent survey, 46.9% of children with ADHD were reported as bullied, picked on or excluded. That is a broad survey measure, not a prediction for your child. It is still a good reason to ask instead of waiting for them to bring it up. Public-health guidance says to listen, check safety and work with adults at school on a response.", "how": [ "Ask about particular places: lunch, the bus, the group chat.", "Stay calm, thank them for telling you, and check they are safe right now.", "Agree the next step with the school, then keep checking that the behaviour has stopped." ], "category": "Safety", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "Large US ADHD parent survey for prevalence; public-health guidance for responding, without an ADHD-specific intervention effect." }, "impact": { "score": 65, "headline_stat": "46.9% of children with ADHD were reported as bullied, picked on or excluded", "stat_source": 0 }, "effect": { "kind": "share_of_people", "value": 46.9, "unit": "%", "outcome": "parent-reported bullying, picking on or exclusion in US children with ADHD", "comparison": "2016 to 2017 survey, not an intervention benefit", "stat_source": 0 }, "sources": [ { "title": "Factors Associated With Bullying Victimization and Bullying Perpetration in Children and Adolescents With ADHD: 2016 to 2017 National Survey of Children's Health", "publisher": "Journal of Attention Disorders", "year": 2022, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9378474/", "tier": 2 }, { "title": "How to Prevent Bullying", "publisher": "US Department of Health and Human Services", "year": 2021, "url": "https://www.stopbullying.gov/prevention/how-to-prevent-bullying", "tier": 1 }, { "title": "Support the Children Involved", "publisher": "US Department of Health and Human Services", "year": 2026, "url": "https://www.stopbullying.gov/prevention/support-the-children-involved", "tier": 1 } ], "caution": "Seek urgent help for threats or injury. Respond to harm whether your child was targeted, harmed others or both.", "practice": { "examples": [ "'Who do you sit with at lunch, and does anyone make it hard for you to join in?'", "Tell school what happened and ask who will check that your child is safe." ], "pitfalls": [ "Blaming the child can stop them telling you anything. Make it clear the bullying is not their fault.", "Telling a child to fight back can increase danger, so work with adults on a safer response." ], "do": { "1m": "Say it out loud until it sounds like you: 'If someone is hurting or excluding you, I want to know and help.'", "5m": "Ask about one part of your child's day and listen without jumping straight to advice.", "15m": "If something has happened, record the basic facts and prepare a safety-focused conversation with school." }, "guides": [ { "title": "How to Prevent Bullying", "publisher": "US Department of Health and Human Services", "url": "https://www.stopbullying.gov/prevention/how-to-prevent-bullying", "kind": "guide", "lang": "en" }, { "title": "Support the Children Involved", "publisher": "US Department of Health and Human Services", "url": "https://www.stopbullying.gov/prevention/support-the-children-involved", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 6, "age_max": 17 }, "boosts": [ { "when": { "focus_any": [ "school", "relationships" ] }, "delta": 12, "reason": "Bullying involvement is common in the cited ADHD school-age survey." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "child-dental-prevention", "canonical_url": "https://adhd100.jock.pl/child-dental-prevention/", "rank": 32, "title": "Support your child's tooth care", "summary": "Keep brushing and dental advice manageable, especially when attention or sensory needs get in the way.", "why": "Brushing with fluoride toothpaste helps prevent decay in children generally. Reviews of ADHD and dental health suggest more difficulties, though a newer review found the size and consistency of the link uncertain. Practical help with brushing and dental advice for your child are sensible prevention, not a treatment for ADHD.", "how": [ "Help your child brush twice daily with fluoride toothpaste suited to their age, including before bed.", "Follow the NHS guide for their age on supervision and technique.", "Ask the dentist when the next check is due, and explain if your child finds brushing hard to tolerate." ], "category": "Dental health", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General NHS dental-prevention guidance plus ADHD observational reviews with mixed findings; no GRADE rating for the action." }, "impact": { "score": 65, "headline_stat": "Brush children's teeth at least 2 times daily", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 2, "unit": "times/day", "outcome": "toothbrushing with fluoride toothpaste", "comparison": "general children's dental guidance", "stat_source": 0, "bound": "at_least" }, "sources": [ { "title": "Children's teeth", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/live-well/healthy-teeth-and-gums/taking-care-of-childrens-teeth/", "tier": 1 }, { "title": "Dental Caries in Children with Attention Deficit/Hyperactivity Disorder: A Meta-Analysis", "publisher": "Caries Research", "year": 2022, "url": "https://pubmed.ncbi.nlm.nih.gov/34929707/", "tier": 2 }, { "title": "Attention-deficit hyperactivity disorder and oral health in children and adolescents: a systematic review", "publisher": "European Archives of Paediatric Dentistry", "year": 2025, "url": "https://pubmed.ncbi.nlm.nih.gov/40846831/", "tier": 2 } ], "caution": "Ask a dentist about pain, persistent bleeding, injury or difficulty brushing; supervision and toothpaste use should suit your child's age.", "practice": { "examples": [ "Help with the bedtime brush when your child cannot manage it independently.", "Tell the dentist if the toothpaste sensation or brushing process makes tooth care difficult." ], "pitfalls": [ "Expecting your child to brush alone too early may leave teeth unclean. Keep helping or supervising.", "Rinsing right after brushing washes the fluoride away. Follow the NHS advice on spitting for your child's age." ], "do": { "1m": "Name the part of brushing your child finds hardest, so you can ask for help with it.", "5m": "Check the NHS advice for your child's age and identify one brushing step to support.", "15m": "Prepare a question for the dentist about brushing difficulties and check when the next visit is due." }, "guides": [ { "title": "Children's teeth", "publisher": "NHS", "url": "https://www.nhs.uk/live-well/healthy-teeth-and-gums/taking-care-of-childrens-teeth/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_max": 17 }, "boosts": [] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "child-head-injury-protection", "canonical_url": "https://adhd100.jock.pl/child-head-injury-protection/", "rank": 33, "title": "Check your child's sports helmet", "summary": "Make protective gear part of active play, and be clear about its limits.", "why": "In children generally, helmets can reduce serious harm from head injuries, as long as they suit the activity and fit properly. ADHD is associated with more accidental injuries, so dependable protection matters more. A helmet cannot prevent every injury or guarantee protection against concussion.", "how": [ "Check the helmet is made and certified for the activity.", "Use the CDC fitting guide for that activity and the maker's instructions.", "Check fit and condition, and help your child wear it every time they do the activity." ], "category": "Injury prevention", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General CDC protective-equipment guidance with ADHD injury-risk reviews; no ADHD-specific helmet trial estimate." }, "impact": { "score": 65, "headline_stat": "Helmets should fit properly and be worn consistently and correctly", "stat_source": 0 }, "sources": [ { "title": "Safety Guidelines: Helmets", "publisher": "CDC", "year": 2025, "url": "https://www.cdc.gov/heads-up/safety/index.html", "tier": 1 }, { "title": "The impacts associated with having ADHD: an umbrella review", "publisher": "Frontiers in Psychiatry", "year": 2024, "url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1343314/full", "tier": 2 }, { "title": "Physical activity guidelines for children and young people", "publisher": "NHS", "year": 2024, "url": "https://www.nhs.uk/live-well/exercise/physical-activity-guidelines-children-and-young-people/", "tier": 1 } ], "caution": "A helmet does not rule out concussion or other injury. Get medical advice after a worrying head injury.", "practice": { "examples": [ "Check the bike helmet before a ride rather than assuming last year's fit is still right.", "Use a helmet made for the sport your child is doing." ], "pitfalls": [ "No helmet is concussion-proof. Keep safe play and supervision in place.", "A loose or damaged helmet may not protect properly. Check the fit and condition." ], "do": { "1m": "Try to remember when your child's helmet fit was last checked.", "5m": "Open the activity-specific CDC helmet guide and identify the fit checks.", "15m": "With your child present, check the helmet using the guide and manufacturer's instructions." }, "guides": [ { "title": "Safety Guidelines: Helmets", "publisher": "CDC", "url": "https://www.cdc.gov/heads-up/safety/index.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_max": 17 }, "boosts": [] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "notice-persistent-low-mood", "canonical_url": "https://adhd100.jock.pl/notice-persistent-low-mood/", "rank": 34, "title": "Notice lasting changes in mood", "summary": "Recognise when sadness, irritability or loss of interest needs a conversation about help.", "why": "ADHD and depression can happen together, so don't automatically put a change in mood down to ADHD. NIMH describes major depression as depressed mood or loss of interest lasting at least two weeks and getting in the way of daily life. In children it may look like irritability more than sadness. Treat these as reasons to get help, not a checklist for diagnosing yourself or your child.", "how": [ "Compare now with your usual: mood, enjoyment, how well you manage ordinary days.", "Tell someone you trust what has changed and how long it has been going on.", "Take those examples to a health professional, and go sooner if symptoms are severe." ], "category": "Mental health", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "General NIMH and CDC symptom-recognition guidance, with NIMH evidence that ADHD often co-occurs with other mental disorders." }, "impact": { "score": 65, "headline_stat": "Major depression symptoms last at least 2 weeks", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 2, "unit": "weeks", "outcome": "duration in the description of major depression, not a delay before help", "comparison": "symptom-recognition threshold, not a self-diagnosis", "stat_source": 0, "bound": "at_least" }, "sources": [ { "title": "Depression", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/depression", "tier": 1 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 }, { "title": "Anxiety and Depression in Children", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/children-mental-health/about/about-anxiety-and-depression-in-children.html", "tier": 1 } ], "caution": "This cannot diagnose depression. For thoughts of suicide, seek help now: contact a crisis line or helpline in your country, and call your local emergency number if anyone is in immediate danger.", "practice": { "examples": [ "Things you usually enjoy have felt empty for days and this is affecting daily life.", "Your child is unusually irritable and has stopped enjoying time with friends." ], "pitfalls": [ "Waiting for visible sadness can miss depression in children, so notice irritability and loss of interest too.", "Two weeks is not a waiting rule. Get help sooner for severe symptoms or safety concerns." ], "do": { "1m": "Ask yourself: has my mood or enjoyment changed from usual? Then pick the person you could tell.", "5m": "Note what changed, when it began and one example of how it affects everyday life.", "15m": "Use those examples to request a conversation with a health professional for yourself or your child." }, "guides": [ { "title": "Depression", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/depression", "kind": "guide", "lang": "en" }, { "title": "Anxiety and Depression in Children", "publisher": "CDC", "url": "https://www.cdc.gov/children-mental-health/about/about-anxiety-and-depression-in-children.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "emotions" ] }, "delta": 12, "reason": "Depression can affect mood, enjoyment and everyday functioning." }, { "when": { "cooccurring_any": [ "depression" ] }, "delta": 10, "reason": "Persistent or worsening depression symptoms warrant professional support." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "request-adhd-psychoeducation", "canonical_url": "https://adhd100.jock.pl/request-adhd-psychoeducation/", "rank": 35, "title": "Ask for a diagnosis explanation", "summary": "Knowing what your diagnosis means and what the options are lets you take part in decisions about your care.", "why": "Psychoeducation means explaining ADHD, what the diagnosis means for you and what support is available. NICE recommends a structured discussion after diagnosis covering treatment choices, school or work adjustments, driving and other practical issues, and NHS guidance says your specialist should explain what happens next. This supports informed decisions, but these sources do not establish a numerical symptom benefit from a single information session.", "how": [ "Ask the clinician to walk you through how the assessment led to the diagnosis.", "Pick the two questions that matter most to you, such as treatment choices or school support.", "Ask for a short written explanation you can go back to.", "If it's too much to take in at once, ask for a second conversation." ], "category": "Care planning", "domain": "treatment-care", "effort": "low", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "NICE NG87 1.4.3 recommends a structured discussion after diagnosis; NHS guidance agrees; no trial effect or GRADE rating claimed" }, "impact": { "score": 65, "headline_stat": "Discuss what the diagnosis means and what happens next", "stat_source": 0 }, "sources": [ { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 }, { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "year": 2022, "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 } ], "caution": "Use the conversation to understand the diagnosis and your options. Treatment decisions should be made for you specifically, with your clinician.", "practice": { "examples": [ "Ask: 'Which problems does this diagnosis explain, and which need a separate assessment?'", "Ask for an explanation your child can follow, alongside the information for adults." ], "pitfalls": [ "Too much information at once can be hard to retain; choose two questions and ask for written notes.", "An explanation is where care starts, so leave with a named next step." ], "do": { "1m": "Type the question about ADHD you most want answered.", "5m": "List two questions and one part of the diagnosis you want explained.", "15m": "Read the matching NHS guide and turn whatever is unclear into questions for the appointment.", "plan": { "title": "Turn information into a care decision", "steps": [ "Ask what the diagnosis means in your situation.", "Discuss treatment and support choices in manageable chunks.", "Keep a short written account of the agreed next step." ] } }, "guides": [ { "title": "ADHD in adults", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-adults/", "kind": "guide", "lang": "en" }, { "title": "ADHD in children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "kind": "guide", "lang": "en" }, { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "diagnosed": [ "yes" ] }, "delta": 8, "reason": "The next steps after diagnosis should be explained." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "adult-strength-work", "canonical_url": "https://adhd100.jock.pl/adult-strength-work/", "rank": 36, "title": "Add gentle strength work", "summary": "Build strength and mobility, starting from a point that suits your body.", "why": "Strength activity supports health and mobility in the general population. Observational reviews find higher rates of obesity in adults with ADHD, which is a reason to look after physical health broadly. This is general health advice, not evidence that strength exercises treat ADHD symptoms.", "how": [ "Pick a few suitable movements from the NHS illustrated guide.", "Use a stable chair or other support as the guide shows, and build up gradually.", "Work toward strength activity on at least two days a week, adapting it if you need to." ], "category": "Movement", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General CDC activity recommendations and NHS exercise guidance, with ADHD obesity association evidence; no formal certainty rating." }, "impact": { "score": 64, "headline_stat": "Include muscle-strengthening activity on at least 2 days each week", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 2, "unit": "days/week", "outcome": "muscle-strengthening activity frequency", "comparison": "general adult health guidance", "stat_source": 0, "bound": "at_least" }, "sources": [ { "title": "Adult Activity: An Overview", "publisher": "CDC", "year": 2023, "url": "https://www.cdc.gov/physical-activity-basics/guidelines/adults.html", "tier": 1 }, { "title": "Strength exercises", "publisher": "NHS", "year": 2024, "url": "https://www.nhs.uk/live-well/exercise/strength-exercises/", "tier": 1 }, { "title": "The impacts associated with having ADHD: an umbrella review", "publisher": "Frontiers in Psychiatry", "year": 2024, "url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1343314/full", "tier": 2 } ], "caution": "Get advice on adapting exercise if illness, injury, balance problems or pain get in the way.", "practice": { "examples": [ "Use the NHS guide to learn a gentle chair-based starting exercise.", "Ask a physiotherapist about adaptations if standing movements are difficult." ], "pitfalls": [ "Heavy loads at the start can make the next session harder. Learn comfortable movements first.", "Pain is not a progress target, so stop and seek advice if a movement hurts." ], "do": { "1m": "Decide whether you'd rather learn strength moves at home or with an instructor.", "5m": "Read the NHS guide and select one movement that appears suitable for you.", "15m": "If suitable, try a few gentle movements from the guide with the recommended support, resting as needed.", "plan": { "title": "Build a manageable strength habit", "steps": [ "Choose suitable exercises and support.", "Practise comfortable movements without rushing.", "Gradually build toward the weekly recommendation." ] } }, "guides": [ { "title": "Strength exercises", "publisher": "NHS", "url": "https://www.nhs.uk/live-well/exercise/strength-exercises/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "activity": [ "low" ] }, "delta": 12, "reason": "Building up activity offers general health benefits." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "regular-balanced-meals", "canonical_url": "https://adhd100.jock.pl/regular-balanced-meals/", "rank": 37, "title": "Make regular meals easier", "summary": "Aim for food you can count on, including a simple breakfast if mornings are hard.", "why": "A balanced diet supports nutrition and health in the general population. NHS ADHD advice specifically recommends regular meals, and the adult symptoms it describes include forgetfulness and trouble organising time. An ordinary protein food like yoghurt, eggs or beans adds nutrients, but these sources do not establish a special high-protein breakfast as an ADHD treatment.", "how": [ "Pick simple meals with familiar foods from different food groups.", "Add a protein food when it suits you, without chasing a special ADHD protein target.", "Lean on easy options like tinned beans, bread, yoghurt, fruit or frozen vegetables.", "Ask for dietary support if eating stays hard or your diet gets very restricted." ], "category": "Food", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": true, "basis": "NHS ADHD lifestyle guidance and general balanced-diet recommendations; no rated ADHD trial evidence for meal timing or protein breakfast." }, "impact": { "score": 64, "headline_stat": "Aim for a balanced diet and regular mealtimes", "stat_source": 0 }, "sources": [ { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 }, { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 }, { "title": "The Eatwell Guide", "publisher": "NHS", "year": 2022, "url": "https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/the-eatwell-guide/", "tier": 1 } ], "caution": "Food allergies, swallowing problems, growth worries or an eating disorder need personal dietary advice.", "practice": { "examples": [ "Try yoghurt with cereal and fruit when that is an easy breakfast for you.", "Use beans on toast as a simple meal rather than waiting for time to cook something elaborate." ], "pitfalls": [ "A complicated meal plan can be hard to sustain, so choose a few easy foods you already like.", "Calling protein an ADHD cure overstates the evidence. Aim for adequate, varied nutrition." ], "do": { "1m": "Name one easy meal you already like and could eat often.", "5m": "Choose a simple breakfast or other meal from foods you usually have.", "15m": "Put together a short shopping list for a few easy meals with variety across the day." }, "guides": [ { "title": "The Eatwell Guide", "publisher": "NHS", "url": "https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/the-eatwell-guide/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "discuss-substance-risk-treatment", "canonical_url": "https://adhd100.jock.pl/discuss-substance-risk-treatment/", "rank": 38, "title": "Discuss substance risk with your team", "summary": "An honest review can deal with worries about substance use without assuming prescribed ADHD care causes addiction.", "why": "A Swedish registry study of people with ADHD linked medication treatment with a lower rate of recorded substance misuse over two years, an adjusted rate ratio of 0.85. It was an observational target-trial emulation, so it cannot prove the medication prevented misuse, or that misuse is impossible. NICE recommends talking about the raised risk of substance misuse after diagnosis, and assessing the risk of misuse and diversion before medication starts.", "how": [ "Tell the prescriber about substance use now and any past problems, including misuse of prescribed medicines.", "If you need help with both, ask how ADHD care and substance-use care can work together.", "Raise any worries about dependence, diversion, or being pressured to share your medicine.", "Agree who keeps an eye on the risks and how to reach the care team if things change." ], "category": "Combined care", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "NICE NG87 1.4.3 and 1.7.4 recommend the discussion and risk assessment; large ADHD-specific observational target-trial emulation, no GRADE rating and no causal prevention claim" }, "impact": { "score": 63, "headline_stat": "Registry study: ADHD medication linked with less recorded substance misuse (rate ratio 0.85)", "stat_source": 0 }, "sources": [ { "title": "ADHD drug treatment and risk of suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality: emulation of target trials", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12344785/", "tier": 2 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 }, { "title": "Common questions about methylphenidate for adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/medicines/methylphenidate-adults/common-questions-about-methylphenidate-for-adults/", "tier": 1 } ], "caution": "Substance use and prescribing need an assessment of your own situation. This finding does not support taking someone else's medicine, taking extra, or tackling substance problems without clinical help.", "practice": { "examples": [ "Mention substance use even if it feels like it has nothing to do with an ADHD appointment.", "If ADHD and substance-use services are separate, ask who coordinates your care." ], "pitfalls": [ "A link with lower recorded risk is not proof that medicine prevents addiction. Talk about your own risks.", "Fear of being judged can hide what the prescriber needs to know to prescribe safely. Ask how the team can make an honest conversation easier." ], "do": { "1m": "Write down the substance-use or medicine-safety worry you want to raise privately with your clinician.", "5m": "List the substances and medicines you use, and any worries about control or safety.", "15m": "Write your questions about joined-up treatment, confidentiality and how the team watches for risk.", "plan": { "title": "Make substance risk part of care", "steps": [ "Share the relevant history with the prescriber.", "Agree whether coordinated specialist support is needed.", "Review risks and contact arrangements as circumstances change." ] } }, "guides": [ { "title": "Tips for Talking With a Health Care Provider About Your Mental Health", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider", "kind": "guide", "lang": "en" }, { "title": "Common questions about methylphenidate for adults", "publisher": "NHS", "url": "https://www.nhs.uk/medicines/methylphenidate-adults/common-questions-about-methylphenidate-for-adults/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "cooccurring_any": [ "substance" ] }, "delta": 18, "reason": "NICE includes substance misuse risk in the assessment before ADHD medication." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "youth-vaping-conversation", "canonical_url": "https://adhd100.jock.pl/youth-vaping-conversation/", "rank": 39, "title": "Ask for help with youth vaping", "summary": "Give your child a calm way to reliable information and professional support.", "why": "General CDC guidance warns that nicotine addiction can affect concentration and sleep, and recommends supportive conversations with young people. ADHD is associated with higher rates of smoking and substance problems, although older nicotine studies do not measure modern vaping specifically. A conversation can open the door to help, without treating nicotine as an attention aid.", "how": [ "Pick a calm moment and ask what your child knows or has noticed about vaping.", "Listen without criticising, and ask what they'd like to know.", "Ask a healthcare professional for reliable information and help if your child already vapes." ], "category": "Nicotine", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General CDC youth vaping guidance with ADHD nicotine-risk context; no formal certainty rating for this prevention conversation." }, "impact": { "score": 63, "headline_stat": "Ask a healthcare professional about help if your child vapes", "stat_source": 0 }, "sources": [ { "title": "Protecting Youth From the Harms of Vaping", "publisher": "CDC", "year": 2024, "url": "https://www.cdc.gov/tobacco/e-cigarettes/protecting-youth.html", "tier": 1 }, { "title": "The impacts associated with having ADHD: an umbrella review", "publisher": "Frontiers in Psychiatry", "year": 2024, "url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1343314/full", "tier": 2 } ], "caution": "If your child uses nicotine, ask their healthcare professional about appropriate support. Treatment choices for young people need individual advice.", "practice": { "examples": [ "Ask what your child thinks when you pass a vape display together.", "Offer a conversation with a school nurse or clinician if your child would rather talk privately." ], "pitfalls": [ "A lecture can shut the conversation down. Listen first and keep it open.", "Assuming older smoking-risk estimates describe vaping precisely overstates the evidence, so avoid quoting them as vaping odds." ], "do": { "1m": "Come up with one neutral question about vaping that asks what your child thinks.", "5m": "Read the CDC parent guide and choose one question for a healthcare professional.", "15m": "Prepare a supportive conversation and, if needed, request advice from your child's clinician." }, "guides": [ { "title": "Protecting Youth From the Harms of Vaping", "publisher": "CDC", "url": "https://www.cdc.gov/tobacco/e-cigarettes/protecting-youth.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_max": 17, "age_min": 11 }, "boosts": [ { "when": { "cooccurring_any": [ "substance" ] }, "delta": 12, "reason": "Existing substance concerns make professional support more relevant." