ADHD and ABA with Nicole Stewart, BCBA

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. 

Transcript

[00:00:00] Nicole Stewart: But you wanna make sure that you are reaching every single learner because that way, like what I do for somebody with ADHD is going to also reach everybody else more effectively as well. So I think that that's a big piece when you're designing trainings. I also think having really clear contingencies helps people with ADHD.

Setting really clear expectations, having things in writing, having follow-ups, having follow-up notes.

Allyson Wharam: Welcome everyone. I am here with Nicole Stewart, BCBA, and today we're going to be talking about the work that she does with ADHD, both clinically with learners directly, but also the work that she's doing to help support other practitioners to do that work in organizations as well.

Welcome, Nicole. I'm so glad to have you.

Nicole Stewart: Yes. Thank you so much, Ally. I'm so happy to be here. I love your podcast. I love your business and everything you do, so I'm always excited to collaborate.

Allyson Wharam: Yeah, likewise. And I should mention, I just recorded with Christina individually as well, so that will be coming out [00:01:00] and then I just recorded with you all on your podcast, Reinforcing Conversations, so, a little plug for that too. That was, that was so fun.

Nicole Stewart: Oh, I know, so great. Little crossover.

Allyson Wharam: Yeah. Yeah, I know. I love a good crossover. So start off with telling us a little bit about your story. I'd love to hear how you came to do the work that you're doing right now.

Nicole Stewart: Yeah. So I think most, I don't know if most people have these stories, but I feel like a lot of my career is kind of a door opens and I'm like, "Yeah, that feels like a good door to step into."

Allyson Wharam: I can relate to that. Yeah

Nicole Stewart: So, you know, I started, I was in college and I was pre-med, so I'm like, you know, let's flash back.

Allyson Wharam: Also relatable.

Nicole Stewart: Oh, 2006. I'm probably wearing the same clothes I was wearing back then, 'cause the

Allyson Wharam: Yeah.

Nicole Stewart: Styles have all circled again. Um, not the exact same clothes, 'cause, you know life. But,

Allyson Wharam: Yeah.

Nicole Stewart: I was pre-med, I ordered my books for the MCATs. I was like all ready to go, and then I was like, "Oh my God, I don't know if I wanna be pre-med. I don't know [00:02:00] if I wanna be a doctor." And I think, like, we always figured I wanted to be a doc- my whole family was like, "Oh, she wants to be a doctor" because I'm like, I have like serious medical anxiety.

So I think we maybe have confused that with,

Allyson Wharam: Yeah

Nicole Stewart: an interest in medicine. But I have always been a science person, so, I was like, "I don't know if I wanna do this." I got the MCAT books. And then for my other major, so I majored in biology and public health, for my other major I had to do an internship. I went to a career fair and I found the New England Center for Children, and they did internships and I was like, "I like kids."

Like, I knew if I was gonna become a doctor I wanted to do something in pediatrics. So I was like, "I like kids. Let me go try this out. That seems cool." And I was like hooked. I was like, "Oh my God, this is it. This is what I wanna do." Like from day one, I was like, "This is so cool. It's like teaching, it's like science."

Um, New England Center for Children, for anybody listening, is an ABA [00:03:00] school up in Massachusetts. They also have partner classrooms all over New England and they have a center in Abu Dhabi as well, and they also have partner programs in other countries as well, so they're huge. They have residential day programs, preschool, daycare, in-home, early intervention, partner classrooms in public schools.

Their own curriculum. They do it all. And so like what a amazing place to start my career, to just like stumble into. And so I was there and then I worked there and then they were like, "Hey, so we offer discounted masters." And I was like, "That sounds cool. Sure." I, you know, another door opened.

Walked through the door, got a master's in special ed and severe special needs, and then my now ex-husband got into social work school. We moved to New York City. I was a lead teacher. I worked in public schools also in Massachusetts for a little bit. So I had worked in residential, I worked in public schools, and then as a teacher.

And then I moved to New York City and [00:04:00] was a teacher in a private school and I stayed there for 11 years and I moved into becoming the clinical director of their sister behavioral clinic. And I got to a point where I was like I wanna keep learning and growing, and that doesn't necessarily mean watching this clinic grow and being supervising.

