Dr John Flett Paediatrician

Dr John Flett Paediatrician 25+ years as a specialist paediatrician. Special Interest in ADHD, autism, learning & school difficulties, anxiety & mood.

Developmental care & general paediatrics. Info here is for patients of Dr Flett only.

The cup was the wrong colour. And now he's on the floor of someone else's lounge.It's a fourth birthday party. Twelve ch...
03/08/2026

The cup was the wrong colour. And now he's on the floor of someone else's lounge.

It's a fourth birthday party. Twelve children sit down for the cake. Eleven stay put. Yours has already been over the couch, into the dog's water and halfway up the security gate. Then the meltdown — full volume — because the cup was green, not blue.

Here's what's actually happening in that little head.

Every toddler's brakes are still soft. Like the brakes on a small bicycle, they engage late and grab gently — that's normal at three. But a small child heading towards ADHD has brakes that engage even later, even softer. That's the brain's pause button: the tiny gap between "think it" and "do it". In these children, it runs behind.

The 30% Rule helps here too. Take roughly a third off his age, and his self-control suddenly makes sense. A four-year-old body, carrying closer to a toddler's brakes.

He's not being naughty. His timing is different.

One thing to try today: give a calm five-minute warning before every change — leaving the park, starting the bath, coming to supper. You're not spoiling him. You're lending him the brakes he hasn't built yet.

What's the transition that reliably blows up in your house? 👇

He's not getting worse. The scaffolding came down."He coped beautifully at junior school. Then Grade 8 arrived and withi...
02/08/2026

He's not getting worse. The scaffolding came down.

"He coped beautifully at junior school. Then Grade 8 arrived and within two terms I didn't recognise him."

I hear this sentence every single week. And the parents always ask the same thing: what went wrong?

Nothing went wrong with your child. Something went wrong with the fit between him and his world.

Junior school was doing enormous invisible work — one teacher, one room, same-day tasks, a tap on the desk when he drifted. That's scaffolding. A bright child with ADHD stands on it beautifully.

Then high school removes every piece at once. Eight teachers, eight rooms, deadlines three weeks out, and a brain that only knows NOW and NOT NOW. It doesn't test intelligence nearly as much as it tests organisation — and organisation is precisely the thing his brain does last.

This is why the brightest children often fall furthest. They compensated longest, so nobody built them any systems. When the compensation runs out, there's nothing underneath.

If you're watching this happen right now — you're not imagining it. And it's fixable.

031 1000 474 | [email protected]
drflett.com | courses.drflett.com | guidelittleminds.com

"Everyone said I was overreacting. I'd been right since he was two."To the mum who's been quietly wondering since her ch...
01/08/2026

"Everyone said I was overreacting. I'd been right since he was two."

To the mum who's been quietly wondering since her child was small:

A mother said something like this in my rooms recently, half-apologising for even coming. Everyone had told her to give it time. To stop worrying. That he was just a busy boy.

Then she described two years of watching. The meals never finished. The danger that never registered. The meltdowns other people's children didn't seem to have. She knew the pattern long before she had a word for it.

She wasn't overreacting. She was paying attention. There's a difference, and it matters.

If that's you — trust the watching. You know your child better than the birthday-party aunt, better than the well-meaning stranger in the car park. Spotting it early isn't panicking. It's parenting.

And whatever the answer turns out to be, a child whose mother pays that kind of attention is already a fortunate child.

What did you notice long before anyone else believed you? 💛

— Dr John Flett

A mum came to see me with a folder. Two online ADHD checklists, both printed out, both scored high. She had her argument...
31/07/2026

A mum came to see me with a folder. Two online ADHD checklists, both printed out, both scored high. She had her argument ready before she'd sat down, in that flat voice parents use when they're expecting to be dismissed.

She was right that something was wrong. She'd been right for two years.

But her boy had tonsils you could see from the corridor. He slept with his mouth open, and when she lay next to him and counted, she counted eleven pauses in his breathing in a single night. His hearing had never been checked after four ear infections. And underneath all of that — yes — he did have a real attention difficulty.

Start at the attention and you spend six months treating an exhausted child. Exhausted children improve at exactly the rate you'd expect, which is not at all, and then everybody quietly decides that nothing works.

A ten-question attention checklist cannot see tonsils.

So the free screening I've built asks about eleven areas instead of one: attention, activity and impulses, feelings and worries, language and play, movement and the senses, sleep and feeding, developmental and medical history, family history, daily life across six settings, what your child is brilliant at, and the short list of things that need a doctor today rather than an emailed result.

Ages three to six. About twenty minutes. Free. Link in the comments.

📞 031 1000 474 · [email protected]

courses.drflett.com · drflett.com



First comment:

The screening is here — free, ages 3 to 6, about twenty minutes: https://courses.drflett.com/can-you-spot-adhd-before-school-even-starts/

"Let's wait and see" sounds kind. Sometimes it's the most expensive advice a small child ever gets.A mum sat across from...
30/07/2026

"Let's wait and see" sounds kind. Sometimes it's the most expensive advice a small child ever gets.

A mum sat across from me recently with her bright, exhausting four-year-old — half-apologising for coming. "We didn't want to label him. Everyone said give it time, he'll settle when big school starts."

He'd never sat through a meal. Transitions ended in tears. He'd bolted into a car park twice, with no sense of the danger. And Dad, she mentioned almost in passing, "was exactly the same — bright, but never finished a thing."

She wasn't overreacting. She'd been reading the pattern accurately for two years — and being told to ignore it.