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "child-sleep-support", "canonical_url": "https://adhd100.jock.pl/child-sleep-support/", "rank": 40, "title": "Ask for tailored sleep support", "summary": "Get help with your child's actual sleep problem, not another generic bedtime rule.", "why": "In a trial of children with ADHD and sleep problems, a brief clinician-led sleep programme improved parent-reported sleep and modestly improved ADHD symptoms. At three months, moderate or severe sleep problems were reduced by 25.7 percentage points compared with usual care. By six months the sleep gap was smaller, 46% versus 34%, an adjusted 12.8 points, while the ADHD symptom gain held. Parents knew which group their child was in, and the objective sleep-duration estimates were uncertain.", "how": [ "Say whether the main problem is settling, pushing back at bedtime, or waking in the night.", "Ask your child's clinician about behavioural sleep support tailored to them.", "Bring the sleep strategies you have already tried and agree how progress will be reviewed." ], "category": "Sleep", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": true, "basis": "Randomised trial in 244 children aged 5 to 12 with ADHD; no formal GRADE rating reported." }, "impact": { "score": 62, "headline_stat": "Trial: sleep programme cut moderate or severe sleep problems by 25.7 percentage points at 3 months", "stat_source": 0 }, "sources": [ { "title": "Impact of a behavioural sleep intervention on symptoms and sleep in children with attention deficit hyperactivity disorder, and parental mental health: randomised controlled trial", "publisher": "BMJ", "year": 2015, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4299655/", "tier": 2 }, { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 }, { "title": "About Sleep", "publisher": "CDC", "year": 2024, "url": "https://www.cdc.gov/sleep/about/index.html", "tier": 1 } ], "caution": "Get clinical advice for sleep problems that persist. Breathing pauses and marked daytime sleepiness need assessment.", "practice": { "examples": [ "Ask for help when bedtime routinely turns into a long struggle.", "Explain that your child falls asleep but wakes repeatedly, rather than describing every problem as insomnia." ], "pitfalls": [ "The trial tested a supported programme. Don't expect one bedtime tip to reproduce its result.", "A sleep programme should fit the problem. If breathing or unusual movements are involved, ask about other sleep disorders." ], "do": { "1m": "Name the one sleep problem that most disrupts your child's night.", "5m": "Write down that problem, its daytime impact and what you have already tried.", "15m": "Prepare or send an appointment request asking about tailored sleep support.", "plan": { "title": "Prepare for a sleep review", "steps": [ "Describe the main difficulty and current sleep pattern.", "Agree a tailored plan with the clinician.", "Review what changes and what remains difficult." ] } }, "guides": [ { "title": "ADHD in children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "kind": "guide", "lang": "en" }, { "title": "About Sleep", "publisher": "CDC", "url": "https://www.cdc.gov/sleep/about/index.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 5, "age_max": 12 }, "boosts": [ { "when": { "focus_any": [ "sleep" ] }, "delta": 10, "reason": "Sleep difficulties make this directly relevant." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "notice-your-childs-anxiety", "canonical_url": "https://adhd100.jock.pl/notice-your-childs-anxiety/", "rank": 41, "title": "Notice worry behind the behaviour", "summary": "Watch for fear and avoidance, not only the ADHD signs everyone can see.", "why": "CDC reports anxiety in about four in ten US children with ADHD in a national parent survey. Anxiety can show up as irritability, stomach aches or avoiding school and play, so it can be mistaken for difficult behaviour. Noticing the pattern can help you describe the problem to a professional, but does not establish a diagnosis.", "how": [ "Ask gently what feels worrying, instead of assuming your child is refusing on purpose.", "Notice when fear or avoidance starts getting in the way at school, at home or with friends.", "Describe the pattern to your child's health professional and ask what they advise." ], "category": "Mental health", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "CDC ADHD survey data establish co-occurrence; general child mental-health guidance supports recognition and seeking help." }, "impact": { "score": 62, "headline_stat": "About 40% of US children with ADHD also had anxiety in a parent survey", "stat_source": 0 }, "effect": { "kind": "share_of_people", "value": 40, "unit": "%", "outcome": "parent-reported anxiety among US children with ADHD, approximate", "comparison": "survey prevalence, not the benefit of this action", "stat_source": 0 }, "sources": [ { "title": "Data on ADHD in Children", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/data/index.html", "tier": 1 }, { "title": "Anxiety and Depression in Children", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/children-mental-health/about/about-anxiety-and-depression-in-children.html", "tier": 1 } ], "caution": "This cannot diagnose anxiety. Get prompt help for severe distress, self-harm or major loss of functioning.", "practice": { "examples": [ "Your child reports stomach aches before school and worries about getting things wrong.", "A child who looks angry is actually scared about joining a group." ], "pitfalls": [ "Arguing that a worry is irrational may close the conversation, so first listen to the fear.", "Do not treat every physical symptom as anxiety, so mention persistent symptoms to a clinician." ], "do": { "1m": "Try the question out loud: 'What feels hardest or most worrying about this?'", "5m": "Write down one repeated worry, when it appears and what your child avoids.", "15m": "Talk with your child, then prepare a short account of the pattern for their health professional." }, "guides": [ { "title": "Anxiety and Depression in Children", "publisher": "CDC", "url": "https://www.cdc.gov/children-mental-health/about/about-anxiety-and-depression-in-children.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent" }, "boosts": [ { "when": { "focus_any": [ "emotions", "school" ] }, "delta": 12, "reason": "Anxiety can interfere with school and play and may appear as irritability." }, { "when": { "cooccurring_any": [ "anxiety" ] }, "delta": 10, "reason": "Persistent anxiety affecting daily activities deserves attention." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "seek-parent-behaviour-training", "canonical_url": "https://adhd100.jock.pl/seek-parent-behaviour-training/", "rank": 42, "title": "Ask about parent behaviour training", "summary": "For young children with ADHD, trained parent support is a first treatment, even though the evidence on symptoms is weak.", "why": "Behavioural parent training teaches caregivers ways to support a child's behaviour, with guided practice and feedback. NICE recommends a group programme as the first treatment under age 5, and the AAP recommends it first at ages 4 to 5 and alongside other treatment at 6 to 11. The evidence is weaker than that status suggests: EBI found parent-rated preschool symptoms 0.634 SMD better with very low certainty, effects on oppositional and conduct behaviour in older children were small (very low to low certainty), and NICE noted benefits looked less impressive when teachers did the rating. Most results cover about 12 weeks or to trial endpoint.", "how": [ "Ask your child's clinician for a recognised parent training programme run by a trained therapist.", "Check that it includes coached practice, positive reinforcement and regular progress reviews.", "Say what makes attending hard, and ask about one-to-one or group formats and practical help.", "Settle on a small set of goals with the therapist, with your child's needs in them." ], "category": "Therapy", "domain": "treatment-care", "effort": "high", "evidence": { "grade": "A", "certainty": "very_low", "adhd_specific": true, "basis": "NICE NG87 1.5.7 and 1.5.11, AAP key action statements 5a and 5b (AAP grade A); EBI symptom estimates very low certainty, NICE review E: benefits smaller with teacher ratings", "ebi": { "intervention": "Parent-mediated behavioral interventions", "age": "preschool", "outcome": "Core ADHD symptoms", "rater": "parent-rated", "timepoint": "short" } }, "impact": { "score": 62, "headline_stat": "Parent behaviour training is the first choice below age 6", "stat_source": 2 }, "sources": [ { "title": "EBI-ADHD: companion data to Gosling et al., BMJ 2025, commit 86eff22a9ffb", "publisher": "BMJ / Gosling et al.", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "ADHD evidence review E: non-pharmacological efficacy and adverse events (NG87)", "publisher": "NICE", "year": 2018, "url": "https://www.nice.org.uk/guidance/ng87/evidence/e-nonpharmacological-efficacy-and-adverse-events-pdf-4783686305", "tier": 1 }, { "title": "Parent Training in Behavior Management", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/treatment/behavior-therapy.html", "tier": 1 }, { "title": "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents", "publisher": "American Academy of Pediatrics", "year": 2019, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7067282/", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 } ], "caution": "Look for a trained professional who works with young children. Parent training gives you tools and support, and it does not mean you caused your child's ADHD.", "practice": { "examples": [ "Ask a potential therapist whether sessions include coached practice with feedback.", "Say that getting to sessions is hard, and ask what other ways the service can deliver them." ], "pitfalls": [ "A general parenting talk may not be a structured treatment. Ask which programme and methods they use.", "Blaming yourself adds pressure and helps nobody. Ask for training that teaches you and backs you up." ], "do": { "1m": "Write down one daily situation, like bedtime or leaving the house, you'd want a parent-training therapist's help with.", "5m": "Write to your child's clinician asking about behavioural parent training.", "15m": "Hold a programme's description up against CDC's questions for finding a therapist.", "plan": { "title": "Find a suitable training programme", "steps": [ "Ask for an appropriate programme or referral.", "Discuss goals, attendance barriers and the training format.", "Review progress with the therapist and adjust the support together." ] } }, "guides": [ { "title": "Parent Training in Behavior Management", "publisher": "CDC", "url": "https://www.cdc.gov/adhd/treatment/behavior-therapy.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_max": 17 }, "boosts": [ { "when": { "age_max": 5 }, "delta": 18, "reason": "NICE and the AAP recommend parent training as the first treatment at this age." }, { "when": { "age_min": 12 }, "delta": -10, "reason": "Guidelines give parent training a smaller role for teenagers." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "request-workplace-adjustments", "canonical_url": "https://adhd100.jock.pl/request-workplace-adjustments/", "rank": 43, "title": "Ask for workplace adjustments", "summary": "A focused support request can help your workplace reduce barriers linked to ADHD.", "why": "Workplace adjustments change the demands or surroundings that make ADHD harder to manage. NHS guidance gives examples like a quieter workspace, written instructions and help structuring tasks, and NICE says the conversation after diagnosis should cover your right to reasonable adjustments at work. These are practical recommendations, not evidence that any particular adjustment improves symptoms by a known amount.", "how": [ "Identify one work barrier and the change you think could address it.", "Find the right manager, occupational health contact or workplace support service.", "Talk about what information they need and what you are comfortable sharing.", "Agree the adjustment and a date to check whether it helps." ], "category": "Work care", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD-specific NHS advice on reasonable adjustments and NICE NG87 1.4.3; no rated trial effect for particular changes" }, "impact": { "score": 61, "headline_stat": "Request workplace changes to help manage ADHD", "stat_source": 0 }, "sources": [ { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 } ], "caution": "Disclosure and workplace rights depend on local rules and your circumstances. Ask about confidentiality and share only what the request needs.", "practice": { "examples": [ "If holding on to spoken instructions is the problem, ask for a written follow-up.", "Talk about a quieter workspace with whoever handles workplace adjustments." ], "pitfalls": [ "'Make work easier' is hard for anyone to act on. Name the barrier and the change you want.", "No adjustment suits every role. Agree when you'll check how it's working." ], "do": { "1m": "Write down the one work barrier you'd most like support with.", "5m": "Write one sentence on the barrier and one on an adjustment that might help.", "15m": "Draft a short support request and work out who at work should receive it.", "plan": { "title": "Make a focused adjustment request", "steps": [ "Identify a specific work barrier.", "Discuss a suitable adjustment and relevant confidentiality.", "Review whether the agreed change helps." ] } }, "guides": [ { "title": "ADHD in adults", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-adults/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 16 }, "boosts": [ { "when": { "works": true }, "delta": 12, "reason": "NHS guidance describes adjustments for people with ADHD at work." }, { "when": { "focus_any": [ "work" ] }, "delta": 6, "reason": "Adjustments can address identified work barriers." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "binge-eating-support", "canonical_url": "https://adhd100.jock.pl/binge-eating-support/", "rank": 44, "title": "Get help for loss-of-control eating", "summary": "If you often eat a lot quickly and can't stop when full, see a GP. Binge eating is treatable.", "why": "A meta-analysis of 12 studies found about four times the odds of binge eating disorder in people with ADHD compared with people without. The NHS calls binge eating disorder a serious mental health condition where people eat without feeling in control, and says most people recover with the right support. Treatment usually starts with guided self-help or talking therapy, and often includes planning regular meals and snacks.", "how": [ "Notice whether you regularly eat a lot in a short time and can't stop when you're full.", "Book a GP appointment and say how often it happens and how you feel afterwards.", "Ask about guided self-help, or a referral to an eating disorder service." ], "category": "Food", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "ADHD eating-disorder meta-analysis (12 studies, 4,013 people with ADHD) plus general NHS assessment and treatment guidance; the treatment evidence is not ADHD-specific and no GRADE rating is given." }, "impact": { "score": 58, "headline_stat": "ADHD is linked with about four times the odds of binge eating disorder (odds ratio 4.13)", "stat_source": 0 }, "sources": [ { "title": "The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis", "publisher": "International Journal of Eating Disorders", "year": 2016, "url": "https://pubmed.ncbi.nlm.nih.gov/27859581/", "tier": 2 }, { "title": "Overview - Binge eating disorder", "publisher": "NHS", "year": 2023, "url": "https://www.nhs.uk/mental-health/conditions/binge-eating/overview/", "tier": 1 }, { "title": "Treatment - Binge eating disorder", "publisher": "NHS", "year": 2023, "url": "https://www.nhs.uk/mental-health/conditions/binge-eating/treatment/", "tier": 1 } ], "caution": "Binge eating disorder needs a clinical assessment. Don't start a strict diet on your own, because the NHS says dieting during treatment can make binge eating harder to stop.", "practice": { "examples": [ "Tell the GP you often eat until uncomfortably full and feel ashamed afterwards.", "Call the Beat adult helpline to talk it through before booking an appointment." ], "pitfalls": [ "Treating binges as a willpower problem keeps the cycle going. Ask for proper support.", "Skipping meals to make up for a binge can set up the next one. Ask about regular eating instead." ], "do": { "1m": "Ask yourself honestly: does eating often feel out of your control?", "5m": "Note when binges happened this week and how you felt before and after.", "15m": "Book a GP appointment and write down what you want to tell them.", "plan": { "title": "Get from notice to support", "steps": [ "Keep a short note of binges and how you felt for a week or two.", "Take the notes to a GP appointment, with a friend if that helps.", "Ask about guided self-help or an eating disorder referral." ] } }, "guides": [ { "title": "Overview - Binge eating disorder", "publisher": "NHS", "url": "https://www.nhs.uk/mental-health/conditions/binge-eating/overview/", "kind": "guide", "lang": "en" }, { "title": "Treatment - Binge eating disorder", "publisher": "NHS", "url": "https://www.nhs.uk/mental-health/conditions/binge-eating/treatment/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "cooccurring_any": [ "depression", "anxiety", "substance" ] }, "delta": 10, "reason": "NHS: eating disorders are more likely with depression, anxiety or alcohol or drug misuse." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "review-medication-driving-safety", "canonical_url": "https://adhd100.jock.pl/review-medication-driving-safety/", "rank": 45, "title": "Discuss treatment and driving safety", "summary": "Bring driving into your treatment review, looking at both attention problems and possible side effects.", "why": "ADHD is associated with higher transport risk, and a large registry study linked medication treatment with fewer transport accidents (adjusted rate ratio 0.88), though that does not prove cause. In EBI, small adult methylphenidate trials gave an uncertain driving result, SMD 0.53 with a confidence interval from -0.073 to 1.133 and very low certainty, over about 12 weeks or to trial endpoint. NICE recommends talking about driving after diagnosis, and NHS guidance notes that dizziness, sleepiness or sight problems from medicine can make driving unsafe.", "how": [ "Tell your prescriber whether you drive, and describe any attention worries or near misses.", "Report sleepiness, dizziness, changes in vision or any other treatment effect that matters behind the wheel.", "Ask how your symptoms and treatment affect your fitness to drive, in your circumstances.", "Check the local licensing and reporting rules with an official source." ], "category": "Medication", "domain": "treatment-care", "effort": "low", "evidence": { "grade": "A", "certainty": "very_low", "adhd_specific": true, "basis": "NICE NG87 1.4.3 recommends discussing driving; EBI driving trials very low certainty; registry associations non-randomised", "ebi": { "intervention": "Methylphenidate", "age": "adult", "outcome": "Driving", "rater": "clinician-rated", "timepoint": "short" } }, "impact": { "score": 55, "headline_stat": "Ask your clinician if you are unsure whether driving on treatment is safe", "stat_source": 0 }, "sources": [ { "title": "Common questions about methylphenidate for adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/medicines/methylphenidate-adults/common-questions-about-methylphenidate-for-adults/", "tier": 1 }, { "title": "EBI-ADHD: companion data to Gosling et al., BMJ 2025, commit 86eff22a9ffb", "publisher": "BMJ / Gosling et al.", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "ADHD drug treatment and risk of suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality: emulation of target trials", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12344785/", "tier": 2 }, { "title": "Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations", "publisher": "NICE", "year": 2019, "url": "https://www.nice.org.uk/guidance/ng87/chapter/Recommendations", "tier": 1 } ], "caution": "Do not drive if symptoms or side effects make it unsafe. Medication does not guarantee safe driving, so get individual clinical advice and follow local licensing rules.", "practice": { "examples": [ "Mention a near miss at your review rather than discussing concentration only in the office.", "Ask whether dizziness or sleepiness could affect how safely you drive." ], "pitfalls": [ "A registry link cannot certify that you personally are safe to drive. Ask for an assessment of you.", "If you only look for symptom benefit, you can miss medicine effects that make driving worse. Report both." ], "do": { "1m": "Write down one driving moment that worried you, to take to your clinician.", "5m": "Write down attention problems or side effects that could affect your driving.", "15m": "Write a question about driving for your treatment review, and find the official local reporting guidance.", "plan": { "title": "Include driving in the clinical review", "steps": [ "Describe driving-related difficulties and treatment effects.", "Ask the clinician about fitness to drive in your situation.", "Follow the agreed safety plan and local licensing requirements." ] } }, "guides": [ { "title": "Common questions about methylphenidate for adults", "publisher": "NHS", "url": "https://www.nhs.uk/medicines/methylphenidate-adults/common-questions-about-methylphenidate-for-adults/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 15 }, "boosts": [ { "when": { "drives": true }, "delta": 15, "reason": "Driving safety is relevant to both ADHD symptoms and medicine effects." }, { "when": { "medication": [ "current" ] }, "delta": 6, "reason": "NHS lists dizziness, blurred vision and sleepiness as effects that can make driving unsafe." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "support-the-parent-too", "canonical_url": "https://adhd100.jock.pl/support-the-parent-too/", "rank": 46, "title": "Ask for support for yourself too", "summary": "You count too. Your needs sit alongside your child's.", "why": "NICE says family members and carers of people with ADHD should be encouraged to get their own personal, social and mental health needs assessed, and to join support groups if appropriate. It is also clear that being offered parent training does not mean you are parenting badly. Asking for specific help can open a route to support. There is no single guaranteed effect on parental stress, though.", "how": [ "Name the part of parenting that is hardest to carry by yourself.", "Ask an adult you trust for help that is specific and realistic.", "If stress or low mood is getting in the way of daily life, tell your own health professional." ], "category": "Parent support", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "Explicit NICE recommendation for ADHD family and carer support; not an estimate of a stress-treatment effect." }, "impact": { "score": 55, "headline_stat": "Encourage carers to seek an assessment of their own needs", "stat_source": 0 }, "sources": [ { "title": "ADHD: diagnosis and management, NG87, information and support", "publisher": "NICE, public HSC Northern Ireland copy", "year": 2018, "url": "https://cypsp.hscni.net/wp-content/uploads/ebpp/reports/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933.pdf", "tier": 1 }, { "title": "ADHD & Self Esteem (undated)", "publisher": "Humber Teaching NHS Foundation Trust", "year": 2026, "url": "https://connect.humber.nhs.uk/service/childrens-adhd-intervention-team/adhd-self-esteem/", "tier": 1 }, { "title": "Get help with stress", "publisher": "NHS", "year": 2026, "url": "https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/stress/", "tier": 1 } ], "caution": "Seek urgent support if you feel unable to keep yourself or your child safe.", "practice": { "examples": [ "'Could you listen while I explain what has been difficult this week?'", "Tell your own clinician about persistent distress instead of discussing only your child's symptoms." ], "pitfalls": [ "A vague request may be hard to answer. Say what kind of help would matter.", "Feeling guilty about needing support can delay it, so treat your wellbeing as a legitimate need." ], "do": { "1m": "Write down one name and the help you would ask that person for.", "5m": "Draft a specific request for emotional or practical support.", "15m": "Ask your health service or an established parent group what support exists for carers." }, "guides": [ { "title": "ADHD & Self Esteem (undated)", "publisher": "Humber Teaching NHS Foundation Trust", "url": "https://connect.humber.nhs.uk/service/childrens-adhd-intervention-team/adhd-self-esteem/", "kind": "guide", "lang": "en" }, { "title": "Get help with stress", "publisher": "NHS", "url": "https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/stress/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent" }, "boosts": [ { "when": { "focus_any": [ "emotions", "relationships" ] }, "delta": 12, "reason": "NICE recommends considering the support needs of ADHD family members." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "talk-with-the-school", "canonical_url": "https://adhd100.jock.pl/talk-with-the-school/", "rank": 47, "title": "Keep a conversation with school", "summary": "Share what your child experiences and hear what teachers notice.", "why": "NICE recommends that when ADHD is diagnosed, when symptoms change and at school transitions, the clinician obtains consent and then contacts the school to explain the diagnosis and how ADHD is likely to affect school life. CDC also emphasises close collaboration between school, parents and healthcare providers. This item concerns communication and shared understanding; it does not claim that a conversation alone improves attainment.", "how": [ "Start with your child: what would they like the teacher to understand?", "Ask your child's ADHD clinician to contact the school, with your consent, and explain the diagnosis and its likely effects.", "Bring one concrete worry and one thing that's going well.", "Settle who talks to whom, what useful feedback looks like and when you'll check in again." ], "category": "School", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "NICE NG87 1.4.12 clinician-school liaison recommendation, carried as a step; CDC guidance on family-school collaboration. No isolated communication effect." }, "impact": { "score": 55, "headline_stat": "With consent, the clinician contacts the school after diagnosis", "stat_source": 0 }, "sources": [ { "title": "ADHD: diagnosis and management, NG87, information and support", "publisher": "NICE, public HSC Northern Ireland copy", "year": 2018, "url": "https://cypsp.hscni.net/wp-content/uploads/ebpp/reports/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933.pdf", "tier": 1 }, { "title": "ADHD in the Classroom", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/treatment/classroom.html", "tier": 1 }, { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 } ], "caution": "Agree what information may be shared and involve your child in a way that fits their age and understanding.", "practice": { "examples": [ "'My child says lunchtime feels lonely. What do you notice at school?'", "Ask for feedback that includes successful moments as well as difficulties." ], "pitfalls": [ "Talking only about problems can make school contact daunting, so include what is working.", "Leaving the child out can miss the central concern, so ask for their perspective first." ], "do": { "1m": "Write down the question about school you most want answered.", "5m": "Draft a brief message asking the teacher for a conversation about one concern.", "15m": "Prepare your child's view, your observation and one question for a teacher or school support lead." }, "guides": [ { "title": "ADHD in the Classroom", "publisher": "CDC", "url": "https://www.cdc.gov/adhd/treatment/classroom.html", "kind": "guide", "lang": "en" }, { "title": "ADHD in children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent" }, "boosts": [ { "when": { "focus_any": [ "school" ] }, "delta": 12, "reason": "NICE recommends school liaison at diagnosis, symptom changes and school transitions." