In this episode of In the Field: The ABA Podcast, I sit down with Nicole Stewart, BCBA, to talk about what ADHD really looks like in kids and adults, and why it's so often overlooked in clinical work. Nicole brings over 15 years of experience in the field. She now runs a private practice offering therapy, parent coaching, and ADHD-focused training for organizations, after years of clinical work that included time at the New England Center for Children and as a clinical director. 

We get into Nicole's perspectives on what ADHD actually is on a neurobiological level, why it's so often masked or misdiagnosed (especially in girls), and why pairing and rapport, not bigger reinforcers, are usually the real lever for behavior change. We also talk about how organizations can build ADHD aware training and supervision systems for staff, not just clients.

Key Topics:

ADHD as a Neurobiological Difference, Not Just a Behavior Pattern: Why ADHD comes down to how the brain regulates dopamine, how that shapes prefrontal cortex and basal ganglia development, and why understanding the neurology changes how we individualize treatment.

Masking and Missed Diagnoses: Why girls with inattentive ADHD are so often overlooked when "behavioral contrast" between home and school leads to under-diagnosis, and what that masking actually costs kids emotionally.

Executive Functioning, Defined: Nicole breaks down executive functioning as "the CEO of the brain" and explains why a child's executive functioning age can lag years behind their chronological age, creating mismatched expectations.

Emotional Regulation and the Fight or Flight Connection: How a highly sensitive nervous system response can turn something small (a bump in the hallway) into a major escalation, and why teaching emotional recognition has to come before teaching coping skills.

Skill Deficit vs Performance Deficit: Why ADHD related "noncompliance" is so often misread as a skill issue or simple defiance when it's actually a performance deficit driven by interest, novelty, or response effort.

Pairing Over Bigger Reinforcers: Why a strong, conditioned relationship with the learner is the single most effective ADHD strategy Nicole has found, more impactful than denser reinforcement schedules or larger rewards.

Supporting Staff with ADHD, Not Just Clients: How clinical supervisors can apply universal design for learning to staff trainings, and why clear contingencies, written follow-ups, and flexible scheduling support BCBAs® and RBTs® who are themselves neurodivergent.

Key Takeaways:

• ADHD is a medical and neurobiological condition, not just a set of behaviors to extinguish.
• Masking can delay diagnosis, especially in girl, leaving real struggles invisible.
• Corrective feedback disproportionately affects kids with ADHD, often four to five times more than their peers, fueling shame and avoidance over time.
• Pairing and rapport outperform bigger reinforcers or denser schedules when working with ADHD learners.
• Universal design for learning benefits every learner and every staff member, not only those with ADHD.
• Skill deficits and performance deficits require different solutions, and ADHD often hides as the latter.
• Organizational training on ADHD, alongside autism and other comorbid diagnoses, improves individualization across the board.

Keywords:

ADHD, ABA and ADHD, Executive Functioning, Emotional Regulation, Skill Deficit vs Performance Deficit, Pairing, Universal Design for Learning, Masking in Girls, Neurodivergent Staff, BCBA® Supervision, RBT® Training, Nicole Stewart, Mom The Behaviorist, ADHD Coaching, Comorbid Diagnoses, ADHD in the Workplace

Connect with Nicole Stewart:

Website: nicolestewartbcba.com
Instagram: @mom_the_behaviorist
Podcast: Reinforcing Conversations
CEUs on ADHD: Search "Nicole Stewart" on BehaviorLive

Disclaimer:

BCBA®, BACB® [or any other BACB® trademark used] is/are registered to the Behavior Analytic Certification Board® BACB®. This website and products are not in any way sponsored by the BACB®.

All information and products are for educational purposes only.