Here's what "wait and see" actually costs. The pre-school years are when a child builds his first idea of who he is. Wait too long, and he arrives in Grade 1 already collecting the words "naughty" and "too much". You can't un-hear those at five.

And here's the part that changes everything: you don't need the label to start the help. One instruction at a time, not three. A five-minute warning before every change. Protected, boring, consistent sleep. Structure is love, not punishment — and for little ones, it is the treatment.

This week on the blog: the before-school clues worth noting, why family history is clinical gold, and how to ask for a developmental review without anyone reaching for a prescription.

Read it here ▸ https://courses.drflett.com/can-you-spot-adhd-before-school-even-starts/

What did "wait and see" cost — or save — in your house? 👇

There is a brown ring on the ceiling of my consulting room. Two years ago it was the size of a coin, and I said the six ...
27/07/2026

There is a brown ring on the ceiling of my consulting room. Two years ago it was the size of a coin, and I said the six most expensive words in the English language.

I'll keep an eye on it.

I did not keep an eye on it. Nobody ever does. That is the thing about keeping an eye on something — it isn't a plan, it's a way of feeling like you've made a decision without making one.

We do exactly the same with children. Only 2 to 6% of children with ADHD are picked up before their fourth birthday. More than half wait until somewhere between twelve and seventeen. Girls wait longest of all.

And a decade of waiting is made of something. It's made of school reports that say "could do better if he applied himself". It's made of a boy who slowly stops putting his hand up, because putting his hand up has stopped going well.

So I've built something to stop the waiting. A free whole-child screening for children aged three to six — eleven areas rather than one, about twenty minutes, and a plain-language summary by email. I read every one that comes in.

It's a screening tool, not a diagnosis, and it never will be one. What it does is turn "I have a feeling something isn't right" into something specific enough for a doctor to work with.

Free · ages 3 to 6 · link in the comments

📞 031 1000 474 · [email protected]

courses.drflett.com · drflett.com



Start here — it's free and takes about twenty minutes: https://courses.drflett.com/can-you-spot-adhd-before-school-even-starts/

"Ag, he's just a busy boy. All boys are like that."It's the sentence I hear most from parents of little ones — usually d...
26/07/2026

"Ag, he's just a busy boy. All boys are like that."

It's the sentence I hear most from parents of little ones — usually delivered by a well-meaning aunt while your four-year-old scales the couch for the third time.

And sometimes it's true. Toddlers are busy. That's the job.

But here's the myth I want to gently take apart: the idea that ADHD arrives on the first day of school.

It doesn't. ADHD is a difference in how the brain is wired — and that wiring is there long before anyone writes it down. School doesn't cause it. School is simply the first place that demands the exact skills an ADHD brain finds hardest: sitting, waiting, queuing, listening in a group of thirty.

So while a firm diagnosis is genuinely difficult before four or five, the pattern is often visible much earlier. The child who sits noticeably further from "busy" than every other busy child in the room. The family where Dad "was exactly the same at that age."

That last clue carries more weight than most people realise. ADHD runs strongly through families — it's one of the most heritable conditions in all of childhood.

"Busy boy" might be right. But if you've been quietly wondering since he was two, you're allowed to keep wondering out loud.

Were you told "he's just busy" — and what did your gut say? 👇

Nobody claps for the mum who kept bedtime the same all winter. So I will.Nobody sees the checklist that went back on the...
25/07/2026

Nobody claps for the mum who kept bedtime the same all winter. So I will.

Nobody sees the checklist that went back on the fridge, or the twenty quiet minutes at the homework table, or the email sent to the teacher in week one instead of week eight.

It does not look like much. It certainly does not look heroic.

But I have watched hundreds of ADHD school years unfold from my consulting room, and I can tell you exactly what heroism looks like in July. It looks boring. Same bedtime. Same routine. Same calm voice at the door: "Snack's on the counter. We'll chat later."

Structure is love, not punishment. Your child's brain is wired to lean on the scaffolding you build — and every unremarkable, repeated evening is you holding that scaffolding up in the cold, when nobody is watching and the January energy is long gone.

If that is you this week: I see it. It counts. It may be the single most important thing anyone does for your child this year.

What is the one small routine you are defending this term, even when it is hard? 👇

— Dr John Flett

Two families. Same class, same diagnosis. By November, worlds apart. The difference was not effort — it was timing.I thi...
23/07/2026

Two families. Same class, same diagnosis. By November, worlds apart. The difference was not effort — it was timing.

I think of them as the tortoise and the hare.

The hare family relaxed everything in Term 3 — late nights, routines "when we get to it", homework battles avoided rather than solved. Then Term 4 arrived and they sprinted: emergency tutors, crash revision, tears at midnight.

The tortoise family did nothing dramatic. Same bedtime every night. Twenty minutes of homework at the same table, at the same time. One short email to the teacher each Friday.

Boring. Repetitive. Slow. And their son walked into November exams calm, rested and prepared, while a brilliant classmate walked in running on fumes.

The hare is not lazy or unloving — just tired and hopeful, betting that intensity later can replace consistency now. For an ADHD brain, that bet almost never pays off, because these brains are built on external structure. Remove it, and you remove the scaffolding mid-construction.

I have written the full guide to the Third Term Trap: why the first three weeks back decide the year, the truth about the after-school crash, and the five small moves tortoise families make — including how to restart routines and open the teacher channel in week one:

👉 https://courses.drflett.com/the-third-term-trap/

Address

8 Village Road, The Assessment Centre
Kloof
3610

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Thursday 08:00 - 16:30
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