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "check-adhd-claims-online", "canonical_url": "https://adhd100.jock.pl/check-adhd-claims-online/", "rank": 48, "title": "Check ADHD claims before sharing", "summary": "Keep the lived experience that helps, and check factual claims against reliable sources.", "why": "In a 2022 study, clinicians rated 52% of the 100 most popular ADHD TikTok videos as misleading. That was a snapshot of selected videos. It does not estimate all ADHD content today, and it did not study treatment effects in people with ADHD. MedlinePlus suggests checking who runs a site, where its information comes from, when it was updated and whether it is selling something.", "how": [ "Pull apart 'this happened to me' from a claim about everyone with ADHD.", "Open the cited source. Who was studied, what was measured, and how certain is the result?", "Hold the claim up against an official health source before you share it or act on it." ], "category": "Information", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "Small cross-sectional ADHD-content study, not outcomes measured in people with ADHD; public-health information-appraisal guidance." }, "impact": { "score": 53, "headline_stat": "52% of the 100 most popular ADHD TikTok videos were rated misleading", "stat_source": 0 }, "sources": [ { "title": "TikTok and Attention-Deficit/Hyperactivity Disorder: A Cross-Sectional Study of Social Media Content Quality", "publisher": "Canadian Journal of Psychiatry", "year": 2022, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9659797/", "tier": 3 }, { "title": "Evaluating Health Information (undated)", "publisher": "MedlinePlus, US National Library of Medicine", "year": 2026, "url": "https://medlineplus.gov/evaluatinghealthinformation.html", "tier": 1 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 } ], "caution": "A relatable video cannot diagnose ADHD or justify changing treatment. Take diagnostic or treatment questions to a qualified clinician.", "practice": { "examples": [ "A video says everyone who dislikes waiting has ADHD; check the NIMH description of persistent impairment.", "A creator shares a helpful experience but sells a cure; check the evidence separately from the story." ], "pitfalls": [ "A confident delivery or a large audience is not verification, so follow the source link.", "One misleading video does not make all lived experience worthless, so assess the specific factual claim." ], "do": { "1m": "Take the last health claim you heard and ask: 'What evidence would let someone else check this?'", "5m": "Open one source behind an ADHD claim and check its author, date and study population.", "15m": "Compare one claim with the NIMH page and the MedlinePlus checklist before deciding whether to share it." }, "guides": [ { "title": "Evaluating Health Information (undated)", "publisher": "MedlinePlus, US National Library of Medicine", "url": "https://medlineplus.gov/evaluatinghealthinformation.html", "kind": "guide", "lang": "en" }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "screens-before-sleep", "canonical_url": "https://adhd100.jock.pl/screens-before-sleep/", "rank": 49, "title": "Give screens a bedtime boundary", "summary": "Keep a short wind-down before bed free of videos, games and scrolling.", "why": "General sleep guidance recommends a screen-free stretch before bed, and the NHS page on adult ADHD also suggests avoiding screens close to bedtime. Sleep difficulties are common in ADHD, and protecting sleep is reason enough to try this. It does not establish that screens cause ADHD, or that cutting back on gaming treats ADHD symptoms.", "how": [ "Pick a stopping point before the time you mean to go to bed.", "When it comes, switch to something quiet, like reading.", "If sleep stays hard, go through your whole sleep pattern with a clinician." ], "category": "Sleep", "domain": "body-health", "effort": "low", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General CDC sleep guidance and NHS adult ADHD self-care advice, supported by ADHD sleep-risk evidence; no formal certainty rating." }, "impact": { "score": 53, "headline_stat": "Turn off electronic devices at least 30 minutes before bedtime", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 30, "unit": "minutes", "outcome": "screen-free interval before bedtime", "comparison": "general sleep guidance, not ADHD symptom reduction", "stat_source": 0, "bound": "at_least" }, "sources": [ { "title": "About Sleep", "publisher": "CDC", "year": 2024, "url": "https://www.cdc.gov/sleep/about/index.html", "tier": 1 }, { "title": "Insomnia", "publisher": "NHS", "year": 2024, "url": "https://www.nhs.uk/conditions/insomnia/", "tier": 1 }, { "title": "The impacts associated with having ADHD: an umbrella review", "publisher": "Frontiers in Psychiatry", "year": 2024, "url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1343314/full", "tier": 2 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 } ], "practice": { "examples": [ "Finish a game before the wind-down period starts.", "Swap the last video for a few pages of a book." ], "pitfalls": [ "If cutting screens leaves you no way to wind down, the rule may not stick. Pick a quiet replacement.", "Ongoing insomnia needs more than a screen rule. Ask for help if it affects daily life." ], "do": { "1m": "Pick the quiet thing you'll do after screens this evening.", "5m": "Work out a screen stopping time that leaves a short wind-down before bed.", "15m": "Try the first part of your wind-down with reading or another quiet screen-free activity." }, "guides": [ { "title": "About Sleep", "publisher": "CDC", "url": "https://www.cdc.gov/sleep/about/index.html", "kind": "guide", "lang": "en" }, { "title": "Insomnia", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/insomnia/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "sleep" ] }, "delta": 10, "reason": "Sleep difficulties make this directly relevant." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "caffeine-sleep-review", "canonical_url": "https://adhd100.jock.pl/caffeine-sleep-review/", "rank": 50, "title": "Review caffeine and sleep together", "summary": "Include caffeine timing, from coffee, tea and energy drinks, when you talk about your sleep.", "why": "Caffeine can get in the way of sleep, and general NHS guidance says to keep it away from bedtime. The NHS page on adult ADHD also suggests avoiding caffeine close to bedtime. Adults with ADHD already report more sleep problems than peers without ADHD. Knowing when you have caffeine can help a clinician assess your sleep, but caffeine is not an established ADHD treatment.", "how": [ "List your caffeinated drinks and roughly when you have them.", "Note when you try to sleep and how your sleep goes.", "Ask a clinician or pharmacist how your caffeine timing fits your sleep and any medicines." ], "category": "Caffeine", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General NHS insomnia advice and NHS adult ADHD self-care advice, with ADHD-specific sleep-risk evidence; no rating for a timing review." }, "impact": { "score": 52, "headline_stat": "Avoid tea or coffee for at least 6 hours before bed", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 6, "unit": "hours", "outcome": "suggested interval between caffeine and bedtime", "comparison": "general NHS insomnia advice", "stat_source": 0, "bound": "at_least" }, "sources": [ { "title": "Insomnia", "publisher": "NHS", "year": 2024, "url": "https://www.nhs.uk/conditions/insomnia/", "tier": 1 }, { "title": "Sleep in adults with ADHD: Systematic review and meta-analysis of subjective and objective studies", "publisher": "Neuroscience and Biobehavioral Reviews", "year": 2018, "url": "https://pubmed.ncbi.nlm.nih.gov/29477617/", "tier": 2 }, { "title": "About Sleep", "publisher": "CDC", "year": 2024, "url": "https://www.cdc.gov/sleep/about/index.html", "tier": 1 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 } ], "caution": "Use this to prepare for a conversation, especially if you take medicines, are pregnant or have ongoing sleep problems.", "practice": { "examples": [ "Bring a note that your last coffee is late afternoon and you struggle to fall asleep.", "Include tea and energy drinks when describing your caffeine use." ], "pitfalls": [ "Counting only coffee misses other sources. Include every caffeinated drink.", "Using caffeine as ADHD medication skips the assessment. Talk about the problem you're trying to solve." ], "do": { "1m": "Name the time of your usual last caffeinated drink of the day.", "5m": "List yesterday's caffeinated drinks and their approximate times.", "15m": "Prepare a short sleep-and-caffeine note and one question for a clinician or pharmacist." }, "guides": [ { "title": "About Sleep", "publisher": "CDC", "url": "https://www.cdc.gov/sleep/about/index.html", "kind": "guide", "lang": "en" }, { "title": "Insomnia", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/insomnia/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "sleep" ] }, "delta": 10, "reason": "Sleep difficulties make this directly relevant." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "appointment-text-reminders", "canonical_url": "https://adhd100.jock.pl/appointment-text-reminders/", "rank": 51, "title": "Ask for appointment text reminders", "summary": "Let the service remind you, then turn the text into a plan for getting there.", "why": "Text reminders raised attendance at healthcare appointments in a Cochrane review, a risk ratio of 1.14 from seven studies of 5,841 people, with moderate-quality evidence. That means about 14% higher attendance in relative terms, not 14 percentage points. None of the studies were in ADHD, but NIMH notes that adults with ADHD may find it hard to keep appointments, so a reminder you can act on is especially useful.", "how": [ "Find out if the service sends text reminders for appointments.", "Make sure it has your right number and the way you like to be contacted.", "When a reminder comes in, check the date, the place and anything you need to prepare.", "Put travel or connection time in your calendar, and use the service's own way to rebook if you need to." ], "category": "Appointments", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "B", "certainty": "moderate", "adhd_specific": false, "basis": "Cochrane 2013: moderate-quality evidence, seven studies and 5,841 participants, RR 1.14 versus no reminders; not ADHD-specific." }, "impact": { "score": 49, "headline_stat": "Text reminders raised appointment attendance by about 14%, relative (risk ratio 1.14)", "stat_source": 0 }, "sources": [ { "title": "Mobile phone messaging reminders for attendance at healthcare appointments", "publisher": "Cochrane", "year": 2013, "url": "https://www.cochrane.org/evidence/CD007458_mobile-phone-messaging-reminders-attendance-healthcare-appointments", "tier": 1 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 }, { "title": "Support Available (Adult ADHD Services)", "publisher": "East London NHS Foundation Trust", "year": 2026, "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "tier": 1 } ], "practice": { "examples": [ "Check the clinic has your current number while booking.", "Turn the text into a calendar entry that includes when to leave home." ], "pitfalls": [ "The reminder goes to an old phone number. Confirm your contact details when you book.", "The text arrives and you still forget the journey. Add a separate prompt for when to leave home." ], "do": { "1m": "Look up your next appointment and ask yourself if the service has your current phone number.", "5m": "Check the reminder options for one upcoming appointment.", "15m": "Confirm one appointment's details and add the preparation and travel time to your calendar.", "plan": { "title": "Make reminders actionable", "steps": [ "Check contact details with one service.", "Enable its reminder option if available.", "Turn incoming reminders into a practical attendance plan." ] } }, "guides": [ { "title": "Support Available (Adult ADHD Services)", "publisher": "East London NHS Foundation Trust", "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "time", "organisation" ] }, "delta": 10, "reason": "NIMH notes keeping appointments can be hard with ADHD." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "restless-legs-review", "canonical_url": "https://adhd100.jock.pl/restless-legs-review/", "rank": 52, "title": "Ask about restless legs at night", "summary": "Describe uncomfortable urges to move your legs at night, and ask whether a physical cause should be checked.", "why": "General NHS guidance links restless legs to broken sleep and, in some people, low iron. An ADHD umbrella review found restless legs symptoms in 11 to 43% of children with ADHD across studies. Sleep difficulties are common in ADHD, so a distinct night-time leg problem deserves its own description instead of being filed as ordinary hyperactivity. Assessment and testing depend on symptoms, and iron supplements are not a general ADHD treatment.", "how": [ "Notice whether the discomfort comes on at rest or in the evening, and whether moving helps.", "Tell a clinician if it disrupts sleep, and mention tiredness, heavy periods or dietary concerns where relevant.", "Ask whether an examination or a blood test for possible iron deficiency makes sense." ], "category": "Sleep", "domain": "body-health", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "NHS symptom-based assessment and iron-deficiency guidance, with ADHD sleep-risk context; no trial estimate for this action." }, "impact": { "score": 49, "headline_stat": "Seek help when restless legs stop you sleeping", "stat_source": 0 }, "sources": [ { "title": "Restless legs syndrome", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/restless-legs-syndrome/", "tier": 1 }, { "title": "Iron deficiency anaemia", "publisher": "NHS", "year": 2024, "url": "https://www.nhs.uk/conditions/iron-deficiency-anaemia/", "tier": 1 }, { "title": "The impacts associated with having ADHD: an umbrella review", "publisher": "Frontiers in Psychiatry", "year": 2024, "url": "https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1343314/full", "tier": 2 } ], "caution": "Ask a clinician about testing and any supplements. An overdose of iron can be fatal for a young child, so keep iron products out of their reach.", "practice": { "examples": [ "Describe an uncomfortable urge to move your legs when trying to sleep.", "Mention heavy periods and unusual tiredness if these occur alongside the leg symptoms." ], "pitfalls": [ "Restless legs are not the same as ordinary fidgeting. Describe when it happens and how it feels.", "Taking iron without an assessment can cause harm. Leave testing and treatment decisions with a clinician." ], "do": { "1m": "Think back: is the leg discomfort worse when you're resting at night?", "5m": "Note the sensation, when it happens and whether movement changes it.", "15m": "Prepare a clinical appointment request describing the sleep impact and any other symptoms." }, "guides": [ { "title": "Restless legs syndrome", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/restless-legs-syndrome/", "kind": "guide", "lang": "en" }, { "title": "Iron deficiency anaemia", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/iron-deficiency-anaemia/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "sleep" ] }, "delta": 10, "reason": "Sleep difficulties make this directly relevant." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "test-workspace-sound", "canonical_url": "https://adhd100.jock.pl/test-workspace-sound/", "rank": 53, "title": "Compare quiet with gentle noise", "summary": "Try a comfortable sound setting, and keep it only if the task gets easier.", "why": "A 2024 meta-analysis of 13 studies, 335 children and college-age young adults with ADHD or ADHD symptoms, found a small, short-term benefit of white or pink noise on lab task performance: Hedges' g 0.249. The authors rated it moderate certainty using GRADE. But every study tested only minutes of noise, so lasting gains in symptoms or learning are not shown. People without ADHD symptoms did slightly worse with noise, no study tested brown noise, and quiet may still suit you better.", "how": [ "Start in quiet, with a small task you can repeat.", "If you want to test noise, use gentle white or pink noise, low and comfortable.", "Do similar tasks in quiet and with noise, and look at accuracy as well as whether you finished.", "Stay with quiet if the sound distracts you or feels unpleasant." ], "category": "Workspace", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "A", "certainty": "moderate", "adhd_specific": true, "basis": "2024 meta-analysis: 13 studies, 335 children and young adults with ADHD or ADHD symptoms; authors' own GRADE rating moderate, brief laboratory tasks only." }, "impact": { "score": 48, "headline_stat": "White or pink noise: small gain on lab tasks, tested over minutes only (SMD 0.249)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.249, "unit": "SMD", "outcome": "brief laboratory task performance, ADHD or ADHD symptoms", "comparison": "white or pink noise vs low or no noise", "stat_source": 0 }, "sources": [ { "title": "Systematic Review and Meta-Analysis: Do White Noise and Pink Noise Help With Attention in ADHD?", "publisher": "Journal of the American Academy of Child and Adolescent Psychiatry", "year": 2024, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11283987/", "tier": 2 }, { "title": "Disconnection", "publisher": "Oxford Health NHS Foundation Trust", "year": 2025, "url": "https://oxfordhealth.nhs.uk/mindset/skills/concentration/disconnection/", "tier": 1 }, { "title": "Treatment of ADHD", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/treatment/index.html", "tier": 1 } ], "caution": "Keep the volume low and comfortable. Don't mask alarms, traffic or other sounds you need for safety, and stop if the sound causes discomfort.", "practice": { "examples": [ "Compare a short proofreading task in quiet and with gentle white noise.", "A parent helps a child notice whether background sound makes a familiar worksheet easier or harder." ], "pitfalls": [ "It's easy to assume louder works better. Keep it low and comfortable.", "A soundtrack you enjoy can pass for better work. Check errors as well as how it feels." ], "do": { "1m": "Pick a task where background sound helped you or got in your way. That's your test task.", "5m": "Remove one avoidable source of noise and try a small task in the quieter setting.", "15m": "Compare quiet and gentle noise on similar short tasks, stopping if the sound is uncomfortable.", "plan": { "title": "Find a workable sound setting", "steps": [ "Try a quieter baseline.", "If wanted, compare gentle white or pink noise.", "Keep the setting that supports your task without discomfort." ] } }, "guides": [ { "title": "Disconnection", "publisher": "Oxford Health NHS Foundation Trust", "url": "https://oxfordhealth.nhs.uk/mindset/skills/concentration/disconnection/", "kind": "guide", "lang": "en" }, { "title": "Treatment of ADHD", "publisher": "CDC", "url": "https://www.cdc.gov/adhd/treatment/index.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "attention", "school" ] }, "delta": 10, "reason": "The evidence concerns attention during brief tasks." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "phone-away-before-driving", "canonical_url": "https://adhd100.jock.pl/phone-away-before-driving/", "rank": 54, "title": "Put your phone away before driving", "summary": "Sort the phone and the route before you move off, so driving is the only thing you're doing.", "why": "In a cohort of young drivers, those with ADHD had a 1.36 times higher risk of a first crash than those without ADHD, about 36% higher. That is an association, not a measured benefit of putting the phone away. NHTSA lists phones, and adjusting the radio or GPS, as driving distractions, and advises Do Not Disturb or putting the phone away. The ADHD crash-risk finding is why this routine matters more for you.", "how": [ "Set the route and anything else you need before you move.", "Silence the notifications you can do without, and put the phone out of reach.", "Let a passenger deal with messages or route changes that can't wait.", "If you have to use the phone yourself, stop somewhere safe first." ], "category": "Driving", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "ADHD crash-risk cohort (measured in ADHD) plus national general-population safety guidance for the action; the phone-away routine has no ADHD efficacy estimate." }, "impact": { "score": 47, "headline_stat": "Young drivers with ADHD: about 36% higher risk of a first crash (hazard ratio 1.36)", "stat_source": 0 }, "sources": [ { "title": "Motor Vehicle Crash Risk Among Adolescents and Young Adults With ADHD", "publisher": "JAMA Pediatrics", "year": 2017, "url": "https://pubmed.ncbi.nlm.nih.gov/28604931/", "tier": 2 }, { "title": "Put the Phone Away or Pay: tips for safe driving", "publisher": "National Highway Traffic Safety Administration", "year": 2026, "url": "https://www.nhtsa.gov/campaign/distracted-driving", "tier": 1 } ], "caution": "Only read or change settings when you're safely parked. This routine does not establish that you are fit to drive. Follow local licensing rules and any clinical advice given to you.", "practice": { "examples": [ "Put the phone in a closed bag before starting the engine.", "Ask a passenger to handle a message while you keep driving." ], "pitfalls": [ "A quick glance feels harmless. Wait until you're safely parked.", "If the route needs changing mid-drive, let a passenger do it or stop somewhere safe first." ], "do": { "1m": "If you're not driving right now, pick where the phone goes on your next journey.", "5m": "Before your next drive, set up phone silencing, your route and an out-of-reach phone location.", "15m": "While parked, check the phone and navigation settings you will use for future journeys.", "plan": { "title": "Make distraction checks routine", "steps": [ "Choose a phone location before driving.", "Set the route and silence optional alerts before moving.", "Use the same preparation for the next journey." ] } }, "guides": [ { "title": "Put the Phone Away or Pay: tips for safe driving", "publisher": "National Highway Traffic Safety Administration", "url": "https://www.nhtsa.gov/campaign/distracted-driving", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "age_min": 15 }, "boosts": [ { "when": { "focus_any": [ "attention", "impulsivity" ] }, "delta": 10, "reason": "Phone distractions compete with attention to driving." }, { "when": { "drives": true }, "delta": 10, "reason": "The crash-risk evidence concerns licensed drivers." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "self-test-what-you-study", "canonical_url": "https://adhd100.jock.pl/self-test-what-you-study/", "rank": 55, "title": "Recall before you reread", "summary": "Test what you can remember first, then let the answers tell you what to look at again.", "why": "In a meta-analysis of classroom studies, testing improved learning by Hedges' g 0.499 compared with a range of control conditions. That's general student evidence, it does not show a separate ADHD effect, and the score gap is not a percentage rise in grades. NHS information describes ADHD making it hard to concentrate and organise study, and a short self-test with feedback gives study time a clear job.", "how": [ "Pick a small piece of material where you can check the answers.", "Close or cover it, then answer a few questions from memory.", "Check your answers and fix mistakes straight away.", "Later, go back to the questions you couldn't answer yet." ], "category": "Study skills", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General classroom meta-analysis: 222 studies, 48,478 students, g 0.499; no source GRADE rating or ADHD subgroup estimate." }, "impact": { "score": 47, "headline_stat": "Quizzing yourself: small to medium learning gain in general student samples (SMD 0.499)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.499, "unit": "SMD", "outcome": "learning in general classroom samples", "comparison": "testing or quizzing vs varied control learning conditions", "stat_source": 0 }, "sources": [ { "title": "Testing (Quizzing) Boosts Classroom Learning: A Systematic and Meta-Analytic Review", "publisher": "Psychological Bulletin, author-hosted full text", "year": 2021, "url": "https://www.rongjunyu.org/_files/ugd/7b277c_c3a0d8bcdd924857ac911612ad3d6621.pdf", "tier": 2 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 }, { "title": "Memorization Strategies", "publisher": "University of North Carolina at Chapel Hill Learning Center", "year": 2026, "url": "https://learningcenter.unc.edu/tips-and-tools/enhancing-your-memory/", "tier": 3 } ], "practice": { "examples": [ "After a paragraph, cover it and explain its main point before checking.", "Use a few practice questions, then correct the answers you missed." ], "pitfalls": [ "Reading an answer feels like knowing it. Try to recall it before you look.", "A hard self-test becomes a judgement of ability; use missed answers to choose what to revisit." ], "do": { "1m": "Without looking, say one fact you studied recently. Then decide how you'll check it later.", "5m": "Cover a short piece of study material, recall its main point and check your answer.", "15m": "Answer a few low-stakes questions, check them and mark what needs another attempt.", "30m": "Study one small topic using repeated recall and correction, then schedule a later revisit.", "plan": { "title": "Give study a feedback loop", "steps": [ "Turn one small topic into checkable questions.", "Practise recalling answers and correcting mistakes.", "Revisit the questions that still need work." ] } }, "guides": [ { "title": "Memorization Strategies", "publisher": "University of North Carolina at Chapel Hill Learning Center", "url": "https://learningcenter.unc.edu/tips-and-tools/enhancing-your-memory/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "school", "attention" ] }, "delta": 10, "reason": "Self-testing gives study a clear task and feedback." }, { "when": { "student": true }, "delta": 10, "reason": "The evidence comes from student and classroom learning." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "share-child-led-time", "canonical_url": "https://adhd100.jock.pl/share-child-led-time/", "rank": 56, "title": "Share time your child enjoys", "summary": "Make time together that is for connection, with the correcting left out.", "why": "NICE recommends positive contact between parents or carers and children with ADHD. NHS ADHD guidance suggests sharing a child's interests and enjoyable activities to support connection and self-esteem. The effect of a short shared activity alone has not been quantified, and it should not become another task your child must perform correctly.", "how": [ "Ask your child what they'd like to do with you.", "Give them your attention for a stretch you can actually manage.", "Notice what they enjoy and follow their lead. Don't turn it into a lesson." ], "category": "Parenting", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "Explicit NICE relationship-support recommendation and NHS ADHD self-esteem guidance; no standalone trial estimate." }, "impact": { "score": 47, "headline_stat": "Support positive parent and child contact", "stat_source": 0 }, "sources": [ { "title": "ADHD: diagnosis and management, NG87, information and support", "publisher": "NICE, public HSC Northern Ireland copy", "year": 2018, "url": "https://cypsp.hscni.net/wp-content/uploads/ebpp/reports/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933.pdf", "tier": 1 }, { "title": "ADHD & Self Esteem (undated)", "publisher": "Humber Teaching NHS Foundation Trust", "year": 2026, "url": "https://connect.humber.nhs.uk/service/childrens-adhd-intervention-team/adhd-self-esteem/", "tier": 1 } ], "practice": { "examples": [ "Let your child explain a favourite game while you listen.", "Join in drawing, or watch a short part of a programme they want to share." ], "pitfalls": [ "Turning the activity into a behaviour review can crowd out connection, so discuss concerns separately.", "An ambitious outing may never happen. Pick something small and within reach." ], "do": { "1m": "Jot down something your child loves and a curious question you could ask about it.", "5m": "Ask your child to show or tell you something they enjoy, and listen without correcting.", "15m": "Share a small activity your child chooses, with the focus on enjoying the time together." }, "guides": [ { "title": "ADHD & Self Esteem (undated)", "publisher": "Humber Teaching NHS Foundation Trust", "url": "https://connect.humber.nhs.uk/service/childrens-adhd-intervention-team/adhd-self-esteem/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent" }, "boosts": [ { "when": { "focus_any": [ "relationships" ] }, "delta": 12, "reason": "Positive parent and child contact is recommended in NICE ADHD guidance." