Hallowell and Ratey stress the importance of creating a “stellar” environment, noting that one’s environment can impact their gene expression—”In lay terms, that means how you live is a determinant of whether or not you get a disease to which you are genetically predisposed” (77). They reflect on how major shifts in environment, such as becoming a patient, can trigger ADHD symptoms. While they acknowledge that not all environmental factors can be controlled, the authors identify five main areas that readers should consider—structure, diet, sleep, positivity, and help.

First, the authors recommend establishing a daily structure, which may not come naturally to those with ADHD or VAST. This can involve creating a to-do list and a schedule, for which there are several helpful resources including planners and apps. They also recommend setting reminders and planning rewards. For people managing a child’s daily structure, the authors suggest readers balance daily structure and a clear chain of command with scheduled free time. They also caution people against relying too heavily on technology, which can become addictive—”beware the rabbit hole of Internet and social media browsing!” (80). The text then lists characteristics of healthy home, learning, and work environments.