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "choose-how-to-share-adhd", "canonical_url": "https://adhd100.jock.pl/choose-how-to-share-adhd/", "rank": 57, "title": "Choose how to explain your ADHD", "summary": "Tell a trusted person the part of your experience that helps them understand what you need.", "why": "Attention and impulse-control difficulties from ADHD can spill into conversations and relationships. NICE lists social relationship issues among the topics a clinician can discuss after diagnosis, and an NHS adult ADHD booklet suggests that helping important people understand your ADHD can reduce misunderstanding. Whether to tell anyone is your choice. Neither source promises that people will respond well or that sharing guarantees things improve.", "how": [ "Pick someone you trust, and a calm moment.", "Explain one difficulty and what it does, from your own life rather than a list of traits.", "Ask for one helpful response. Say what you want kept private." ], "category": "Communication", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "NICE names relationships as a post-diagnosis discussion topic, not a recommendation to disclose; NHS booklet and communication guidance. Benefit of disclosure is not quantified." }, "impact": { "score": 45, "headline_stat": "Relationship issues belong in the post-diagnosis discussion", "stat_source": 0 }, "sources": [ { "title": "ADHD: diagnosis and management, NG87, information and support", "publisher": "NICE, public HSC Northern Ireland copy", "year": 2018, "url": "https://cypsp.hscni.net/wp-content/uploads/ebpp/reports/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933.pdf", "tier": 1 }, { "title": "Making Sense: A Guide to Living with Adult ADHD", "publisher": "Nottinghamshire Healthcare NHS Trust", "year": 2013, "url": "https://leicspart.nhs.uk/wp-content/uploads/2022/12/Making-Sense-of-Adult-ADHD-booklet.pdf", "tier": 1 }, { "title": "How to talk about your mental health (undated)", "publisher": "NHS Every Mind Matters", "year": 2026, "url": "https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/how-to-talk-about-your-mental-health/", "tier": 1 } ], "caution": "You do not need to disclose to someone who may use the information to intimidate or harm you.", "practice": { "examples": [ "'I sometimes lose the thread while listening. It helps if we pause and check what I heard.'", "'I would like you to understand this, but I am not ready to tell the wider family.'" ], "pitfalls": [ "Sharing everything at once can overwhelm you both. Start with one example that matters.", "Disclosure is not an obligation, so consider trust and privacy before sharing." ], "do": { "1m": "Fill in the blanks out loud: 'One thing I find difficult is ___. A helpful response would be ___.'", "5m": "Choose one trusted person and draft a short explanation of what you want them to understand.", "15m": "Use the NHS conversation guide to prepare what to share, what to ask for and what should stay private." }, "guides": [ { "title": "How to talk about your mental health (undated)", "publisher": "NHS Every Mind Matters", "url": "https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/how-to-talk-about-your-mental-health/", "kind": "guide", "lang": "en" }, { "title": "Making Sense: A Guide to Living with Adult ADHD", "publisher": "Nottinghamshire Healthcare NHS Trust", "url": "https://leicspart.nhs.uk/wp-content/uploads/2022/12/Making-Sense-of-Adult-ADHD-booklet.pdf", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "relationships" ] }, "delta": 12, "reason": "NICE lists social relationship issues among post-diagnosis discussion topics." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "find-supportive-peers", "canonical_url": "https://adhd100.jock.pl/find-supportive-peers/", "rank": 58, "title": "Try a supportive ADHD group", "summary": "Find people who get it, and check that the group feels safe and useful.", "why": "NICE recommends giving people with ADHD and their families information about ADHD support groups. Other people with the same experience can offer understanding and practical suggestions. The recommendation does not show that a group reduces ADHD symptoms. You can just listen at first and decide whether it meets your needs.", "how": [ "Find a group through a health service or an established ADHD organisation.", "Check who it's for, whether someone moderates it and how privacy works.", "Go to one meeting with no pressure to share. Keep only the advice you can verify." ], "category": "Peer support", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "A", "certainty": "not_rated", "adhd_specific": true, "basis": "Explicit NICE ADHD support recommendation; no published certainty rating or symptom-reduction estimate for peer groups." }, "impact": { "score": 45, "headline_stat": "Provide information about local and national ADHD support groups", "stat_source": 0 }, "sources": [ { "title": "ADHD: diagnosis and management, NG87, information and support", "publisher": "NICE, public HSC Northern Ireland copy", "year": 2018, "url": "https://cypsp.hscni.net/wp-content/uploads/ebpp/reports/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933.pdf", "tier": 1 }, { "title": "Support Available: understanding emotional regulation in ADHD", "publisher": "East London NHS Foundation Trust", "year": 2026, "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "tier": 1 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 }, { "title": "Evaluating Health Information (undated)", "publisher": "MedlinePlus, US National Library of Medicine", "year": 2026, "url": "https://medlineplus.gov/evaluatinghealthinformation.html", "tier": 1 } ], "caution": "Peer support complements professional help. Do not follow another member's medication or diagnostic advice.", "practice": { "examples": [ "Join an adult group as a listener before deciding whether to return.", "A parent asks an ADHD service which local carer group welcomes newcomers." ], "pitfalls": [ "Anecdotes are not treatment evidence, so verify medical claims with a qualified professional.", "A group that pressures you to disclose or buy something may not suit you, so leave or try another." ], "do": { "1m": "Write down what you'd want from a group: understanding, shared experience or practical encouragement.", "5m": "Use the NHS resource list to identify one suitable group and check its audience and cost.", "15m": "Check moderation and privacy arrangements, then enquire about attending once as a listener." }, "guides": [ { "title": "Support Available: understanding emotional regulation in ADHD", "publisher": "East London NHS Foundation Trust", "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "kind": "guide", "lang": "en" }, { "title": "ADHD in adults", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-adults/", "kind": "guide", "lang": "en" }, { "title": "Evaluating Health Information (undated)", "publisher": "MedlinePlus, US National Library of Medicine", "url": "https://medlineplus.gov/evaluatinghealthinformation.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "relationships" ] }, "delta": 12, "reason": "NICE includes peer and voluntary support in information for people with ADHD." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "if-then-starting-plan", "canonical_url": "https://adhd100.jock.pl/if-then-starting-plan/", "rank": 59, "title": "Link a small action to a clear cue", "summary": "Decide now what you'll do the next time a familiar situation comes up.", "why": "A general-population meta-analysis of 642 tests found an average effect of d 0.36 for this kind of planning. A robust Bayesian correction for publication bias shrank it to d 0.15, and that smaller number is the honest one: a modest benefit, with no separate ADHD result and no formal certainty rating. NIMH notes that adults with ADHD often find it hard to stay organised and finish tasks, which is where a cue and action decided in advance can help.", "how": [ "Pick one action small enough to do the moment the cue happens.", "Write it as: if this happens, then I will do this.", "Choose a cue you'll actually notice, and say the sentence once.", "After trying it, swap a cue that didn't work or an action that was too big." ], "category": "Task starts", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General-population meta-analysis of 642 tests (some samples were children with ADHD, no separate ADHD estimate); publication-bias-adjusted d 0.15; no formal certainty rating." }, "impact": { "score": 45, "headline_stat": "If-then plans: modest benefit in general populations after bias correction (SMD 0.15)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.15, "unit": "SMD", "outcome": "cognitive, affective and behavioural outcomes, general populations", "comparison": "implementation-intention plans vs control conditions", "stat_source": 0 }, "sources": [ { "title": "The When and How of Planning: Meta-Analysis of the Scope and Components of Implementation Intentions in 642 Tests", "publisher": "European Review of Social Psychology", "year": 2024, "url": "https://kops.uni-konstanz.de/entities/publication/cf394f1f-49d8-4256-bf24-df7af124514a", "tier": 2 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 } ], "practice": { "examples": [ "If I put down my work bag, then I will put my keys in their home.", "If I open tomorrow's calendar, then I will add the travel time for my appointment." ], "pitfalls": [ "A cue like 'later' is too vague. Tie it to an event you'll recognise.", "If the action is a whole project, shrink it to the first step you can see." ], "do": { "1m": "Finish the sentence 'If this happens, then I will...' in your head, with a cue you know and one small action.", "5m": "Write your cue and action, then rehearse the sentence once.", "15m": "Walk through the situation and make the action easier to begin when the cue appears.", "plan": { "title": "Test one cue and action", "steps": [ "Choose an action that matters to you.", "Attach it to a clear cue and rehearse.", "Revise the plan after seeing what actually happens." ] } }, "guides": [ { "title": "If-Then Planning", "publisher": "University of Melbourne, Centre for Behaviour Change", "url": "https://psychologicalsciences.unimelb.edu.au/__data/assets/pdf_file/0005/4575488/If-Then-Planning-MCBC-Resource_Final.pdf", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "organisation", "time", "attention" ] }, "delta": 10, "reason": "A clear cue links a planned action to a situation." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "melatonin-clinician-discussion", "canonical_url": "https://adhd100.jock.pl/melatonin-clinician-discussion/", "rank": 60, "title": "Ask a clinician about melatonin", "summary": "If your child keeps struggling to fall asleep, ask a clinician whether melatonin is right for them.", "why": "A four-week placebo-controlled trial in children aged 6 to 12 with ADHD and chronic sleep-onset insomnia found melatonin brought sleep onset earlier. Sleep onset moved 26.9 minutes earlier with melatonin and 10.5 minutes later with placebo, while behaviour, cognition and quality of life did not significantly improve. This is short-term sleep evidence, not evidence of an ADHD cure, and longer-term decisions need specialist review.", "how": [ "Bring a description of your child's sleep timing and the approaches already tried.", "Ask the clinician to work out what's behind the trouble getting to sleep.", "If melatonin comes up, ask about the expected benefit, side effects and follow-up." ], "category": "Sleep", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": true, "basis": "Small short-term placebo-controlled ADHD insomnia trial plus NHS guidance; no formal certainty rating." }, "impact": { "score": 45, "headline_stat": "Specialists may prescribe melatonin when other sleep methods have not worked", "stat_source": 0 }, "sources": [ { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 }, { "title": "Effect of melatonin on sleep, behavior, and cognition in ADHD and chronic sleep-onset insomnia", "publisher": "Journal of the American Academy of Child and Adolescent Psychiatry", "year": 2007, "url": "https://pubmed.ncbi.nlm.nih.gov/17242627/", "tier": 2 }, { "title": "About melatonin", "publisher": "NHS", "year": 2023, "url": "https://www.nhs.uk/medicines/melatonin/about-melatonin/", "tier": 1 }, { "title": "Common questions about melatonin", "publisher": "NHS", "year": 2023, "url": "https://www.nhs.uk/medicines/melatonin/common-questions-about-melatonin/", "tier": 1 } ], "caution": "For children, melatonin is a decision led by a clinician. Discuss side effects, interactions and follow-up. This item gives no dosing or self-treatment advice.", "practice": { "examples": [ "Ask whether your child's difficulty is delayed sleep timing or another sleep problem.", "Ask what would count as a useful improvement and when it would be reviewed." ], "pitfalls": [ "Natural doesn't mean risk-free. Talk melatonin through with the specialist instead of picking a product yourself.", "Better sleep doesn't guarantee better ADHD symptoms. Agree which sleep outcome you're checking." ], "do": { "1m": "Write down one sleep question you want answered before melatonin comes up.", "5m": "List the sleep approaches already tried and whether they helped.", "15m": "Prepare your sleep history, medicine list and questions for the specialist appointment." }, "guides": [ { "title": "Common questions about melatonin", "publisher": "NHS", "url": "https://www.nhs.uk/medicines/melatonin/common-questions-about-melatonin/", "kind": "guide", "lang": "en" }, { "title": "ADHD in children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 6, "age_max": 17 }, "boosts": [ { "when": { "focus_any": [ "sleep" ] }, "delta": 10, "reason": "Sleep difficulties make this directly relevant." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "one-calendar", "canonical_url": "https://adhd100.jock.pl/one-calendar/", "rank": 61, "title": "Keep commitments in one calendar", "summary": "Pick one calendar and check it before you agree to any date.", "why": "A calendar holds appointments so your working memory doesn't have to. Keeping all dated commitments in one place is taught in adult ADHD CBT, but using a calendar on its own has no established effect on symptoms. The practical aim is a simple system you'll actually reopen.", "how": [ "Pick one calendar you can reach whenever you make plans.", "As soon as you agree to something, add the date, the place or link, and what you need to prepare.", "Check it before saying yes to anything else, and in your daily review." ], "category": "Planning", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD clinical guidance and programme content; the isolated strategy has no separately rated efficacy estimate." }, "impact": { "score": 45, "headline_stat": "Use a calendar and check it each evening", "stat_source": 0 }, "sources": [ { "title": "Support Available (Adult ADHD Services)", "publisher": "East London NHS Foundation Trust", "year": 2026, "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "tier": 1 }, { "title": "Description and Demonstration of CBT for ADHD in Adults", "publisher": "Cognitive and Behavioral Practice", "year": 2010, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3874265/", "tier": 2 } ], "practice": { "examples": [ "Put the video appointment link inside its calendar event.", "Add the library return date when you borrow the book." ], "pitfalls": [ "Keeping two calendars manually can create conflicting dates, so choose one view you trust.", "Vague tasks can bury appointments in a calendar. Keep flexible tasks in your task list." ], "do": { "1m": "Decide which calendar you'll look at before you accept your next appointment.", "5m": "Enter your next commitment with its location and preparation note.", "15m": "Compare next week's calendar with recent appointment messages and correct any gaps.", "30m": "Bring active dated commitments into one calendar view and check for travel or preparation clashes.", "plan": { "title": "Build a trusted calendar", "steps": [ "Enter new commitments immediately.", "Pair a calendar check with an existing daily routine.", "Review whether missed events need clearer details or better reminders." ] } }, "guides": [ { "title": "Support Available (Adult ADHD Services)", "publisher": "East London NHS Foundation Trust", "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "kind": "guide", "lang": "en" }, { "title": "Autism and ADHD", "publisher": "BYTES Primary Care Network, NHS", "url": "https://www.bytespcn.nhs.uk/autism-and-adhd/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "time", "organisation" ] }, "delta": 10, "reason": "Calendar checks support remembering timed commitments." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "recognise-emotional-dysregulation", "canonical_url": "https://adhd100.jock.pl/recognise-emotional-dysregulation/", "rank": 62, "title": "Treat big feelings as part of ADHD", "summary": "Fast, strong feelings are common in adult ADHD. Naming them helps you and your clinician plan support.", "why": "A meta-analysis of 13 studies with 2,535 adults found much higher emotion dysregulation in adults with ADHD than in healthy comparison groups, a Hedges' g of 1.17, and the authors call it a core feature. These were observational comparisons, so the number describes a difference, not what any treatment does. NHS ADHD services describe feeling emotions more quickly, strongly and suddenly as part of ADHD, not a personal flaw.", "how": [ "Notice which situations set off your fastest, strongest reactions.", "Put the pattern in plain words, something like 'my feelings arrive fast and loud, then fade'.", "Bring two or three examples to your next ADHD review, alongside the attention and organisation problems." ], "category": "Emotions", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "Observational meta-analysis in adults with ADHD establishes the feature; NHS ADHD service guidance supports naming it. No intervention estimate." }, "impact": { "score": 45, "headline_stat": "Adults with ADHD show much more emotion dysregulation than adults without (g 1.17)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 1.17, "unit": "SMD", "outcome": "general emotion dysregulation in adults with ADHD", "comparison": "vs healthy controls, cross-sectional; a difference, not a treatment effect", "stat_source": 0 }, "sources": [ { "title": "Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis", "publisher": "BMC Psychiatry", "year": 2020, "url": "https://link.springer.com/article/10.1186/s12888-020-2442-7", "tier": 2 }, { "title": "Support Available: understanding emotional regulation in ADHD", "publisher": "East London NHS Foundation Trust", "year": 2026, "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "tier": 1 }, { "title": "Making Sense: A Guide to Living with Adult ADHD", "publisher": "Nottinghamshire Healthcare NHS Trust", "year": 2013, "url": "https://leicspart.nhs.uk/wp-content/uploads/2022/12/Making-Sense-of-Adult-ADHD-booklet.pdf", "tier": 1 } ], "caution": "Strong feelings are not always ADHD. Seek help promptly for low mood lasting weeks, hopelessness or thoughts of self-harm.", "practice": { "examples": [ "A small change of plan brings a flash of anger that is gone twenty minutes later.", "'When I feel criticised, the feeling hits hard and fast. It helps if you give me a minute.'" ], "pitfalls": [ "Calling every feeling ADHD can hide depression or anxiety, so mention lasting changes in mood too.", "A label is not an excuse for harm. You still own how you act." ], "do": { "1m": "What was the last strong feeling you had, and what set it off? Name both.", "5m": "Write two recent examples of fast, strong feelings and how long each lasted.", "15m": "Read the NHS emotional regulation page and add your examples to the notes for your next review." }, "guides": [ { "title": "Support Available: understanding emotional regulation in ADHD", "publisher": "East London NHS Foundation Trust", "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "kind": "guide", "lang": "en" }, { "title": "Making Sense: A Guide to Living with Adult ADHD", "publisher": "Nottinghamshire Healthcare NHS Trust", "url": "https://leicspart.nhs.uk/wp-content/uploads/2022/12/Making-Sense-of-Adult-ADHD-booklet.pdf", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "emotions" ] }, "delta": 12, "reason": "Emotion dysregulation is much higher in adults with ADHD than in comparison groups." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "space-study-revisits", "canonical_url": "https://adhd100.jock.pl/space-study-revisits/", "rank": 63, "title": "Spread study across later revisits", "summary": "Come back to material on a later day instead of relying on one long session.", "why": "A general-population review covering 317 experiments found that spacing study episodes affects later verbal recall, with useful intervals depending on how long you need to remember. It does not establish an ADHD-specific spacing schedule or one best gap for every subject. NHS information describes planning and concentration difficulties in ADHD, so putting a small revisit in the calendar can make this learning strategy easier to use.", "how": [ "Pick one small topic you need to remember after today.", "Plan another short look at it on a later day.", "When you come back, try to recall it before you check.", "Set the next gap by your deadline and by how much you remembered." ], "category": "Study skills", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "B", "certainty": "not_rated", "adhd_specific": false, "basis": "General learning meta-analysis; 317 experiments, no ADHD-specific effect and no formal GRADE rating." }, "impact": { "score": 45, "headline_stat": "Spacing review: 317 experiments on study timing and verbal recall", "stat_source": 0 }, "sources": [ { "title": "Distributed practice in verbal recall tasks: A review and quantitative synthesis", "publisher": "Psychological Bulletin", "year": 2006, "url": "https://pubmed.ncbi.nlm.nih.gov/16719566/", "tier": 2 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 }, { "title": "Memorization Strategies", "publisher": "University of North Carolina at Chapel Hill Learning Center", "year": 2026, "url": "https://learningcenter.unc.edu/tips-and-tools/enhancing-your-memory/", "tier": 3 } ], "practice": { "examples": [ "Revisit a small set of terms on another day instead of repeating them only in one sitting.", "Put a short return to yesterday's topic into the calendar before you close your notes." ], "pitfalls": [ "A rigid schedule adds more admin than learning; schedule only the next revisit.", "Spacing can slide into passive rereading. Recall and correct when you come back." ], "do": { "1m": "Pick one thing you want to remember next week and when you could look at it again.", "5m": "Add one short revisit of a current topic to your calendar.", "15m": "Review an earlier topic, check what you recalled and arrange its next revisit.", "30m": "Split one upcoming topic into small sessions across the time available before your deadline.", "plan": { "title": "Return before the deadline", "steps": [ "Choose a small amount of material.", "Schedule and complete a later revisit.", "Adjust the next interval using what you remembered." ] } }, "guides": [ { "title": "Memorization Strategies", "publisher": "University of North Carolina at Chapel Hill Learning Center", "url": "https://learningcenter.unc.edu/tips-and-tools/enhancing-your-memory/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "school", "time" ] }, "delta": 10, "reason": "Planned revisits distribute learning over time." }, { "when": { "student": true }, "delta": 10, "reason": "The evidence comes from student and classroom learning." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "first-visible-step", "canonical_url": "https://adhd100.jock.pl/first-visible-step/", "rank": 64, "title": "Shrink a task to its first action", "summary": "Make the first step concrete enough to do without planning it all again.", "why": "Breaking a job down means fewer decisions before you can start. ADHD CBT teaches it and NHS practical guidance recommends it. Trials test whole programmes, so nobody can put a defensible percentage on one small step.", "how": [ "Pick a task you keep putting off.", "Swap its broad label for an action you can picture doing, like 'open the form'.", "Do that, then pick the next small step.", "With a child, name the next action together and offer to help them get going." ], "category": "Task starting", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD clinical guidance and programme content; the isolated strategy has no separately rated efficacy estimate." }, "impact": { "score": 44, "headline_stat": "Break complex tasks into smaller parts", "stat_source": 0 }, "sources": [ { "title": "De-procrastination", "publisher": "Oxford Health NHS Foundation Trust", "year": 2025, "url": "https://oxfordhealth.nhs.uk/mindset/skills/de-procrastination/", "tier": 1 }, { "title": "Description and Demonstration of CBT for ADHD in Adults", "publisher": "Cognitive and Behavioral Practice", "year": 2010, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3874265/", "tier": 2 }, { "title": "Treatment of ADHD", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/treatment/index.html", "tier": 1 } ], "practice": { "examples": [ "Change 'sort insurance' to 'find the renewal email'.", "Change 'write essay' to 'open the document and add a working title'." ], "pitfalls": [ "A step can still be too big. If you can't see how to begin, shrink it again.", "Planning every step can turn into its own task. Start with the next useful one." ], "do": { "1m": "Name a task you've been putting off and the first physical thing it needs.", "5m": "Do that first action and identify what comes next.", "15m": "Break one job into a few actions and complete the first manageable part.", "30m": "Work through a short sequence, pausing to make each next step concrete.", "plan": { "title": "Make one stuck task approachable", "steps": [ "Replace the vague task with a visible action.", "Try that action and resize it if necessary.", "Reuse the approach on the next task that stalls." ] } }, "guides": [ { "title": "De-procrastination", "publisher": "Oxford Health NHS Foundation Trust", "url": "https://oxfordhealth.nhs.uk/mindset/skills/de-procrastination/", "kind": "guide", "lang": "en" }, { "title": "Education (ADHD: while you wait)", "publisher": "Leicestershire Partnership NHS Trust", "url": "https://www.leicspart.nhs.uk/while-you-wait/adhd/education/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "work", "school", "organisation" ] }, "delta": 10, "reason": "Smaller actions support getting started on complex tasks." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "medication-reminder-plan", "canonical_url": "https://adhd100.jock.pl/medication-reminder-plan/", "rank": 65, "title": "Plan medication reminders safely", "summary": "Work out a reminder and storage plan with your pharmacist that fits your prescription and your day.", "why": "CDC medication-safety guidance suggests timers or reminders, and talking to a pharmacist or doctor when you don't understand the instructions. That's general safety advice, not proof that a particular app or pill organiser improves ADHD outcomes. NHS information lists forgetfulness as a common adult ADHD sign, so it's worth planning with your pharmacist how you'll remember prescribed treatment and tell what you've already taken.", "how": [ "Notice where remembering or recording your prescribed medicine gets hard.", "Write down a question about a reminder that fits what the prescription says.", "Ask a pharmacist whether an organiser suits this medicine and how it has to be stored.", "Ask how to record what you took, and who to contact when you're not sure." ], "category": "Reminders", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "General CDC medication-safety guidance plus NHS ADHD symptom information; no rated trial of the proposed reminder system." }, "impact": { "score": 44, "headline_stat": "Use reminders and ask about unclear medication instructions", "stat_source": 0 }, "sources": [ { "title": "Medication Safety and Your Health", "publisher": "CDC", "year": 2024, "url": "https://www.cdc.gov/medication-safety/about/index.html", "tier": 1 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 } ], "caution": "Follow your prescription. If you're not sure whether you've taken a dose, or how to store or organise a medicine, ask your pharmacist or prescriber instead of guessing. Keep medicines secure and out of children's reach. A reminder does not decide what to take.", "practice": { "examples": [ "Bring a note saying, 'I cannot always remember whether I recorded taking it.'", "Ask whether a proposed organiser preserves the medicine's storage and child-safety requirements." ], "pitfalls": [ "A reminder going off is not proof you took the medicine. Ask how to keep a clear record.", "The handy storage spot is one a child can reach. Ask for a secure storage plan." ], "do": { "1m": "Write down the reminder or storage question you most want to ask your pharmacist.", "5m": "Write that question beside the medicine instructions you plan to bring.", "15m": "Prepare a short list of your reminder, recording and safe-storage difficulties for a pharmacist conversation.", "plan": { "title": "Prepare a safe reminder discussion", "steps": [ "Identify where the current routine becomes unclear.", "Bring the prescription instructions and your questions to the pharmacist.", "Agree how reminders, records and secure storage will work together." ] } }, "guides": [ { "title": "Medication Safety and Your Health", "publisher": "CDC", "url": "https://www.cdc.gov/medication-safety/about/index.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "medication": [ "current" ] }, "boosts": [ { "when": { "focus_any": [ "organisation", "time" ] }, "delta": 10, "reason": "NHS lists forgetfulness as a common adult ADHD sign." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "single-task-inbox", "canonical_url": "https://adhd100.jock.pl/single-task-inbox/", "rank": 66, "title": "Capture tasks in one place", "summary": "Give new tasks one reliable place to land, so there's less to hold in your head.", "why": "Scattered notes make it harder to find what needs doing. One task list is part of ADHD skills programmes and NHS practical advice, but its own effect has not been established. The programme evidence is not proof that a particular notebook or app treats ADHD.", "how": [ "Pick one notebook or simple notes list that's easy to reach.", "Put new tasks there as they come up, without sorting them first.", "At a regular daily check, move dated commitments to your calendar and pick a next action." ], "category": "Organisation", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD clinical guidance and programme content; the isolated strategy has no separately rated efficacy estimate." }, "impact": { "score": 44, "headline_stat": "Keep one central place for tasks and reminders", "stat_source": 0 }, "sources": [ { "title": "Strategies and support (ADHD: while you wait)", "publisher": "Leicestershire Partnership NHS Trust", "year": 2026, "url": "https://www.leicspart.nhs.uk/while-you-wait/adhd/strategies-and-support/", "tier": 1 }, { "title": "Description and Demonstration of CBT for ADHD in Adults", "publisher": "Cognitive and Behavioral Practice", "year": 2010, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3874265/", "tier": 2 } ], "practice": { "examples": [ "Put 'return library book' beside 'reply to repair email' in the same inbox.", "Dictate a task into your existing notes app when typing is awkward." ], "pitfalls": [ "A perfect filing system can delay capture, so write a rough task first.", "An inbox that is never reopened becomes storage, so attach its check to a regular daily event." ], "do": { "1m": "Pick the place your next task will go, somewhere you already use, and picture opening it.", "5m": "Make a single inbox and put three loose tasks into it.", "15m": "Collect tasks from one other list, move appointments to your calendar and choose one next action.", "30m": "Consolidate your currently active task lists, leaving old archives alone; test whether the new inbox is easy to reopen.", "plan": { "title": "Make capture easy to repeat", "steps": [ "Use one inbox for new tasks.", "Check it at the same daily cue.", "Remove a capture step if you keep avoiding it." ] } }, "guides": [ { "title": "Strategies and support (ADHD: while you wait)", "publisher": "Leicestershire Partnership NHS Trust", "url": "https://www.leicspart.nhs.uk/while-you-wait/adhd/strategies-and-support/", "kind": "guide", "lang": "en" }, { "title": "Support Available (Adult ADHD Services)", "publisher": "East London NHS Foundation Trust", "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "organisation" ] }, "delta": 10, "reason": "A single list supports keeping track of tasks." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "automate-a-regular-bill", "canonical_url": "https://adhd100.jock.pl/automate-a-regular-bill/", "rank": 67, "title": "Automate a bill you can cover", "summary": "Reduce repeated remembering while keeping visibility over the money leaving your account.", "why": "NHS adult ADHD self-help advice suggests paying bills by direct debit or standing order, with low-balance alerts. US consumer guidance adds the catch: automatic payments can trigger fees when money runs short, so keep checking your account. A Swedish population study found default rates in adults with ADHD climb in middle age, but it didn't test automatic payments, so this is a practical safeguard, not proven debt prevention.", "how": [ "Start with a legitimate bill that recurs, with a predictable amount and date.", "Make sure the payment fits your available balance, counting other bills that are due.", "Read the authorisation and cancellation terms before you set it up.", "Save the confirmation, turn on balance or payment alerts, and check the first payment." ], "category": "Money", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD-specific NHS self-help guidance, general consumer safeguards and an ADHD population cohort on financial distress; no ADHD autopay efficacy trial." }, "impact": { "score": 43, "headline_stat": "Pay bills by direct debit or standing order", "stat_source": 2 }, "sources": [ { "title": "How do automatic payments from a bank account work?", "publisher": "Consumer Financial Protection Bureau", "year": 2026, "url": "https://www.consumerfinance.gov/ask-cfpb/how-do-automatic-payments-from-a-bank-account-work-en-2021/", "tier": 1 }, { "title": "ADHD, financial distress, and suicide in adulthood: A population study", "publisher": "Science Advances", "year": 2020, "url": "https://pubmed.ncbi.nlm.nih.gov/32998893/", "tier": 2 }, { "title": "Autism and ADHD", "publisher": "BYTES Primary Care Network, NHS", "year": 2026, "url": "https://www.bytespcn.nhs.uk/autism-and-adhd/", "tier": 1 } ], "caution": "Automatic payments can cause fees when there isn't enough money in the account. Check amounts, dates and cancellation terms. Automating a bill does not make it affordable.", "practice": { "examples": [ "Consider automating a stable monthly bill after checking the payment date.", "Keep a low-balance alert so automation does not hide a cash-flow problem." ], "pitfalls": [ "It's easy to automate before checking you can afford it. Look at upcoming payments first.", "An old subscription keeps renewing without you noticing. Include recurring payments in your money check." ], "do": { "1m": "Name one predictable bill you still have to remember by hand.", "5m": "Check that bill's amount and next payment date.", "15m": "Review its automatic-payment terms alongside your upcoming balance and other bills.", "30m": "If it fits your budget, set up one payment, save the terms and arrange a check after the first withdrawal.", "plan": { "title": "Automate with visibility", "steps": [ "Choose one predictable and affordable bill.", "Check terms and payment timing before authorising it.", "Confirm the first payment and keep balance alerts useful." ] } }, "guides": [ { "title": "How do automatic payments from a bank account work?", "publisher": "Consumer Financial Protection Bureau", "url": "https://www.consumerfinance.gov/ask-cfpb/how-do-automatic-payments-from-a-bank-account-work-en-2021/", "kind": "guide", "lang": "en" }, { "title": "Autism and ADHD", "publisher": "BYTES Primary Care Network, NHS", "url": "https://www.bytespcn.nhs.uk/autism-and-adhd/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "money", "organisation" ] }, "delta": 10, "reason": "Recurring payments reduce repeated bill administration." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "child-enjoyable-exercise", "canonical_url": "https://adhd100.jock.pl/child-enjoyable-exercise/", "rank": 68, "title": "Help your child find active fun", "summary": "Pick movement your child likes, and keep expectations for ADHD symptoms modest.", "why": "In EBI-ADHD, physical training gave a small to moderate estimated improvement in symptoms, SMD 0.487, with a 95% confidence interval of 0.225 to 0.748. That came from small trials rated very low certainty, so the size of the benefit is uncertain. It was short term, around 12 weeks or the study endpoint, and cannot establish lasting benefit. Movement is still good for general health whether or not ADHD symptoms change.", "how": [ "Let your child pick an activity that suits their age, like dancing, swimming or a ball game.", "Start with a manageable amount and build gradually, using supervision and protective equipment where needed.", "Try a team sport, a solo activity or outdoor play, depending on what your child enjoys.", "Keep activity alongside their agreed ADHD care, and notice enjoyment as well as any change in symptoms." ], "category": "Movement", "domain": "body-health", "effort": "medium", "evidence": { "grade": "C", "certainty": "very_low", "adhd_specific": true, "basis": "EBI-ADHD re-estimation: 9 physical-training trials, 302 young people; mixed raters, short-term core symptoms.", "ebi": { "intervention": "Physical training", "age": "youth", "outcome": "Core ADHD symptoms", "rater": "mixed", "timepoint": "short" } }, "impact": { "score": 43, "headline_stat": "Very low certainty: small to medium symptom gain from physical training (SMD 0.487)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.487, "unit": "SMD", "outcome": "short-term core ADHD symptom improvement, very low certainty", "comparison": "physical training vs passive controls", "stat_source": 0, "ci_lo": 0.225, "ci_hi": 0.748, "n_studies": 9, "n": 302 }, "sources": [ { "title": "Supplementary materials for EBI-ADHD", "publisher": "Gosling et al., EBI-ADHD team (BMJ 2025 supplement)", "year": 2025, "url": "https://corentinjgosling.github.io/EBI-ADHD-UR-2025/", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "Physical activity guidelines for children and young people", "publisher": "NHS", "year": 2024, "url": "https://www.nhs.uk/live-well/exercise/physical-activity-guidelines-children-and-young-people/", "tier": 1 }, { "title": "ADHD in children and young people", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "tier": 1 } ], "caution": "Choose activities that suit your child's age, health and ability. Ask about adaptations if a medical condition limits exercise.", "practice": { "examples": [ "Try a short dance session at home before committing to a class.", "If a team sport feels overwhelming, try a solo activity or an informal ball game." ], "pitfalls": [ "There's no established best sport for ADHD. Pick one your child will want to go back to.", "Expecting sport to replace treatment overstates the evidence. Keep the agreed care plan in view." ], "do": { "1m": "Ask your child which active game or sport sounds enjoyable.", "5m": "Choose one manageable activity and check what supervision or equipment it needs.", "15m": "Try a short, age-appropriate activity together, adjusting the time and effort to your child.", "30m": "Explore an accessible activity session or outdoor play opportunity your child wants to try.", "plan": { "title": "Find a repeatable activity", "steps": [ "Choose an enjoyable activity that fits your child's abilities.", "Try a short session with suitable supervision.", "Repeat and build gradually if your child likes it.", "Discuss persistent difficulties with the clinician rather than treating exercise as a cure." ] } }, "guides": [ { "title": "Physical activity guidelines for children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/live-well/exercise/physical-activity-guidelines-children-and-young-people/", "kind": "guide", "lang": "en" }, { "title": "ADHD in children and young people", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/adhd-children-teenagers/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 6, "age_max": 17 }, "boosts": [ { "when": { "activity": [ "low" ] }, "delta": 12, "reason": "Building up activity offers general health benefits." }, { "when": { "focus_any": [ "attention", "impulsivity" ] }, "delta": 5, "reason": "Trials measured core ADHD symptoms, but certainty is very low." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "listen-and-check-understanding", "canonical_url": "https://adhd100.jock.pl/listen-and-check-understanding/", "rank": 69, "title": "Repeat back what you heard", "summary": "Before you answer, say back the main point, so a missed word doesn't turn into a fight.", "why": "Adults with ADHD may miss parts of a conversation or interrupt, and that can lead to misunderstandings. NHS guidance describes active listening as repeating back what the person said to check you've understood. It's a communication habit. There is no reliable ADHD-specific effect size for relationship satisfaction.", "how": [ "Pick a time when you can both actually pay attention.", "Let one person finish. Then sum up what they meant in your own words.", "Check you got it right before you explain your side." ], "category": "Relationships", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "General NHS relationship guidance plus NIMH descriptions of ADHD-related conversational difficulties." }, "impact": { "score": 43, "headline_stat": "Repeat back what someone said to check you understand", "stat_source": 0 }, "sources": [ { "title": "Maintaining healthy relationships and mental wellbeing (undated)", "publisher": "NHS Every Mind Matters", "year": 2026, "url": "https://www.nhs.uk/every-mind-matters/lifes-challenges/maintaining-healthy-relationships-and-mental-wellbeing/", "tier": 1 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 } ], "caution": "Communication exercises are not a solution to coercion or abuse. Seek confidential support if you feel unsafe.", "practice": { "examples": [ "'It sounds as if the change of plan left you feeling ignored. Have I understood?'", "'I lost part of that sentence. Could you repeat the main point?'" ], "pitfalls": [ "Repeating words without checking meaning can feel mechanical, so ask whether your summary fits.", "A discussion can get too heated to hear each other. Pause, and come back when you're calmer." ], "do": { "1m": "Try the line out loud: 'What I heard was ___. Is that what you meant?'", "5m": "Practise listening to one concern and summarising it before offering advice.", "15m": "Take turns discussing one small disagreement, checking understanding before deciding what comes next." }, "guides": [ { "title": "Maintaining healthy relationships and mental wellbeing (undated)", "publisher": "NHS Every Mind Matters", "url": "https://www.nhs.uk/every-mind-matters/lifes-challenges/maintaining-healthy-relationships-and-mental-wellbeing/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "relationships" ] }, "delta": 12, "reason": "Interrupting and distractibility can affect conversations in adult ADHD." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "make-room-after-late-diagnosis", "canonical_url": "https://adhd100.jock.pl/make-room-after-late-diagnosis/", "rank": 70, "title": "Make room for mixed feelings", "summary": "Relief, anger or sadness after a late ADHD diagnosis can sit side by side, with no deadline for feeling better.", "why": "An NHS adult ADHD booklet describes relief after diagnosis, alongside sadness, anger or regret at not being diagnosed earlier. NIMH explains that teachers and parents may not have recognised ADHD, or may have provided supportive settings that hid its impact. That can help you make sense of your own reaction. It does not mean grief has universal stages, or that there is a proven timetable for adjusting.", "how": [ "Notice which feelings are there, without deciding which ones you ought to have.", "Tell someone you trust what you are rethinking and what support you want now.", "If distress sticks around or disrupts daily life, take it to a health professional." ], "category": "Identity", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "NHS adult ADHD clinical guidance and NIMH explanation of late recognition; no trial estimate for identity or grief work." }, "impact": { "score": 43, "headline_stat": "Diagnosis can bring relief, and sadness, anger or regret", "stat_source": 0 }, "sources": [ { "title": "Making Sense: A Guide to Living with Adult ADHD", "publisher": "Nottinghamshire Healthcare NHS Trust", "year": 2013, "url": "https://leicspart.nhs.uk/wp-content/uploads/2022/12/Making-Sense-of-Adult-ADHD-booklet.pdf", "tier": 1 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 }, { "title": "How to talk about your mental health (undated)", "publisher": "NHS Every Mind Matters", "year": 2026, "url": "https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/how-to-talk-about-your-mental-health/", "tier": 1 } ], "caution": "Grief-like feelings do not explain every change in mood. Seek help for persistent hopelessness, loss of functioning or thoughts of self-harm.", "practice": { "examples": [ "'I am relieved to understand myself, and sad about help I did not have.'", "'I do not know yet what this diagnosis means to me, and I would like someone to listen.'" ], "pitfalls": [ "Feeling pressured to be grateful can hide distress, so allow more than one reaction.", "Imagining a single perfect alternative life can become painful, so return to the support you need now." ], "do": { "1m": "Name one feeling about your diagnosis and leave it as it is.", "5m": "Write what the diagnosis helps explain and one question or feeling you want to discuss.", "15m": "Read the post-diagnosis section of the NHS booklet and prepare a conversation with someone you trust." }, "guides": [ { "title": "Making Sense: A Guide to Living with Adult ADHD", "publisher": "Nottinghamshire Healthcare NHS Trust", "url": "https://leicspart.nhs.uk/wp-content/uploads/2022/12/Making-Sense-of-Adult-ADHD-booklet.pdf", "kind": "guide", "lang": "en" }, { "title": "How to talk about your mental health (undated)", "publisher": "NHS Every Mind Matters", "url": "https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/how-to-talk-about-your-mental-health/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18, "diagnosed": [ "yes" ] }, "boosts": [ { "when": { "focus_any": [ "emotions" ] }, "delta": 12, "reason": "An adult ADHD diagnosis can bring mixed emotional reactions." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "praise-specific-effort", "canonical_url": "https://adhd100.jock.pl/praise-specific-effort/", "rank": 71, "title": "Praise a specific effort", "summary": "Help your child see what went well, including the small tries that are easy to miss.", "why": "NHS ADHD guidance recommends noticing effort and giving specific praise. In the EBI review, full parent-mediated programmes gave a small short-term improvement in parent-rated ADHD symptoms near 12 weeks, SMD 0.345, with very low certainty. Those programmes bundle multiple skills together. So the estimate does not measure praise alone, and it does not establish lasting benefit.", "how": [ "Spot a small behaviour your child is working on.", "Say what you saw, warmly and promptly, in a way your child likes.", "Praise the effort or the progress, and stop there. No criticism tacked on the end." ], "category": "Parenting", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "C", "certainty": "very_low", "adhd_specific": true, "basis": "NHS practical advice; EBI context is a multi-component parent intervention, not an isolated estimate for praise.", "ebi": { "intervention": "Parent-mediated behavioral interventions", "age": "youth", "outcome": "Core ADHD symptoms", "rater": "parent-rated", "timepoint": "short" } }, "impact": { "score": 43, "headline_stat": "Recognise effort and small improvements", "stat_source": 0 }, "sources": [ { "title": "ADHD & Self Esteem (undated)", "publisher": "Humber Teaching NHS Foundation Trust", "year": 2026, "url": "https://connect.humber.nhs.uk/service/childrens-adhd-intervention-team/adhd-self-esteem/", "tier": 1 }, { "title": "ADHD: supporting relationships (undated)", "publisher": "Norfolk and Waveney Children and Young People's Health Services, NHS", "year": 2026, "url": "https://www.justonenorfolk.nhs.uk/nd-digital-library/understanding-neurodiversity/adhd/", "tier": 1 }, { "title": "EBI-ADHD umbrella review: re-estimated dataset, commit 86eff22a9ffb", "publisher": "Gosling et al., BMJ accompanying open data", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ, full text via PMC", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 } ], "caution": "Praise is support, not a substitute for assessment or a complete parent-training programme.", "practice": { "examples": [ "'You let your sister finish her sentence. Thank you for waiting.'", "'That was frustrating, and I noticed you asked for help.'" ], "pitfalls": [ "'Well done, but why not always?' weakens the praise. Let it stand on its own.", "A distant goal can hide progress, so recognise a small step your child actually took." ], "do": { "1m": "Pick a recent effort your child made and say out loud the exact words you'd use to praise it.", "5m": "Notice and warmly describe an effort your child makes during an ordinary interaction.", "15m": "Read the NHS self-esteem guide and choose one small effort to notice over the next few days." }, "guides": [ { "title": "ADHD & Self Esteem (undated)", "publisher": "Humber Teaching NHS Foundation Trust", "url": "https://connect.humber.nhs.uk/service/childrens-adhd-intervention-team/adhd-self-esteem/", "kind": "guide", "lang": "en" }, { "title": "ADHD: supporting relationships (undated)", "publisher": "Norfolk and Waveney Children and Young People's Health Services, NHS", "url": "https://www.justonenorfolk.nhs.uk/nd-digital-library/understanding-neurodiversity/adhd/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent" }, "boosts": [ { "when": { "focus_any": [ "relationships" ] }, "delta": 12, "reason": "NHS ADHD guidance recommends recognising effort to support self-esteem." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "set-limits-before-overload", "canonical_url": "https://adhd100.jock.pl/set-limits-before-overload/", "rank": 72, "title": "Set a limit before overload builds", "summary": "Say what you can offer, and ask for help when demands outrun what you've got.", "why": "General NHS guidance links sustained stress with exhaustion and recommends support and clear personal boundaries. ADHD adds pressure, since work problems and strained relationships are common in adults with the condition. Setting a limit is a practical option. These sources give no established ADHD-specific effect on preventing burnout, and no diagnostic test for it.", "how": [ "Name the pressure costing you the most right now.", "Pick a realistic limit, or a specific request for help.", "Say it clearly to the person involved. If the exhaustion persists, get professional support." ], "category": "Stress", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "General NHS stress and relationship guidance with ADHD-specific functional relevance; no tested ADHD burnout protocol." }, "impact": { "score": 43, "headline_stat": "Set boundaries on the help you can offer", "stat_source": 0 }, "sources": [ { "title": "Maintaining healthy relationships and mental wellbeing (undated)", "publisher": "NHS Every Mind Matters", "year": 2026, "url": "https://www.nhs.uk/every-mind-matters/lifes-challenges/maintaining-healthy-relationships-and-mental-wellbeing/", "tier": 1 }, { "title": "Dealing with stress (undated)", "publisher": "NHS Every Mind Matters", "year": 2026, "url": "https://www.nhs.uk/every-mind-matters/mental-health-issues/stress/", "tier": 1 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 } ], "caution": "Persistent exhaustion, low mood or loss of functioning deserves medical attention rather than assuming it is ADHD burnout.", "practice": { "examples": [ "'I can listen for a little while, but I cannot take on this whole problem tonight.'", "'I am struggling with the amount expected. Can we discuss what support is possible?'" ], "pitfalls": [ "Waiting for total exhaustion can make a conversation harder, so raise the pressure while you can.", "Calling everything burnout may hide depression or another problem, so seek help for persistent changes." ], "do": { "1m": "Say one kind, clear limit out loud: 'I cannot take that on today.'", "5m": "Identify one pressure and one person who could help reduce it.", "15m": "Prepare a short conversation about capacity, including what you can offer and the help you need." }, "guides": [ { "title": "Maintaining healthy relationships and mental wellbeing (undated)", "publisher": "NHS Every Mind Matters", "url": "https://www.nhs.uk/every-mind-matters/lifes-challenges/maintaining-healthy-relationships-and-mental-wellbeing/", "kind": "guide", "lang": "en" }, { "title": "Dealing with stress (undated)", "publisher": "NHS Every Mind Matters", "url": "https://www.nhs.uk/every-mind-matters/mental-health-issues/stress/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "work", "relationships" ] }, "delta": 12, "reason": "ADHD can create difficulties at work and in relationships." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "short-focus-blocks", "canonical_url": "https://adhd100.jock.pl/short-focus-blocks/", "rank": 73, "title": "Work in short, adjustable blocks", "summary": "Give one task a clear start, a stopping point and a planned break.", "why": "ADHD skills guidance uses short work periods to cut down drifting between tasks. The Safren approach sizes each chunk to the attention span the person actually shows. No fixed Pomodoro schedule has an established ADHD treatment effect, and the programme evidence does not isolate timed blocks.", "how": [ "Pick one task and a small chunk of it.", "Choose a work period short enough to try, and set a timer.", "Park other tasks for later, and take a break when the block ends.", "Size the next block by what happened, not by a fixed interval." ], "category": "Attention", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD clinical guidance and programme content; the isolated strategy has no separately rated efficacy estimate." }, "impact": { "score": 43, "headline_stat": "Use time blocks to limit task switching", "stat_source": 0 }, "sources": [ { "title": "Time traps", "publisher": "Oxford Health NHS Foundation Trust", "year": 2025, "url": "https://oxfordhealth.nhs.uk/mindset/skills/time-optimisation/time-traps/", "tier": 1 }, { "title": "Description and Demonstration of CBT for ADHD in Adults", "publisher": "Cognitive and Behavioral Practice", "year": 2010, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3874265/", "tier": 2 } ], "practice": { "examples": [ "Try a short block for an overdue form, then decide whether to continue.", "Use a longer block for engaging reading and a shorter one for dull admin." ], "pitfalls": [ "Treating a timer as a test can make starting harder, so shorten the block when needed.", "A break can become an unplanned detour, so decide how you will return before leaving the task." ], "do": { "1m": "Pick one task and a small piece you could do before a break.", "5m": "Try a five minute start on that piece, with permission to stop afterwards.", "15m": "Try one short focus period, a brief break and a check of what helped you stay with the task.", "30m": "Run a work and break cycle that fits within half an hour, then adjust the next cycle.", "plan": { "title": "Find a workable rhythm", "steps": [ "Try a short block on one task.", "Notice when attention drifts and adjust the duration.", "Keep the rhythm only if it helps you start or return." ] } }, "guides": [ { "title": "Time traps", "publisher": "Oxford Health NHS Foundation Trust", "url": "https://oxfordhealth.nhs.uk/mindset/skills/time-optimisation/time-traps/", "kind": "guide", "lang": "en" }, { "title": "De-procrastination", "publisher": "Oxford Health NHS Foundation Trust", "url": "https://oxfordhealth.nhs.uk/mindset/skills/de-procrastination/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "attention", "time", "work" ] }, "delta": 10, "reason": "Short task blocks reduce opportunities to switch away." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "silence-nonessential-alerts", "canonical_url": "https://adhd100.jock.pl/silence-nonessential-alerts/", "rank": 74, "title": "Silence nonessential notifications", "summary": "Turn off the alerts you don't need, so your next task starts quieter.", "why": "In a short lab experiment with general students, phone notifications alone disrupted an attention task, even when people didn't pick up the phone. It wasn't an ADHD treatment trial and didn't measure long-term effects. NHS ADHD guidance recommends turning notifications off during a task, and NHS information lists being easily distracted as a common adult ADHD sign, so silencing optional alerts is a reasonable experiment.", "how": [ "Pick one task that needs uninterrupted attention.", "Mute optional sounds, vibrations and pop-ups while you do it.", "Keep an agreed way for essential or urgent contacts to reach you.", "Check messages at a chosen stopping point and see whether you finished more easily." ], "category": "Digital focus", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD-specific NHS guidance recommends it; the only measured effect is a brief general student laboratory experiment; no formal certainty rating." }, "impact": { "score": 43, "headline_stat": "Turn off notifications during a task", "stat_source": 0 }, "sources": [ { "title": "Disconnection", "publisher": "Oxford Health NHS Foundation Trust", "year": 2025, "url": "https://oxfordhealth.nhs.uk/mindset/skills/concentration/disconnection/", "tier": 1 }, { "title": "The attentional cost of receiving a cell phone notification", "publisher": "Journal of Experimental Psychology: Human Perception and Performance", "year": 2015, "url": "https://pubmed.ncbi.nlm.nih.gov/26121498/", "tier": 2 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 } ], "practice": { "examples": [ "Mute shopping and news alerts while you finish a form.", "Keep calls from a dependent's carer available while optional apps stay quiet." ], "pitfalls": [ "Silent mode still buzzes on the desk. Check vibration and banner settings too.", "You miss someone you needed to hear from. Set exceptions for essential contacts before you start." ], "do": { "1m": "Pick one type of notification that can safely wait until your next break.", "5m": "Turn off one optional app's sounds, vibrations and banners.", "15m": "Try one quiet task period, then check whether important contacts still reach you.", "plan": { "title": "Keep the useful alerts", "steps": [ "Remove one frequent optional interruption.", "Test urgent-contact exceptions.", "Keep the settings that help your actual tasks." ] } }, "guides": [ { "title": "Disconnection", "publisher": "Oxford Health NHS Foundation Trust", "url": "https://oxfordhealth.nhs.uk/mindset/skills/concentration/disconnection/", "kind": "guide", "lang": "en" }, { "title": "Autism and ADHD", "publisher": "BYTES Primary Care Network, NHS", "url": "https://www.bytespcn.nhs.uk/autism-and-adhd/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 16 }, "boosts": [ { "when": { "focus_any": [ "attention", "work", "school" ] }, "delta": 10, "reason": "Notifications can interrupt attention even without phone use." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "choose-daily-priority", "canonical_url": "https://adhd100.jock.pl/choose-daily-priority/", "rank": 75, "title": "Choose your important task first", "summary": "Don't let easy distractions decide what gets your attention today.", "why": "An interesting or easy job can crowd out an important one. Adult ADHD skills work includes ranking a task list, but the ranking method has no trial estimate of its own. NHS guidance recommends sorting tasks by how important and how urgent they are.", "how": [ "Look at your calendar and task inbox.", "Pick one important task where a delay has a real cost.", "Mark a small first action and a realistic time to try it.", "Leave lower priority tasks for later." ], "category": "Planning", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD clinical guidance and programme content; the isolated strategy has no separately rated efficacy estimate." }, "impact": { "score": 42, "headline_stat": "Prioritise tasks by importance and urgency", "stat_source": 0 }, "sources": [ { "title": "ABCDE system", "publisher": "Oxford Health NHS Foundation Trust", "year": 2025, "url": "https://oxfordhealth.nhs.uk/mindset/skills/time-optimisation/abcde/", "tier": 1 }, { "title": "Description and Demonstration of CBT for ADHD in Adults", "publisher": "Cognitive and Behavioral Practice", "year": 2010, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3874265/", "tier": 2 } ], "practice": { "examples": [ "Start the expiring application before reorganising your folders.", "Choose the reply that unblocks a colleague before browsing optional messages." ], "pitfalls": [ "If everything is urgent, nothing stands out. Pick the task with the clearest consequence.", "The most important job may feel too big. Pick its smallest useful part." ], "do": { "1m": "Name the task whose delay would matter most today, and its smallest useful first move.", "5m": "Mark one priority in your task list and decide when to start it.", "15m": "Review today's commitments, remove an optional task and begin the priority.", "30m": "Protect one work block for the priority, then check whether the next step is clear.", "plan": { "title": "Practise choosing before starting", "steps": [ "Select one priority at your daily check.", "Begin a small part before optional tasks.", "Review what displaced it and adjust tomorrow's plan." ] } }, "guides": [ { "title": "ABCDE system", "publisher": "Oxford Health NHS Foundation Trust", "url": "https://oxfordhealth.nhs.uk/mindset/skills/time-optimisation/abcde/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "organisation", "work" ] }, "delta": 10, "reason": "Prioritising helps identify the next important task." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "home-for-essentials", "canonical_url": "https://adhd100.jock.pl/home-for-essentials/", "rank": 76, "title": "Give essentials a home", "summary": "Put important things back in the same obvious place, and you'll search for them less.", "why": "Losing essentials can wreck a plan that would otherwise work. Fixed places for important things are part of adult ADHD CBT content and NHS guidance. Nobody has established a separate effect size for a key tray or a labelled shelf.", "how": [ "Pick a handy, secure spot for keys, wallet and other essentials.", "Use a tray, hook or shelf you already have before buying a system.", "Put each thing back there after you use it.", "If your usual route through the house makes the spot easy to miss, move it." ], "category": "Organisation", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD clinical guidance and programme content; the isolated strategy has no separately rated efficacy estimate." }, "impact": { "score": 42, "headline_stat": "Keep important belongings in set places", "stat_source": 0 }, "sources": [ { "title": "Support Available (Adult ADHD Services)", "publisher": "East London NHS Foundation Trust", "year": 2026, "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "tier": 1 }, { "title": "Description and Demonstration of CBT for ADHD in Adults", "publisher": "Cognitive and Behavioral Practice", "year": 2010, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3874265/", "tier": 2 } ], "practice": { "examples": [ "Use one tray for your wallet and travel card.", "Keep the reusable work bag on the same hook after unpacking it." ], "pitfalls": [ "A storage place that takes effort to reach is easily bypassed, so move it onto your usual route.", "A tray can fill with unrelated clutter, so keep its purpose narrow." ], "do": { "1m": "Pick a handy, secure home for the thing you lose most often.", "5m": "Clear that small space and put the essential there.", "15m": "Set homes for a few frequently lost items and rehearse returning them.", "30m": "Walk through your arrival and departure routine and simplify any awkward return step.", "plan": { "title": "Make one location reliable", "steps": [ "Give one frequently lost item a home.", "Practise returning it after use.", "Add another item only when the first location works." ] } }, "guides": [ { "title": "Support Available (Adult ADHD Services)", "publisher": "East London NHS Foundation Trust", "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "organisation" ] }, "delta": 10, "reason": "Fixed locations support finding important belongings." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "include-siblings-needs", "canonical_url": "https://adhd100.jock.pl/include-siblings-needs/", "rank": 77, "title": "Make space for siblings too", "summary": "Let brothers and sisters be heard, without making them responsible for ADHD.", "why": "An NHS children's hospital notes that siblings can struggle when much of the family's attention goes to a brother or sister with ADHD, and they may feel embarrassed. NICE asks clinicians to ask families how ADHD affects other family members. Listening to siblings and explaining differences is family support. It is not a tested way to change ADHD symptoms.", "how": [ "Ask each sibling on their own what has been hard or confusing.", "Explain ADHD in words they understand, and keep everyone's safety needs clear.", "Make time to talk, and ask the family team about sibling support if needed." ], "category": "Family", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "NHS clinical guidance on siblings; NICE family recommendation does not mention siblings or a sibling action. No measured effect for a sibling check-in." }, "impact": { "score": 42, "headline_stat": "Siblings can find it hard when attention goes to their brother or sister", "stat_source": 1 }, "sources": [ { "title": "ADHD: diagnosis and management, NG87, information and support", "publisher": "NICE, public HSC Northern Ireland copy", "year": 2018, "url": "https://cypsp.hscni.net/wp-content/uploads/ebpp/reports/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933.pdf", "tier": 1 }, { "title": "Tourette Syndrome and ADHD (undated)", "publisher": "Great Ormond Street Hospital NHS Foundation Trust", "year": 2026, "url": "https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/psychological-and-mental-health-services-pamhs/the-tic-service/tourette-syndrome-and-adhd/", "tier": 1 }, { "title": "ADHD: further support, advice and self-help (undated)", "publisher": "Derbyshire Healthcare NHS Foundation Trust", "year": 2026, "url": "https://www.camhsnorthderbyshire.nhs.uk/adhd", "tier": 1 } ], "caution": "Take threats, injuries or fear between siblings seriously and seek help with keeping everyone safe.", "practice": { "examples": [ "'You seem upset that our plans changed. I want to hear what that was like for you.'", "Ask a sibling what they understand about ADHD and correct one misunderstanding gently." ], "pitfalls": [ "Expecting a sibling to manage outbursts gives them an adult responsibility, so keep support with adults.", "Explaining ADHD should not dismiss hurt, so acknowledge the sibling's experience too." ], "do": { "1m": "Practise the question: 'How has this been for you? You can tell me the difficult parts too.'", "5m": "Check in with a sibling and listen without immediately defending anyone.", "15m": "Use NHS family resources to plan an age-appropriate explanation or ask about sibling support." }, "guides": [ { "title": "Tourette Syndrome and ADHD (undated)", "publisher": "Great Ormond Street Hospital NHS Foundation Trust", "url": "https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/psychological-and-mental-health-services-pamhs/the-tic-service/tourette-syndrome-and-adhd/", "kind": "guide", "lang": "en" }, { "title": "ADHD: further support, advice and self-help (undated)", "publisher": "Derbyshire Healthcare NHS Foundation Trust", "url": "https://www.camhsnorthderbyshire.nhs.uk/adhd", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent" }, "boosts": [ { "when": { "focus_any": [ "relationships" ] }, "delta": 12, "reason": "Siblings can find it hard when much attention goes to a child with ADHD." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "name-your-childs-feelings", "canonical_url": "https://adhd100.jock.pl/name-your-childs-feelings/", "rank": 78, "title": "Help your child name the feeling", "summary": "Leave room for the feeling, and keep behaviour safe and understandable.", "why": "ADHD can make frustration and big emotional reactions hard to manage. NHS child guidance recommends acknowledging feelings and helping a child express them in words or pictures. Naming a feeling is supportive communication. It is not a proven standalone treatment for ADHD, and it can't promise to stop an outburst.", "how": [ "Offer a guess, lightly: 'You seem disappointed. Have I got that right?'", "Accept it if they correct you, or let them point, draw or stay quiet.", "Keep any safety limit short. Talk about what happened after the intensity drops." ], "category": "Emotions", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "NHS ADHD and neurodevelopmental clinical guidance; no published certainty rating for emotion naming alone." }, "impact": { "score": 42, "headline_stat": "Acknowledge feelings and help children express them", "stat_source": 0 }, "sources": [ { "title": "Attention, activity, emotions, and behaviour (undated)", "publisher": "Berkshire Healthcare NHS Foundation Trust", "year": 2026, "url": "https://www.berkshirehealthcare.nhs.uk/advice/adhd-and-autism/attention-activity-emotions-and-behaviour", "tier": 1 }, { "title": "ADHD & Self Esteem (undated)", "publisher": "Humber Teaching NHS Foundation Trust", "year": 2026, "url": "https://connect.humber.nhs.uk/service/childrens-adhd-intervention-team/adhd-self-esteem/", "tier": 1 } ], "caution": "Seek professional support if outbursts involve injury, threats or major disruption.", "practice": { "examples": [ "'You wanted another turn, and stopping feels disappointing.'", "Your child draws an angry face instead of having to explain everything aloud." ], "pitfalls": [ "Guessing with certainty can miss the feeling, so ask and accept a different answer.", "Validating anger does not mean allowing harm, so calmly keep the safety boundary." ], "do": { "1m": "Practise the words: 'I can see this is hard. Are you angry, sad, or something else?'", "5m": "Think with your child about a word or drawing they could use when speaking feels hard.", "15m": "At a calm moment, discuss an upsetting event and let your child describe their own experience." }, "guides": [ { "title": "Attention, activity, emotions, and behaviour (undated)", "publisher": "Berkshire Healthcare NHS Foundation Trust", "url": "https://www.berkshirehealthcare.nhs.uk/advice/adhd-and-autism/attention-activity-emotions-and-behaviour", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent" }, "boosts": [ { "when": { "focus_any": [ "emotions" ] }, "delta": 12, "reason": "NHS ADHD guidance includes support with emotional regulation." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "pause-before-reacting", "canonical_url": "https://adhd100.jock.pl/pause-before-reacting/", "rank": 79, "title": "Pause before you react", "summary": "Give a strong feeling a little room before it turns into a message or an argument.", "why": "In a meta-analysis, adults with ADHD had more difficulty regulating emotions than comparison groups. An NHS adult ADHD service suggests pausing before reacting, agreeing a code word with loved ones so you can step away without conflict, and telling people 'I need a minute'. It's a practical coping idea. There is no reliable ADHD trial estimate for a brief pause by itself.", "how": [ "Catch your early cue: a tight jaw, say, or the urge to interrupt.", "Agree a code word, or a phrase like 'I need a minute', and say when you'll be back.", "Step away if it's safe. Come back to one issue once you feel calmer." ], "category": "Emotions", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD observational meta-analysis establishes relevance; NHS clinical guidance supports the action, without an isolated trial estimate." }, "impact": { "score": 42, "headline_stat": "Pause before reacting", "stat_source": 0 }, "sources": [ { "title": "Support Available: understanding emotional regulation in ADHD", "publisher": "East London NHS Foundation Trust", "year": 2026, "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "tier": 1 }, { "title": "Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis", "publisher": "BMC Psychiatry", "year": 2020, "url": "https://link.springer.com/article/10.1186/s12888-020-2442-7", "tier": 2 }, { "title": "Maintaining healthy relationships and mental wellbeing (undated)", "publisher": "NHS Every Mind Matters", "year": 2026, "url": "https://www.nhs.uk/every-mind-matters/lifes-challenges/maintaining-healthy-relationships-and-mental-wellbeing/", "tier": 1 } ], "caution": "If you fear you may hurt yourself or someone else, seek urgent help rather than relying on a pause.", "practice": { "examples": [ "Before replying to a hurtful comment, say: 'I want to answer when I can think clearly.'", "After a disagreement, return at the agreed time and discuss the specific event." ], "pitfalls": [ "Vanishing mid-argument can feel like rejection. Explain the pause and set up a time to reconnect.", "A pause is not permission to frighten someone, so put safety first if anger is escalating." ], "do": { "1m": "Run it silently: 'I feel overwhelmed. Can we pause and come back to this?'", "5m": "Identify your first warning sign in a recent disagreement and choose a pause phrase.", "15m": "Agree a pause signal and a way to resume difficult conversations with someone you trust." }, "guides": [ { "title": "Support Available: understanding emotional regulation in ADHD", "publisher": "East London NHS Foundation Trust", "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "kind": "guide", "lang": "en" }, { "title": "Maintaining healthy relationships and mental wellbeing (undated)", "publisher": "NHS Every Mind Matters", "url": "https://www.nhs.uk/every-mind-matters/lifes-challenges/maintaining-healthy-relationships-and-mental-wellbeing/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "emotions", "relationships" ] }, "delta": 12, "reason": "ADHD can make emotional regulation harder." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "recognise-your-own-strengths", "canonical_url": "https://adhd100.jock.pl/recognise-your-own-strengths/", "rank": 80, "title": "Name your own strengths", "summary": "Say what you do well, with real examples, and skip the ADHD-as-superpower story.", "why": "NICE lists identifying and building on individual strengths among topics a clinician can cover after an ADHD diagnosis. NHS self-esteem guidance suggests recognising what you are good at. That supports learning about your own abilities, without claiming that ADHD makes everyone creative, resilient or suited to a particular job.", "how": [ "Recall something you handled well and name the skill it took.", "Ask someone you trust for a concrete example of what they value in what you bring.", "Put that description next to your support needs when you talk about work or relationships." ], "category": "Self knowledge", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "NICE names strengths as a post-diagnosis discussion topic, not a recommended self-help action; NHS self-esteem guidance. No evidence that a strengths exercise improves outcomes." }, "impact": { "score": 42, "headline_stat": "Building on strengths is a post-diagnosis topic", "stat_source": 0 }, "sources": [ { "title": "ADHD: diagnosis and management, NG87, information and support", "publisher": "NICE, public HSC Northern Ireland copy", "year": 2018, "url": "https://cypsp.hscni.net/wp-content/uploads/ebpp/reports/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933.pdf", "tier": 1 }, { "title": "Raising low self-esteem", "publisher": "NHS", "year": 2023, "url": "https://www.nhs.uk/mental-health/self-help/tips-and-support/raise-low-self-esteem/", "tier": 1 } ], "practice": { "examples": [ "'I explained a complicated idea clearly to a colleague' is evidence about a skill.", "'I am good at noticing when a friend needs support' describes a strength outside paid work." ], "pitfalls": [ "A list of supposed ADHD superpowers may not fit you, so use your own examples.", "Having strengths does not remove a disability or support need, so include both in the conversation." ], "do": { "1m": "Jot down a situation you handled well and the skill you used.", "5m": "Write two concrete examples of your strengths, including one outside productivity or work.", "15m": "Ask a trusted person for an example of a valued contribution, then compare it with your own view." }, "guides": [ { "title": "Raising low self-esteem", "publisher": "NHS", "url": "https://www.nhs.uk/mental-health/self-help/tips-and-support/raise-low-self-esteem/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "work" ] }, "delta": 12, "reason": "NICE includes strengths and employment issues in post-diagnosis discussions." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "visible-transition-checklist", "canonical_url": "https://adhd100.jock.pl/visible-transition-checklist/", "rank": 81, "title": "Make a short leaving checklist", "summary": "Put the next few actions where you'll see them, so leaving home asks less of your memory.", "why": "NHS ADHD guidance recommends predictable routines and visible checklists, and CDC gives parents similar advice. A short list can make a transition easier to follow when attention wanders, but its own effect on ADHD has not been established. Use the checklist as a prompt you can change, not a test you have to pass.", "how": [ "Pick one transition, like leaving home.", "List only the things you keep missing, in the order you actually do them.", "Put the list where the transition happens. With a child who prefers pictures, use pictures.", "Practise it together, then drop steps that no longer need a prompt." ], "category": "Routines", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD-specific NHS or CDC guidance recommends this action; no isolated trial estimate or formal certainty rating." }, "impact": { "score": 42, "headline_stat": "Build routines and use visual lists", "stat_source": 0 }, "sources": [ { "title": "Support Available (Adult ADHD Services)", "publisher": "East London NHS Foundation Trust", "year": 2026, "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "tier": 1 }, { "title": "Treatment of ADHD", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/treatment/index.html", "tier": 1 } ], "practice": { "examples": [ "By the door: bag, keys, appointment letter.", "A child's picture list shows shoes, coat and school bag." ], "pitfalls": [ "A long list turns into background clutter. Keep only the steps that need help.", "A missed step turns into criticism. Point to the next action and make the cue simpler." ], "do": { "1m": "Write down the thing you most often forget when you leave home. That's line one of your checklist.", "5m": "Write a short leaving list and put it where you collect your belongings.", "15m": "Walk through the next departure using your list, and reorder any steps that feel awkward.", "plan": { "title": "Build one reliable transition", "steps": [ "Choose one departure routine.", "Try a short visible list for that routine.", "Keep useful prompts and remove extra instructions." ] } }, "guides": [ { "title": "Support Available (Adult ADHD Services)", "publisher": "East London NHS Foundation Trust", "url": "https://www.elft.nhs.uk/adult-adhd-services/support-available", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "organisation", "time" ] }, "delta": 10, "reason": "Visible steps support everyday transitions." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "add-shopping-friction", "canonical_url": "https://adhd100.jock.pl/add-shopping-friction/", "rank": 82, "title": "Put a pause before checkout", "summary": "Add an extra step to unplanned shopping, so you get a moment to check what you meant to buy.", "why": "NHS adult ADHD self-help advice suggests a shopping list, switching off one-click purchases and removing shopping apps. A Swedish population study found default rates in adults with ADHD climb in middle age, but it didn't test these tactics. The aim is a pause long enough to decide, not a proven cut in debt, and not a ban on buying things you enjoy.", "how": [ "Write down what you mean to buy before you open the shop or app.", "Turn off one-click checkout, or remove an optional shopping app if it leads to unplanned buys.", "Put an unplanned item on a wish list instead of buying it straight away.", "Go back to the list when you can check the price against money already committed to essentials." ], "category": "Money", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD-specific NHS self-help guidance plus an ADHD population cohort on financial distress; no isolated trial of purchase friction." }, "impact": { "score": 41, "headline_stat": "Use shopping lists and disable one-click buying", "stat_source": 0 }, "sources": [ { "title": "Autism and ADHD", "publisher": "BYTES Primary Care Network, NHS", "year": 2026, "url": "https://www.bytespcn.nhs.uk/autism-and-adhd/", "tier": 1 }, { "title": "ADHD, financial distress, and suicide in adulthood: A population study", "publisher": "Science Advances", "year": 2020, "url": "https://pubmed.ncbi.nlm.nih.gov/32998893/", "tier": 2 } ], "practice": { "examples": [ "Go into a shop with the items you intended to buy already listed.", "Remove a shopping shortcut that you open whenever a task feels difficult." ], "pitfalls": [ "The system bans every purchase you'd enjoy. Leave room for planned choices within your budget.", "A saved wish list turns into another shopping feed. Look at it only when you're checking planned spending." ], "do": { "1m": "Name one shopping shortcut you'd like to make less automatic.", "5m": "Disable one optional shopping shortcut or notification.", "15m": "Make a list for your next purchase and check it against money already committed to bills.", "plan": { "title": "Create a useful checkout pause", "steps": [ "Identify one route into unplanned spending.", "Add a small barrier and use a purchase list.", "Keep the barrier only if it helps you make the choices you wanted." ] } }, "guides": [ { "title": "Autism and ADHD", "publisher": "BYTES Primary Care Network, NHS", "url": "https://www.bytespcn.nhs.uk/autism-and-adhd/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "money", "impulsivity" ] }, "delta": 10, "reason": "Shopping lists and checkout barriers support a spending pause." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "external-time-cues", "canonical_url": "https://adhd100.jock.pl/external-time-cues/", "rank": 83, "title": "Make time visible", "summary": "If noticing the minutes pass is hard, put the time somewhere outside your head.", "why": "ADHD research finds differences in time perception, though lab timing tasks do not prove that a visual timer helps in daily life. NHS guidance suggests clocks, timers and start or stop alarms. Treat them as practical prompts, with no promised size of benefit.", "how": [ "Pick one transition that often slips past you.", "Put a clock or a countdown where you can see it.", "Label the alarm with the action, like 'close laptop and get bag'.", "Keep only the cues that get you to do something useful." ], "category": "Time", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD clinical guidance and programme content; the isolated strategy has no separately rated efficacy estimate." }, "impact": { "score": 41, "headline_stat": "Use timers and alarms as external time cues", "stat_source": 0 }, "sources": [ { "title": "Strategies and support (ADHD: while you wait)", "publisher": "Leicestershire Partnership NHS Trust", "year": 2026, "url": "https://www.leicspart.nhs.uk/while-you-wait/adhd/strategies-and-support/", "tier": 1 }, { "title": "Time-Perception Deficits in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis", "publisher": "Developmental Neuropsychology", "year": 2024, "url": "https://pubmed.ncbi.nlm.nih.gov/38145491/", "tier": 2 } ], "practice": { "examples": [ "Use a visible countdown while getting ready to leave.", "Use an end alarm for a task that often runs into the next appointment." ], "pitfalls": [ "Too many alarms fade into background noise. Start with one important transition.", "A silent timer may go unnoticed. Pick a cue you'll actually notice." ], "do": { "1m": "Name a transition you often miss, and what you want its cue to make you do.", "5m": "Set one clearly labelled transition alarm or place a clock in view.", "15m": "Try your cue during one short task and check whether you noticed it.", "30m": "Observe a routine with a visible clock and change only the cue that was easy to miss.", "plan": { "title": "Test one time cue", "steps": [ "Choose one difficult transition.", "Try a visible or audible cue.", "Keep, move or remove it according to what happened." ] } }, "guides": [ { "title": "Strategies and support (ADHD: while you wait)", "publisher": "Leicestershire Partnership NHS Trust", "url": "https://www.leicspart.nhs.uk/while-you-wait/adhd/strategies-and-support/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "time" ] }, "delta": 10, "reason": "External cues support noticing time and transitions." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "keep-boundaries-calm", "canonical_url": "https://adhd100.jock.pl/keep-boundaries-calm/", "rank": 84, "title": "Keep boundaries clear and calm", "summary": "Make rules your child can understand, and respond the same way each time without escalating.", "why": "NICE supports clear, appropriate rules and consistent responses for children with ADHD. Full parent-mediated programmes gave a small improvement in parent-rated oppositional symptoms near 12 weeks, SMD 0.249, but EBI certainty was very low. That result belongs to the whole programme, not any particular consequence, and whether the benefit lasts is uncertain.", "how": [ "Agree a small number of rules everyone can understand, at a calm moment.", "Explain ahead of time what a proportionate response will be. Keep the words brief and calm.", "Watch for confusion or overwhelm, and help your child practise what's expected." ], "category": "Parenting", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "A", "certainty": "very_low", "adhd_specific": true, "basis": "Explicit NICE parenting recommendation; EBI oppositional-symptom estimate is for full parent-mediated programmes.", "ebi": { "intervention": "Parent-mediated behavioral interventions", "age": "youth", "outcome": "Oppositional symptoms (ODD)", "rater": "parent-rated", "timepoint": "short" } }, "impact": { "score": 41, "headline_stat": "Use clear rules and consistent responses", "stat_source": 0 }, "sources": [ { "title": "ADHD: diagnosis and management, NG87, information and support", "publisher": "NICE, public HSC Northern Ireland copy", "year": 2018, "url": "https://cypsp.hscni.net/wp-content/uploads/ebpp/reports/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933.pdf", "tier": 1 }, { "title": "Attention, activity, emotions, and behaviour (undated)", "publisher": "Berkshire Healthcare NHS Foundation Trust", "year": 2026, "url": "https://www.berkshirehealthcare.nhs.uk/advice/adhd-and-autism/attention-activity-emotions-and-behaviour", "tier": 1 }, { "title": "EBI-ADHD umbrella review: re-estimated dataset, commit 86eff22a9ffb", "publisher": "Gosling et al., BMJ accompanying open data", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ, full text via PMC", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 } ], "caution": "Avoid physical punishment, humiliation or withholding basic needs. Ask for professional help if family conflict or aggression is escalating.", "practice": { "examples": [ "Agree beforehand that a shared game pauses if someone starts hitting.", "Say what is expected in a short sentence, then allow time to process it." ], "pitfalls": [ "Changing the rule in anger makes it harder to understand, so return to the agreed expectation.", "Treating confusion as defiance can escalate things. Check they understood, and offer help." ], "do": { "1m": "Say one calm, concrete boundary out loud: 'I will help you, and I will not let anyone get hurt.'", "5m": "Choose one repeated conflict and decide how to explain the expectation in simple words.", "15m": "Discuss one rule and a proportionate response with your child, then check that they understand." }, "guides": [ { "title": "Attention, activity, emotions, and behaviour (undated)", "publisher": "Berkshire Healthcare NHS Foundation Trust", "url": "https://www.berkshirehealthcare.nhs.uk/advice/adhd-and-autism/attention-activity-emotions-and-behaviour", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent" }, "boosts": [ { "when": { "focus_any": [ "impulsivity", "relationships" ] }, "delta": 12, "reason": "NICE recommends clear and appropriate behaviour rules for children with ADHD." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "paperwork-next-action", "canonical_url": "https://adhd100.jock.pl/paperwork-next-action/", "rank": 85, "title": "Give paperwork a next action", "summary": "Split what needs doing from what only needs keeping, so a pile doesn't turn into a hidden task list.", "why": "The adult ADHD CBT skills description includes organising papers and bills, and NHS ADHD advice recommends simple filing and regular admin time. Those recommendations target trouble with managing multiple steps, but a paper system has no separate proven effect on ADHD symptoms. A small processing routine lets you see whether fewer important actions vanish into the pile.", "how": [ "Keep one place where new paperwork lands.", "Take one document and decide: act on it, keep it, or get rid of it.", "Put any action and deadline in the task list or calendar you already use.", "File it in a simple labelled place, and stop after a batch you can manage." ], "category": "Admin", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD clinical guidance and programme content; the isolated strategy has no separately rated efficacy estimate." }, "impact": { "score": 41, "headline_stat": "Use simple filing and regular admin time", "stat_source": 0 }, "sources": [ { "title": "Autism and ADHD", "publisher": "BYTES Primary Care Network, NHS", "year": 2026, "url": "https://www.bytespcn.nhs.uk/autism-and-adhd/", "tier": 1 }, { "title": "Description and Demonstration of CBT for ADHD in Adults", "publisher": "Cognitive and Behavioral Practice", "year": 2010, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3874265/", "tier": 2 }, { "title": "Making Sense: A Guide to Living with Adult ADHD", "publisher": "Nottinghamshire Healthcare NHS Trust (PDF hosted by Leicestershire Partnership NHS Trust)", "year": 2013, "url": "https://leicspart.nhs.uk/wp-content/uploads/2022/12/Making-Sense-of-Adult-ADHD-booklet.pdf", "tier": 1 } ], "practice": { "examples": [ "A renewal letter becomes a dated task, with the letter kept in a known folder.", "A receipt that needs keeping is filed without being left among unpaid bills." ], "pitfalls": [ "Sorting folders takes the place of the urgent action. Write down the deadline before you file.", "You take on every old pile at once. Start with a small batch of current papers." ], "do": { "1m": "Pick one paper lying around that needs an action, not more sorting.", "5m": "Process one document: name the action, record any deadline and decide where the paper belongs.", "15m": "Work through a small batch using the same action, keep or dispose decisions.", "30m": "Clear current incoming papers and make only the simple folders you actually need.", "plan": { "title": "Keep current papers moving", "steps": [ "Establish one incoming place.", "Process a small batch into actions or storage.", "Repeat at a regular cue and simplify unused folders." ] } }, "guides": [ { "title": "Autism and ADHD", "publisher": "BYTES Primary Care Network, NHS", "url": "https://www.bytespcn.nhs.uk/autism-and-adhd/", "kind": "guide", "lang": "en" }, { "title": "Making Sense: A Guide to Living with Adult ADHD", "publisher": "Nottinghamshire Healthcare NHS Trust (PDF hosted by Leicestershire Partnership NHS Trust)", "url": "https://leicspart.nhs.uk/wp-content/uploads/2022/12/Making-Sense-of-Adult-ADHD-booklet.pdf", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "organisation", "money" ] }, "delta": 10, "reason": "Simple filing separates stored papers from unfinished actions." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "park-distracting-thoughts", "canonical_url": "https://adhd100.jock.pl/park-distracting-thoughts/", "rank": 86, "title": "Park distractions for later", "summary": "Hold on to a useful thought without letting it pull you off the task you chose.", "why": "A side thought can drag you into a different job before the current one is done. Writing it down and coming back to it later is taught as distractibility delay in adult ADHD CBT. In the cited evidence, the technique has not been tested apart from the wider treatment programme.", "how": [ "Keep a small note next to the task.", "When an idea that isn't urgent shows up, write a few words.", "Go back to the task until the stopping point you planned.", "Read the note then, and decide what actually needs doing." ], "category": "Attention", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD clinical guidance and programme content; the isolated strategy has no separately rated efficacy estimate." }, "impact": { "score": 41, "headline_stat": "Keep a notebook for ideas to revisit later", "stat_source": 0 }, "sources": [ { "title": "Education (ADHD: while you wait)", "publisher": "Leicestershire Partnership NHS Trust", "year": 2026, "url": "https://www.leicspart.nhs.uk/while-you-wait/adhd/education/", "tier": 1 }, { "title": "Description and Demonstration of CBT for ADHD in Adults", "publisher": "Cognitive and Behavioral Practice", "year": 2010, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3874265/", "tier": 2 } ], "practice": { "examples": [ "Note 'check train tickets' while writing, then return to your paragraph.", "Capture a new project idea without opening another browser tab." ], "pitfalls": [ "Writing a detailed plan can become the distraction. Capture a short cue and stop.", "Don't park urgent safety needs. This is only for thoughts that can wait." ], "do": { "1m": "Run it in your head: a side thought turns up, you give it a short label, you go back to the task.", "5m": "Start a short task with a place to capture side thoughts in a few words.", "15m": "Try one focus block, then review the distraction note at the end.", "30m": "Use the note through a work and break cycle and keep only the entries that still need action.", "plan": { "title": "Practise returning", "steps": [ "Put a capture note beside one task.", "Record side thoughts briefly during a work block.", "Review them at the stopping point and schedule only what matters." ] } }, "guides": [ { "title": "Education (ADHD: while you wait)", "publisher": "Leicestershire Partnership NHS Trust", "url": "https://www.leicspart.nhs.uk/while-you-wait/adhd/education/", "kind": "guide", "lang": "en" }, { "title": "Autism and ADHD", "publisher": "BYTES Primary Care Network, NHS", "url": "https://www.bytespcn.nhs.uk/autism-and-adhd/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 16 }, "boosts": [ { "when": { "focus_any": [ "attention", "work", "school" ] }, "delta": 10, "reason": "Brief notes let you return to the current task." }, { "when": { "student": true }, "delta": 5, "reason": "NHS ADHD study advice recommends this for students." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "respond-with-self-compassion", "canonical_url": "https://adhd100.jock.pl/respond-with-self-compassion/", "rank": 87, "title": "Answer self-criticism with kindness", "summary": "When 'lazy' pops into your head, describe what really happened and answer yourself the way you'd answer a friend.", "why": "Across 30 trials, mostly outside ADHD, self-compassion programmes reduced stress at the end of treatment, SMD 0.43, but most trials had a high risk of bias and there was no clear advantage over active alternatives. It matters with ADHD because procrastination and trouble finishing tasks are common in adults with ADHD, and easy to mislabel as laziness. NHS self-esteem guidance suggests checking harsh beliefs against evidence and talking to yourself as you would to a friend. The one-minute version is a manageable start, not a proven ADHD treatment.", "how": [ "Notice a harsh label like 'lazy' or 'useless', and don't scold yourself for having it.", "Say what actually happened, plus one fact that doesn't fit the label.", "Give yourself the reply you'd give a friend. Then name one support or repair you need." ], "category": "Self esteem", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "General-population and mixed clinical RCT meta-analysis with high overall risk of bias; NHS self-esteem guidance; NIMH for ADHD relevance. No GRADE rating or ADHD-specific effect." }, "impact": { "score": 40, "headline_stat": "Self-compassion programmes, mostly outside ADHD: small to medium drop in stress (SMD 0.43)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.43, "unit": "SMD", "outcome": "stress reduction after self-compassion programmes, not a brief exercise", "comparison": "vs mixed active and passive controls; mostly not ADHD", "stat_source": 0 }, "sources": [ { "title": "Effects of Self-Compassion Interventions on Reducing Depressive Symptoms, Anxiety, and Stress: A Meta-Analysis", "publisher": "Mindfulness", "year": 2023, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10239723/", "tier": 2 }, { "title": "Raising low self-esteem", "publisher": "NHS", "year": 2023, "url": "https://www.nhs.uk/mental-health/self-help/tips-and-support/raise-low-self-esteem/", "tier": 1 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 }, { "title": "A Quick Guide to Self-Compassion", "publisher": "Newcastle upon Tyne Hospitals NHS Foundation Trust", "year": 2022, "url": "https://staffsocial.newcastle-hospitals.nhs.uk/wp-content/uploads/2022/02/Self-compassion-guide-A4_v2.pdf", "tier": 1 } ], "caution": "Persistent worthlessness, hopelessness or thoughts of self-harm deserve prompt professional support.", "practice": { "examples": [ "After delaying a task: 'I find starting hard. Calling myself lazy will not tell me what support I need.'", "'I missed a message' is fairer than 'I am a bad friend', and still leaves room to apologise." ], "pitfalls": [ "Forced positivity can feel false, so choose a fair and believable sentence.", "Kindness does not erase the effect on others, so pair it with a repair where one is needed." ], "do": { "1m": "Say it silently: 'This is a hard moment. What would I say to someone I care about?'", "5m": "Write one harsh belief about yourself and one concrete fact that challenges it.", "15m": "Read the NHS self-esteem guide and write a kind, balanced reply to one criticism that keeps coming back." }, "guides": [ { "title": "Raising low self-esteem", "publisher": "NHS", "url": "https://www.nhs.uk/mental-health/self-help/tips-and-support/raise-low-self-esteem/", "kind": "guide", "lang": "en" }, { "title": "A Quick Guide to Self-Compassion", "publisher": "Newcastle upon Tyne Hospitals NHS Foundation Trust", "url": "https://staffsocial.newcastle-hospitals.nhs.uk/wp-content/uploads/2022/02/Self-compassion-guide-A4_v2.pdf", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "emotions" ] }, "delta": 12, "reason": "Procrastination and trouble finishing tasks are common in adults with ADHD." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "weekly-planning-check", "canonical_url": "https://adhd100.jock.pl/weekly-planning-check/", "rank": 88, "title": "Review the coming week", "summary": "Spot a deadline while there's still time to get ready for it.", "why": "A short review brings what's coming back into view. NHS ADHD advice includes weekly planning, and Solanto's adult trial tested a broader time management and organisation programme over 12 weeks. That trial does not establish a separate benefit for a weekly review.", "how": [ "Pick a time you can repeat for a quick look at your calendar and tasks.", "Look ahead for appointments, deadlines and anything to prepare.", "Pick a next action you can manage for the most important commitment.", "Move or drop plans that don't fit any more." ], "category": "Planning", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD clinical guidance and programme content; the isolated strategy has no separately rated efficacy estimate." }, "impact": { "score": 40, "headline_stat": "Weekly planning and daily catch-ups can help", "stat_source": 0 }, "sources": [ { "title": "Making Sense: A Guide to Living with Adult ADHD", "publisher": "Nottinghamshire Healthcare NHS Trust (PDF hosted by Leicestershire Partnership NHS Trust)", "year": 2013, "url": "https://leicspart.nhs.uk/wp-content/uploads/2022/12/Making-Sense-of-Adult-ADHD-booklet.pdf", "tier": 1 }, { "title": "Efficacy of meta-cognitive therapy for adult ADHD", "publisher": "American Journal of Psychiatry", "year": 2010, "url": "https://pubmed.ncbi.nlm.nih.gov/20231319/", "tier": 2 } ], "practice": { "examples": [ "Notice the school form deadline and find the document before the final evening.", "Check travel details for next week's appointment while you have time to ask for help." ], "pitfalls": [ "Turning the review into a full life redesign makes it hard to repeat. Stick to the coming week.", "A missed review doesn't mean you owe a catch-up ritual. Restart with the next few days." ], "do": { "1m": "Pick a regular slot in your week for a short look ahead.", "5m": "Check the next few calendar entries and identify one preparation task.", "15m": "Review the coming week, select important next actions and remove a plan that no longer fits.", "30m": "Complete the weekly check and use the remaining time to start one preparation task.", "plan": { "title": "Keep the review small", "steps": [ "Check only the next few days.", "Add a task inbox check if that is manageable.", "Keep a weekly slot, shortening it when it becomes a barrier." ] } }, "guides": [ { "title": "Making Sense: A Guide to Living with Adult ADHD", "publisher": "Nottinghamshire Healthcare NHS Trust (PDF hosted by Leicestershire Partnership NHS Trust)", "url": "https://leicspart.nhs.uk/wp-content/uploads/2022/12/Making-Sense-of-Adult-ADHD-booklet.pdf", "kind": "guide", "lang": "en" }, { "title": "Tackling your to-do list", "publisher": "NHS Every Mind Matters", "url": "https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/self-help-cbt-techniques/tackling-your-to-do-list/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "organisation", "time" ] }, "delta": 10, "reason": "Looking ahead makes upcoming commitments visible." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "block-one-digital-detour", "canonical_url": "https://adhd100.jock.pl/block-one-digital-detour/", "rank": 89, "title": "Block one distracting digital route", "summary": "Put a small barrier between opening your work and sliding into an unrelated app or website.", "why": "In a general adult randomised trial, blocking all smartphone internet for two weeks, with calls and texts still working, improved sustained attention. Sticking with it was hard: only 119 of 467 people who agreed, 25.5%, kept the block on for most days, and the authors suggest less restrictive blocks may work better. NHS ADHD study advice recommends blocking apps for distracting sites, so a small, targeted block during one task is the practical version, and its ADHD-specific benefit is unmeasured.", "how": [ "Name the app or site that most often pulls you away from a task you chose.", "Use a built-in limit or blocker for a short, planned work period.", "Leave open the tools and contacts you actually need.", "See whether the barrier helped before adding more restrictions." ], "category": "Digital focus", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD-specific NHS study guidance recommends blockers; the measured trial is a general adult two-week full mobile internet block; no formal certainty rating." }, "impact": { "score": 39, "headline_stat": "Use apps that block distractions", "stat_source": 0 }, "sources": [ { "title": "Education (ADHD: while you wait)", "publisher": "Leicestershire Partnership NHS Trust", "year": 2026, "url": "https://www.leicspart.nhs.uk/while-you-wait/adhd/education/", "tier": 1 }, { "title": "Blocking mobile internet on smartphones improves sustained attention, mental health, and subjective well-being", "publisher": "PNAS Nexus", "year": 2025, "url": "https://pubmed.ncbi.nlm.nih.gov/39967678/", "tier": 2 }, { "title": "ADHD in adults", "publisher": "NHS", "year": 2025, "url": "https://www.nhs.uk/conditions/adhd-adults/", "tier": 1 } ], "practice": { "examples": [ "Block a shopping site while you submit a work form.", "Limit a distracting feed during a planned study period, leaving course resources available." ], "pitfalls": [ "Block everything and the task becomes impossible. Allow the resources you need.", "Getting around a limit feels like failing. Shorten the period, or block a more specific distraction." ], "do": { "1m": "Name the one app or website that most often breaks into a task you want to finish.", "5m": "Set one temporary limit using a tool you already have.", "15m": "Test that limit during one small task and note what still needs to stay accessible.", "plan": { "title": "Test a useful barrier", "steps": [ "Identify one recurring digital detour.", "Try a limited block during one task.", "Keep, adjust or remove the barrier based on what happened." ] } }, "guides": [ { "title": "Education (ADHD: while you wait)", "publisher": "Leicestershire Partnership NHS Trust", "url": "https://www.leicspart.nhs.uk/while-you-wait/adhd/education/", "kind": "guide", "lang": "en" }, { "title": "Disconnection", "publisher": "Oxford Health NHS Foundation Trust", "url": "https://oxfordhealth.nhs.uk/mindset/skills/concentration/disconnection/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 16 }, "boosts": [ { "when": { "focus_any": [ "attention", "work", "school" ] }, "delta": 10, "reason": "A targeted block reduces access to a recurring distraction." }, { "when": { "student": true }, "delta": 5, "reason": "NHS ADHD study advice recommends this for students." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "check-time-estimates", "canonical_url": "https://adhd100.jock.pl/check-time-estimates/", "rank": 90, "title": "Check how long tasks really take", "summary": "Time your own tasks, so the next plan is more realistic.", "why": "People with ADHD show timing differences in lab research, and NHS guidance suggests measuring everyday activities. Timing a familiar task gives you something to plan with, but this strategy's effect on lateness has not been established in isolation. A wrong estimate is useful data.", "how": [ "Pick one task you repeat, like getting out of the house.", "Guess how long it takes, then note when it starts and finishes.", "Count setup, finding things and switching over in the total.", "Plan the next attempt with what you saw, leaving room for it to vary." ], "category": "Time", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD clinical guidance and programme content; the isolated strategy has no separately rated efficacy estimate." }, "impact": { "score": 39, "headline_stat": "Time activities before making a daily schedule", "stat_source": 0 }, "sources": [ { "title": "Autism and ADHD", "publisher": "BYTES Primary Care Network, NHS", "year": 2026, "url": "https://www.bytespcn.nhs.uk/autism-and-adhd/", "tier": 1 }, { "title": "Time-Perception Deficits in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis", "publisher": "Developmental Neuropsychology", "year": 2024, "url": "https://pubmed.ncbi.nlm.nih.gov/38145491/", "tier": 2 } ], "practice": { "examples": [ "Include finding shoes and locking the door when timing your departure.", "Measure reading and replying to an email, not only typing the reply." ], "pitfalls": [ "Timing everything is extra work. Start with one task you repeat.", "One unusually fast attempt is a shaky guide. Compare a few ordinary ones." ], "do": { "1m": "Pick one task you repeat and usually think will take less time than it does.", "5m": "Estimate and time a brief familiar task, including its setup.", "15m": "Compare an estimate with an observed task duration and update the next calendar slot.", "30m": "Observe one routine from preparation to finish and identify the overlooked transition.", "plan": { "title": "Replace a guess with useful data", "steps": [ "Measure one familiar task.", "Check it on another ordinary day.", "Plan using the observed range and leave some room." ] } }, "guides": [ { "title": "Autism and ADHD", "publisher": "BYTES Primary Care Network, NHS", "url": "https://www.bytespcn.nhs.uk/autism-and-adhd/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "time" ] }, "delta": 10, "reason": "Observed durations give you information for time planning." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "request-child-organisational-training", "canonical_url": "https://adhd100.jock.pl/request-child-organisational-training/", "rank": 91, "title": "Ask for organisational skills training", "summary": "A structured programme may help your child cope with school, but how much it helps is uncertain.", "why": "Organisational skills training teaches a child to plan and manage school materials, with support from trained staff. EBI found teacher-rated academic performance 0.311 SMD better, with very low certainty, so even that small benefit is uncertain. It covers the short term, about 12 weeks or to trial endpoint, not lasting academic gains, and it tested a structured programme, not handing a child a planner.", "how": [ "Raise a structured organisational skills programme with the school psychologist, counsellor or ADHD team.", "Describe where school falls apart so staff can judge whether it fits.", "Ask who runs the training and how they help your child practise.", "Agree with school staff how progress and burden will be reviewed." ], "category": "Therapy", "domain": "treatment-care", "effort": "medium", "evidence": { "grade": "C", "certainty": "very_low", "adhd_specific": true, "basis": "EBI re-estimation: 11 studies, 929 young people; very low certainty for the academic outcome", "ebi": { "intervention": "Organizational skills interventions", "age": "youth", "outcome": "Academic/job performance", "rater": "teacher-rated", "timepoint": "short" } }, "impact": { "score": 39, "headline_stat": "Very low certainty: small gain in teacher-rated school performance (SMD 0.311)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.311, "unit": "SMD", "outcome": "teacher-rated academic performance improvement in youth", "comparison": "vs passive control", "stat_source": 0, "ci_lo": 0.174, "ci_hi": 0.448, "n_studies": 11, "n": 929 }, "sources": [ { "title": "EBI-ADHD: companion data to Gosling et al., BMJ 2025, commit 86eff22a9ffb", "publisher": "BMJ / Gosling et al.", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "ADHD in the Classroom", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/treatment/classroom.html", "tier": 1 } ], "caution": "Ask about a trained, structured service before paying for any programme. It should fit alongside teaching and the rest of your child's ADHD care.", "practice": { "examples": [ "Ask the school counsellor who can run a structured skills programme.", "Bring a teacher's description of recurring missing work to the planning meeting." ], "pitfalls": [ "A planner on its own is not the treatment that was tested. Ask about the teaching, feedback and support.", "Extra tasks can pile on. Ask staff to keep the first goal small enough to manage." ], "do": { "1m": "Write down one way school organisation goes wrong for your child, to raise with trained staff.", "5m": "Draft a message asking the school about structured organisational skills training.", "15m": "List the main school difficulties, and your questions about staff training, time and review.", "plan": { "title": "Assess whether the programme fits", "steps": [ "Describe the school problem to the support team.", "Ask about a trained programme and agree one goal.", "Review progress and workload with the child and staff." ] } }, "guides": [ { "title": "ADHD in the Classroom", "publisher": "CDC", "url": "https://www.cdc.gov/adhd/treatment/classroom.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 6, "age_max": 17 }, "boosts": [ { "when": { "focus_any": [ "organisation", "school", "time" ] }, "delta": 8, "reason": "The programme targets planning and organisation needed for school." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "child-homework-materials-routine", "canonical_url": "https://adhd100.jock.pl/child-homework-materials-routine/", "rank": 92, "title": "Build a homework packing routine", "summary": "Help your child practise a short, visible routine for getting homework materials ready.", "why": "The EBI re-analysis found organisational skills programmes gave young people a small benefit in academic performance, 0.311 SMD, with very low certainty. Teachers did the rating and it was short term, around 12 weeks, so durable benefit is not established. These were multi-part programmes, so a home packing routine on its own cannot be credited with their effect. CDC recommends routines, organisation and manageable steps for children with ADHD, which you can adapt with your child.", "how": [ "Pick one problem that keeps coming back, like finding materials or handing in finished work.", "With your child, give the essential materials one consistent place.", "Practise a short sequence: check what's needed, gather it, put it in the bag.", "Use a visible prompt and notice when a step gets done. If the routine doesn't fit, change it together." ], "category": "Organisation", "domain": "daily-systems", "effort": "medium", "evidence": { "grade": "C", "certainty": "very_low", "adhd_specific": true, "basis": "EBI-ADHD 2025: teacher-rated academic performance, youth, short term, 11 studies and 929 participants; routine-only benefit is unmeasured.", "ebi": { "intervention": "Organizational skills interventions", "age": "youth", "outcome": "Academic/job performance", "rater": "teacher-rated", "timepoint": "short" } }, "impact": { "score": 38, "headline_stat": "Full organisational skills programmes: small school gain, very low certainty (SMD 0.311)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.311, "unit": "SMD", "outcome": "teacher-rated academic performance after a full organisational skills programme", "comparison": "full skills programmes vs control conditions, youth", "stat_source": 0, "ci_lo": 0.174, "ci_hi": 0.448, "n_studies": 11, "n": 929 }, "sources": [ { "title": "Benefits and harms of ADHD interventions: re-estimated meta-analysis dataset", "publisher": "Gosling and colleagues, BMJ 2025, EBI-ADHD", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/UR_ADHD_analysis.xlsx", "tier": 1 }, { "title": "Treatment of ADHD", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/treatment/index.html", "tier": 1 }, { "title": "Education (ADHD: while you wait)", "publisher": "Leicestershire Partnership NHS Trust", "year": 2026, "url": "https://www.leicspart.nhs.uk/while-you-wait/adhd/education/", "tier": 1 } ], "practice": { "examples": [ "A child checks a short materials list before closing the school bag.", "Completed work goes in one agreed folder that is checked during packing." ], "pitfalls": [ "A parent builds a complicated system alone. Pick the smallest useful routine with your child.", "A missing item becomes a judgement on your child's character. Change the cue or the storage place instead." ], "do": { "1m": "Name the homework-materials problem you and your child most want to make easier.", "5m": "Agree one place for the materials needed for the next homework task.", "15m": "Practise gathering and packing the materials together using a short visible list.", "30m": "Try the routine with a real task and remove steps that add effort without helping.", "plan": { "title": "Practise one materials routine", "steps": [ "Choose one recurring materials problem together.", "Give the needed items a home and practise the sequence.", "Review which prompt helps and simplify the rest." ] } }, "guides": [ { "title": "Treatment of ADHD", "publisher": "CDC", "url": "https://www.cdc.gov/adhd/treatment/index.html", "kind": "guide", "lang": "en" }, { "title": "Education (ADHD: while you wait)", "publisher": "Leicestershire Partnership NHS Trust", "url": "https://www.leicspart.nhs.uk/while-you-wait/adhd/education/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 6, "age_max": 17 }, "boosts": [ { "when": { "focus_any": [ "organisation", "school" ] }, "delta": 10, "reason": "The skills evidence concerns organisation and academic performance." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "morning-daylight", "canonical_url": "https://adhd100.jock.pl/morning-daylight/", "rank": 93, "title": "Get some morning daylight", "summary": "Get outside in the morning and let ordinary daylight nudge your sleep timing.", "why": "In general sleep guidance, morning daylight helps set the body clock. Trouble falling asleep is more common in adults with ADHD, so this is a reasonable low-cost habit to try. Ordinary outdoor light is not the same as prescribed bright-light therapy, and a reliable ADHD symptom benefit has not been established.", "how": [ "Find a safe chance to go outside in the morning.", "Start with however much daylight fits comfortably into your morning.", "If your sleep keeps running late, talk to a clinician instead of buying a treatment lamp on your own." ], "category": "Sleep", "domain": "body-health", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "General NHS circadian advice, with ADHD sleep association evidence; no rated trial evidence for this ordinary-daylight habit." }, "impact": { "score": 38, "headline_stat": "Spend 20 minutes outside each morning", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 20, "unit": "minutes", "outcome": "time outside each morning", "comparison": "general NHS London sleep advice, not an ADHD treatment effect", "stat_source": 0, "bound": "about" }, "sources": [ { "title": "Sleep", "publisher": "NHS MyHealth London", "year": 2026, "url": "https://www.myhealthlondon.nhs.uk/be-healthier/healthy-lifestyle/sleep/", "tier": 1 }, { "title": "Sleep in adults with ADHD: Systematic review and meta-analysis of subjective and objective studies", "publisher": "Neuroscience and Biobehavioral Reviews", "year": 2018, "url": "https://pubmed.ncbi.nlm.nih.gov/29477617/", "tier": 2 } ], "caution": "This means normal daylight, not looking at the sun or using a light therapy device.", "practice": { "examples": [ "Sit outside briefly after getting up if that is accessible.", "Take an ordinary morning walk when weather and mobility allow." ], "pitfalls": [ "A light box is a separate treatment. Ask a clinician before using one for a sleep disorder.", "Bad weather doesn't have to break a streak. Use the next safe chance." ], "do": { "1m": "Pick one safe spot outdoors you could get to soon after waking.", "5m": "If daylight and conditions allow, spend a few comfortable minutes outside.", "15m": "Try a short morning outing at a pace and duration that suit you." }, "guides": [ { "title": "Sleep", "publisher": "NHS MyHealth London", "url": "https://www.myhealthlondon.nhs.uk/be-healthier/healthy-lifestyle/sleep/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "sleep" ] }, "delta": 10, "reason": "Sleep difficulties make this directly relevant." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "small-task-reward", "canonical_url": "https://adhd100.jock.pl/small-task-reward/", "rank": 94, "title": "Pair a small task with a reward", "summary": "Make the next small step worth noticing, without punishing the ones you miss.", "why": "NHS ADHD guidance suggests splitting a task into smaller parts and giving yourself a short reward after each, and CDC recommends achievable goals, praise and rewards for children with ADHD. That backs a practical way to make a defined step worth doing, not proof that a reward app or points system treats ADHD. Try a modest reward for a small step, and judge it by whether starting gets easier.", "how": [ "Pick one small task step where you can see it's done.", "Choose a modest, affordable reward or something pleasant to do, in advance.", "Give yourself the reward when that agreed step is done.", "If the step keeps getting missed, make it smaller or change the cue, instead of adding punishment." ], "category": "Task starts", "domain": "daily-systems", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": true, "basis": "ADHD-specific NHS and CDC guidance; no rated trial of a standalone self-reward routine." }, "impact": { "score": 38, "headline_stat": "Reward yourself after each small part", "stat_source": 1 }, "sources": [ { "title": "Treatment of ADHD", "publisher": "CDC", "year": 2026, "url": "https://www.cdc.gov/adhd/treatment/index.html", "tier": 1 }, { "title": "Motivation", "publisher": "Oxford Health NHS Foundation Trust", "year": 2025, "url": "https://oxfordhealth.nhs.uk/mindset/skills/motivation/", "tier": 1 }, { "title": "Tackling your to-do list", "publisher": "NHS Every Mind Matters", "year": 2026, "url": "https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/self-help-cbt-techniques/tackling-your-to-do-list/", "tier": 1 } ], "practice": { "examples": [ "After submitting a form, choose a short enjoyable activity.", "Praise a child for putting completed work in the agreed folder." ], "pitfalls": [ "Only a perfect day earns anything. Count the small agreed step.", "The reward gets expensive or hard to stop. Pick something small with a clear end." ], "do": { "1m": "Pick one tiny task step and something pleasant and affordable to follow it.", "5m": "Write the step and its reward, keeping the finish point clear.", "15m": "Try one small step, acknowledge finishing it and use the reward you chose.", "plan": { "title": "Make starting worth noticing", "steps": [ "Pick one achievable action.", "Pair completion with a modest reward or specific praise.", "Adjust the action or reward if it does not help." ] } }, "guides": [ { "title": "Motivation", "publisher": "Oxford Health NHS Foundation Trust", "url": "https://oxfordhealth.nhs.uk/mindset/skills/motivation/", "kind": "guide", "lang": "en" }, { "title": "Tackling your to-do list", "publisher": "NHS Every Mind Matters", "url": "https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/self-help-cbt-techniques/tackling-your-to-do-list/", "kind": "guide", "lang": "en" }, { "title": "Treatment of ADHD", "publisher": "CDC", "url": "https://www.cdc.gov/adhd/treatment/index.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": {}, "boosts": [ { "when": { "focus_any": [ "attention", "organisation" ] }, "delta": 10, "reason": "An achievable goal makes the rewarded action clear." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "cycle-symptom-discussion", "canonical_url": "https://adhd100.jock.pl/cycle-symptom-discussion/", "rank": 95, "title": "Bring cycle patterns to your clinician", "summary": "Keep a simple symptom record to talk through changes around your period.", "why": "A 2025 review of 11 studies, 4 on the menstrual cycle, suggests ADHD symptoms may vary across the cycle, but the studies were few, small and varied. General NHS advice recommends recording premenstrual symptoms across at least two cycles to inform an appointment. Tracking can help a conversation, but no reliable ADHD benefit or standard medication adjustment can be promised from the current hormone evidence.", "how": [ "If you notice a pattern, jot down period timing, sleep, concentration and any physical or mood symptoms.", "Take the record to a clinician when the symptoms affect your daily life.", "Ask what else could explain the changes, and whether you need further assessment." ], "category": "Hormones", "domain": "body-health", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "Small, heterogeneous ADHD hormone studies and general NHS symptom-diary guidance; no formal GRADE rating or tracking-treatment trial." }, "impact": { "score": 36, "headline_stat": "Record premenstrual symptoms for at least 2 menstrual cycles", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 2, "unit": "menstrual cycles", "outcome": "duration of premenstrual symptom recording", "comparison": "general PMS assessment guidance", "stat_source": 0, "bound": "at_least" }, "sources": [ { "title": "PMS (premenstrual syndrome)", "publisher": "NHS", "year": 2024, "url": "https://www.nhs.uk/conditions/pre-menstrual-syndrome/", "tier": 1 }, { "title": "ADHD and Sex Hormones in Females: A Systematic Review", "publisher": "Journal of Attention Disorders", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12145478/", "tier": 2 } ], "caution": "Do not use cycle timing to change medicines yourself. Seek help for severe symptoms without waiting to finish a diary.", "practice": { "examples": [ "Note that concentration and sleep seem worse before your period, with the dates.", "Bring cramps, bleeding or mood changes into the same clinical discussion." ], "pitfalls": [ "One hard week can't show a hormonal cause. Look for a pattern that repeats.", "A symptom diary doesn't set a medication plan. Treatment decisions stay with the prescriber." ], "do": { "1m": "Ask yourself whether the changes you want to raise seem to line up with your period.", "5m": "Make a brief note of today's symptoms and where you are in your cycle, if known.", "15m": "Prepare questions for a clinician using any cycle and symptom information you already have.", "plan": { "title": "Record enough to discuss", "steps": [ "Choose a few symptoms that affect daily life.", "Make brief entries across cycles when feasible.", "Bring the pattern, including exceptions, to the appointment." ] } }, "guides": [ { "title": "PMS (premenstrual syndrome)", "publisher": "NHS", "url": "https://www.nhs.uk/conditions/pre-menstrual-syndrome/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "sex": "female", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "attention", "sleep", "emotions" ] }, "delta": 5, "reason": "These symptoms may fluctuate with the menstrual cycle." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "breathe-through-stress", "canonical_url": "https://adhd100.jock.pl/breathe-through-stress/", "rank": 96, "title": "Practise gentle calming breaths", "summary": "When stress builds, comfortable breathing is one small thing you can try.", "why": "General NHS stress guidance recommends gentle, regular breathing without forcing it. The ADHD link comes from evidence of greater emotional regulation difficulties in adults, not from an ADHD breathing-treatment trial. It may help you settle in the moment. There is no reliable ADHD-specific estimate of how much.", "how": [ "Sit, stand or lie however feels comfortable.", "Keep your breath gentle. Count slowly only if that helps.", "Practise at calmer times, so the exercise feels familiar when stress hits." ], "category": "Stress", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "General NHS practical guidance with ADHD observational relevance; no ADHD-specific breathing intervention estimate." }, "impact": { "score": 35, "headline_stat": "NHS breathing exercise: practise for at least 5 minutes", "stat_source": 0 }, "effect": { "kind": "guideline_amount", "value": 5, "unit": "minutes", "outcome": "suggested duration of the NHS breathing exercise", "comparison": "practice guidance, not an ADHD treatment effect", "stat_source": 0, "bound": "at_least" }, "sources": [ { "title": "Breathing exercises for stress", "publisher": "NHS", "year": 2026, "url": "https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/breathing-exercises-for-stress/", "tier": 1 }, { "title": "Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis", "publisher": "BMC Psychiatry", "year": 2020, "url": "https://link.springer.com/article/10.1186/s12888-020-2442-7", "tier": 2 }, { "title": "Get help with stress", "publisher": "NHS", "year": 2026, "url": "https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/stress/", "tier": 1 } ], "caution": "Do not assume new chest pain, faintness or severe breathlessness is stress. Seek medical help.", "practice": { "examples": [ "Sit back in your chair and let your breath move without forcing it.", "Skip counting if the count itself makes you tense." ], "pitfalls": [ "Breathing too deeply or too quickly may feel unpleasant. Keep it gentle, and stop if you feel dizzy.", "A breathing exercise cannot remove every stressor, so also seek help with the pressure itself." ], "do": { "1m": "Get comfortable and just notice how you're breathing, without changing it.", "5m": "Follow the NHS breathing exercise gently, counting only if comfortable; stop if you feel worse.", "15m": "Read the guide, practise for five comfortable minutes and identify a calm time to practise again." }, "guides": [ { "title": "Breathing exercises for stress", "publisher": "NHS", "url": "https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/breathing-exercises-for-stress/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "emotions" ] }, "delta": 12, "reason": "Adults with ADHD have elevated emotional regulation difficulties." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "check-the-meaning-of-rejection", "canonical_url": "https://adhd100.jock.pl/check-the-meaning-of-rejection/", "rank": 97, "title": "Check a hurtful message before replying", "summary": "Take the hurt of rejection seriously, and check what the other person actually meant.", "why": "ADHD research supports greater difficulty regulating emotions, and an NHS children's service lists rejection sensitivity among ADHD characteristics. The same service notes that rejection sensitive dysphoria is a popular term, not a separate diagnosis in the UK. Checking an ambiguous message is general relationship advice. It has no established ADHD-specific treatment effect.", "how": [ "Notice the hurt, and pause before you reply.", "Separate what was actually said or done from what you read into it.", "When it's safe, ask them what they meant. If fear of rejection keeps limiting your life, get support." ], "category": "Emotions", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "C", "certainty": "not_rated", "adhd_specific": false, "basis": "ADHD emotional-dysregulation research supplies relevance; general communication guidance supports clarification, not an RSD treatment claim." }, "impact": { "score": 35, "headline_stat": "RSD is not given as a separate diagnosis in the UK", "stat_source": 0 }, "sources": [ { "title": "ADHD: supporting relationships (undated)", "publisher": "Norfolk and Waveney Children and Young People's Health Services, NHS", "year": 2026, "url": "https://www.justonenorfolk.nhs.uk/nd-digital-library/understanding-neurodiversity/adhd/", "tier": 1 }, { "title": "Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis", "publisher": "BMC Psychiatry", "year": 2020, "url": "https://link.springer.com/article/10.1186/s12888-020-2442-7", "tier": 2 }, { "title": "Maintaining healthy relationships and mental wellbeing (undated)", "publisher": "NHS Every Mind Matters", "year": 2026, "url": "https://www.nhs.uk/every-mind-matters/lifes-challenges/maintaining-healthy-relationships-and-mental-wellbeing/", "tier": 1 }, { "title": "ADHD in Adults: 4 Things to Know", "publisher": "NIMH", "year": 2024, "url": "https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know", "tier": 1 } ], "caution": "Do not use an RSD label to diagnose yourself or excuse another person's abuse. Seek help for severe or persistent distress.", "practice": { "examples": [ "A short reply may feel rejecting; ask whether the person is busy before assuming they are angry.", "'When you said that, did you mean you were unhappy with me, or with the plan?'" ], "pitfalls": [ "Calling every painful interaction RSD can miss real mistreatment, so attend to the actual behaviour.", "Repeated reassurance may not settle persistent fear, so seek support if it keeps disrupting relationships." ], "do": { "1m": "Pick an ambiguous comment from memory. Split the words you heard from the meaning you added.", "5m": "Draft one calm clarification question without sending it while highly upset.", "15m": "Read the NHS communication guide and discuss one misunderstanding with the person if it feels safe." }, "guides": [ { "title": "Maintaining healthy relationships and mental wellbeing (undated)", "publisher": "NHS Every Mind Matters", "url": "https://www.nhs.uk/every-mind-matters/lifes-challenges/maintaining-healthy-relationships-and-mental-wellbeing/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "emotions", "relationships" ] }, "delta": 12, "reason": "Adults with ADHD can have greater emotional regulation difficulties." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "try-mindfulness-gently", "canonical_url": "https://adhd100.jock.pl/try-mindfulness-gently/", "rank": 98, "title": "Try mindfulness gently", "summary": "Try a short attention practice, without expecting it to cure ADHD.", "why": "Full mindfulness programmes showed a large short-term improvement in adults' self-rated ADHD symptoms, SMD 0.928, but certainty was very low. The estimate came from small trials near 12 weeks; it does not establish lasting benefit or the effect of a brief exercise. The emotional-dysregulation result was inconclusive, so feeling calmer is something to notice rather than a promised outcome.", "how": [ "Get comfortable and notice a sound, or your breath as it is.", "When your attention drifts, notice it and gently come back.", "Give a brief practice a go before deciding if it suits you. Stop if it increases distress." ], "category": "Mindfulness", "domain": "mind-relationships", "effort": "medium", "evidence": { "grade": "C", "certainty": "very_low", "adhd_specific": true, "basis": "EBI re-estimation: 4 adult trials, 264 participants; self-rated core symptoms at short-term endpoint, not a one-minute practice.", "ebi": { "intervention": "Mindfulness", "age": "adult", "outcome": "Core ADHD symptoms", "rater": "self-rated", "timepoint": "short" } }, "impact": { "score": 35, "headline_stat": "Very low certainty: large short-term gain in adults' self-rated symptoms (SMD 0.928)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.928, "unit": "SMD", "outcome": "adult self-rated core ADHD symptoms after full mindfulness programmes", "comparison": "vs passive controls, including waitlist", "stat_source": 0, "ci_lo": 0.423, "ci_hi": 1.433, "n_studies": 4, "n": 264 }, "sources": [ { "title": "EBI-ADHD umbrella review: re-estimated dataset, commit 86eff22a9ffb", "publisher": "Gosling et al., BMJ accompanying open data", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ, full text via PMC", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "Mindfulness", "publisher": "NHS", "year": 2026, "url": "https://www.nhs.uk/mental-health/self-help/tips-and-support/mindfulness/", "tier": 1 } ], "caution": "Mindfulness is not helpful for everyone. Stop if it worsens distress, and discuss persistent symptoms with a clinician.", "practice": { "examples": [ "Notice the sounds around you while sitting comfortably.", "Notice that your mind has wandered and return to the sensation of breathing." ], "pitfalls": [ "Trying to empty your mind sets a target you don't need. Practise noticing and coming back instead.", "A missed practice does not cancel earlier attempts, so resume only if it is useful to you." ], "do": { "1m": "Listen for a nearby sound or feel your natural breath. When your mind wanders, bring it back gently.", "5m": "Try a short seated practice from the NHS guide, keeping your eyes open if you prefer.", "15m": "Read the NHS mindfulness guide, try a brief exercise and notice whether it feels helpful or distressing." }, "guides": [ { "title": "Mindfulness", "publisher": "NHS", "url": "https://www.nhs.uk/mental-health/self-help/tips-and-support/mindfulness/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "self", "age_min": 18 }, "boosts": [ { "when": { "focus_any": [ "attention" ] }, "delta": 12, "reason": "Adult ADHD trials measured self-rated ADHD symptoms, with very low certainty." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "omega-three-expectations", "canonical_url": "https://adhd100.jock.pl/omega-three-expectations/", "rank": 99, "title": "Check omega 3 claims before buying", "summary": "Before paying for a supplement for your child's ADHD, talk through the evidence and the safety.", "why": "EBI-ADHD found an almost zero estimated benefit from polyunsaturated fatty acids on parent-rated symptoms at about 26 weeks: SMD 0.049, with a 95% confidence interval from -0.101 to 0.198. Certainty was low, and the interval includes no benefit. The Cochrane review rated it high certainty that these supplements had no effect on parent-rated total symptoms in the medium term, SMD -0.08. So this evidence does not support promising that omega 3 supplements will improve your child's ADHD.", "how": [ "Ask which ADHD outcome the supplement claim rests on, and how certain the result is.", "Bring any supplements already used to a pharmacist or clinician review.", "Talk about nutrition separately from promises to treat ADHD." ], "category": "Supplements", "domain": "body-health", "effort": "medium", "evidence": { "grade": "B", "certainty": "low", "adhd_specific": true, "basis": "EBI-ADHD re-estimation: 15 trials, 963 young people, parent-rated core symptoms at medium-term follow-up.", "ebi": { "intervention": "Polyunsaturated fatty acids", "age": "youth", "outcome": "Core ADHD symptoms", "rater": "parent-rated", "timepoint": "medium" } }, "impact": { "score": 32, "headline_stat": "Low certainty: omega 3 barely differs from placebo on symptoms at about 26 weeks (SMD 0.049)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.049, "unit": "SMD", "outcome": "parent-rated core ADHD symptom difference at about 26 weeks", "comparison": "polyunsaturated fatty acids vs placebo", "stat_source": 0, "ci_lo": -0.101, "ci_hi": 0.198, "n_studies": 15, "n": 963 }, "sources": [ { "title": "Supplementary materials for EBI-ADHD", "publisher": "Gosling et al., EBI-ADHD team (BMJ 2025 supplement)", "year": 2025, "url": "https://corentinjgosling.github.io/EBI-ADHD-UR-2025/", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "Polyunsaturated fatty acids (PUFA) supplements for attention deficit hyperactivity disorder (ADHD) in children and adolescents", "publisher": "Cochrane", "year": 2023, "url": "https://www.cochrane.org/evidence/CD007986_polyunsaturated-fatty-acids-pufa-supplements-attention-deficit-hyperactivity-disorder-adhd-children", "tier": 1 }, { "title": "Medication Safety and Your Health", "publisher": "CDC", "year": 2024, "url": "https://www.cdc.gov/medication-safety/about/index.html", "tier": 1 } ], "caution": "Discuss supplements with a clinician or pharmacist, especially alongside medicines. This is an evidence review, not a recommendation to self-treat.", "practice": { "examples": [ "Ask a pharmacist to review a supplement already in your child's cupboard.", "Compare an advert's promise with the review's finding that a meaningful symptom benefit is not established." ], "pitfalls": [ "A tiny average estimate is no guarantee of improvement. Check the uncertainty as well as the headline.", "Supplement safety depends on the whole medicine list, so include non-prescription products in a review." ], "do": { "1m": "Write down exactly what improvement you'd expect before paying for an ADHD supplement.", "5m": "List the supplements and medicines you want a pharmacist to review.", "15m": "Read the Cochrane summary and prepare questions about likely benefit, cost and safety." }, "guides": [ { "title": "Medication Safety and Your Health", "publisher": "CDC", "url": "https://www.cdc.gov/medication-safety/about/index.html", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent", "age_min": 6, "age_max": 17 }, "boosts": [] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } }, { "id": "practise-friendship-without-promises", "canonical_url": "https://adhd100.jock.pl/practise-friendship-without-promises/", "rank": 100, "title": "Practise friendship without pressure", "summary": "Pick one social situation your child wants help with, and keep expectations realistic.", "why": "NHS guidance suggests rehearsing conversations through role-play and supporting friendships. EBI found only a small short-term effect on social communication from social skills training near 12 weeks, SMD 0.253, with very low certainty. The medium-term estimate came from 2 small trials and was too uncertain to show an effect. A brief rehearsal at home has not been shown to deliver what the programme did.", "how": [ "Ask your child which social situation they'd like help with.", "Rehearse one simple exchange together, like joining a game or asking a question.", "Look for enjoyment and your child's own goals, not a change of personality." ], "category": "Friendships", "domain": "mind-relationships", "effort": "low", "evidence": { "grade": "C", "certainty": "very_low", "adhd_specific": true, "basis": "EBI re-estimation of youth social skills trials; practical rehearsal is an extrapolation, not a tested substitute for a programme.", "ebi": { "intervention": "Social skill training", "age": "youth", "outcome": "Social-communication skills", "rater": null, "timepoint": "short" } }, "impact": { "score": 32, "headline_stat": "Very low certainty: small short-term gain in social skills from full programmes (SMD 0.253)", "stat_source": 0 }, "effect": { "kind": "smd", "value": 0.253, "unit": "SMD", "outcome": "youth social-communication skills after full social skills programmes", "comparison": "vs passive controls, including waitlist", "stat_source": 0, "ci_lo": 0.022, "ci_hi": 0.483, "n_studies": 5, "n": 270 }, "sources": [ { "title": "EBI-ADHD umbrella review: re-estimated dataset, commit 86eff22a9ffb", "publisher": "Gosling et al., BMJ accompanying open data", "year": 2025, "url": "https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv", "tier": 1 }, { "title": "Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making", "publisher": "BMJ, full text via PMC", "year": 2025, "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/", "tier": 1 }, { "title": "ADHD: supporting relationships (undated)", "publisher": "Norfolk and Waveney Children and Young People's Health Services, NHS", "year": 2026, "url": "https://www.justonenorfolk.nhs.uk/nd-digital-library/understanding-neurodiversity/adhd/", "tier": 1 } ], "caution": "Do not promise that social skills training will reliably improve ADHD or friendships; the evidence is very uncertain.", "practice": { "examples": [ "Practise asking, 'Can I join the next round?' if your child wants to.", "Take turns asking about a shared interest and listening to the answer." ], "pitfalls": [ "Practising without the child's interest can feel corrective, so let them choose the goal.", "Bullying is not a social-skills failure, so involve responsible adults if a child is being targeted." ], "do": { "1m": "Try one gentle question: 'Is there a friendship situation you want help with?'", "5m": "Rehearse one short exchange with your child, if they want to.", "15m": "Discuss a recent social situation, practise one option and ask whether it feels useful to your child." }, "guides": [ { "title": "ADHD: supporting relationships (undated)", "publisher": "Norfolk and Waveney Children and Young People's Health Services, NHS", "url": "https://www.justonenorfolk.nhs.uk/nd-digital-library/understanding-neurodiversity/adhd/", "kind": "guide", "lang": "en" } ] }, "personalization": { "applies": { "who": "parent" }, "boosts": [ { "when": { "focus_any": [ "relationships", "school" ] }, "delta": 12, "reason": "Friendship and conversational difficulties can affect young people with ADHD." } ] }, "dates": { "first_published": "2026-09-29", "evidence_checked": "2026-09-29" } } ] }