You know, I think in ABA, the career trajectory, right, is you're a technician. At that time it was not RBT, but you're a technician, and then you're a BCBA, and then maybe you're a supervising BCBA, and then a clinical director, and then a regional director. Like your trajectory is to go up the ladder and supervise more and more people.

And I was like, "I don't enjoy that. I'm really not enjoying supervising more and more people." I was good at it. I was really good at putting out fires. I was really good at building rapport with staff and parents. I was really good at systems, but I was so burnt out. I was like, "I don't wanna do this anymore.

I'm [00:05:00] getting further and further away from the stuff that I actually enjoy doing."

Allyson Wharam: Mm-hmm.

Nicole Stewart: So, and then COVID happened, and my divorce happened, and I was like, "I gotta do something different." And so I decided to leave there, and so I started seeing clients privately. And what I kind of learned was it's very hard to see clients privately for 10, 20, 30 hours a week.

It's a very high rate for everybody. But there are a lot of kids who have less severe needs who still need behavioral support that, you know, having worked in all these different settings and worked with lots of different providers, I was qualified to provide. And so I started working with kids with ADHD, with anxiety, who are not yet diagnosed, who are coming to me where the daycare is saying they have behavioral issues, or the school is saying they have behavioral issues, or at home their whole house revolves around the child's behavioral issues.

And so I started working in that space at the same time that my own son was kind of going through some of this on his own, and I'm trying to find a provider him. And I was like, "Oh my God, not only am I qualified to do this, [00:06:00] there's not enough of us doing this out there." And there's this whole other space in ABA that we're not well-serving, and that kids need services for.

And so I started working with kids who mostly have ADHD but may also have anxiety or be gifted or may not be diagnosed or may have autism, doing one hour a week, doing parent coaching, and then, you know, that's moved into... I've always done stuff with adult, like I've always done supervision, things like that.

So I've also done work with adults as well. So it's really just become, you know, this ADHD space and like helping people feel like the best version of themselves.

Allyson Wharam: Yeah, I can relate a lot to that on the parent side as well, hearing you talk about that 'cause that's been my experience. I have ADHD but my oldest is diagnosed with ADHD. I also have a five-year-old who, you know, it's genetic so, uh, the chance- chances are there. But when we were talking to the pediatrician about some of the concerns we had, we got referred [00:07:00] to outpatient OT.

I went to the consultation, we talked about it, and it wasn't really actually the fit for what we were trying to do, because a lot of the issues were around like routines and things at home. And so being able to have someone with our background, uh, 'cause it is different too when you're, you know, you're a mom or a parent, it's different than wearing your behavior analyst hat.

There's a lot of overlap, but it also, you know, you're so close to it, I think is, is the tricky part. So, I totally agree that there is just even from the parent perspective, a huge need in this area and then also hearing, I think a lot of folks can relate to what you're talking about in terms of that career progression where, you know, a lot of us fall in love with the science because we're doing that direct work and we're contacting those contingencies and we're seeing that like direct impact.

And for some folks their reinforcers are just y- you, you move too far away from that when you're kind of moving up that traditional sort of [00:08:00] ladder. So, yeah, I'm excited to kind of like peel back the layers and talk a little bit more about what that work looks like. Just to kind of set the stage for folks that, you know, may not be as familiar with ADHD, what that actually is, what that looks like, could you kind of give a summary of what ADHD is and what that looks like from both a behavioral and just sort of neurobiological perspective?

Nicole Stewart: So you know, neurobiologically, it really comes back to being a dopamine disorder, and dopamine is one of our neurotransmitters, which I feel like now I have to you know, define a word to define a word.

But the neurotransmitters are basically our chemical messengers, so they send messages between different parts of your brain or your central nervous system. And so dopamine is one, we have tons of neurotransmitters, uh, serotonin, norepinephrine, epinephrine- I think adrenaline is epinephrine, but you know, another word that people may be familiar with.

Even like acetylcholine, which is something that probably people haven't heard of that has to do [00:09:00] with your muscles, that's also considered a neurotransmitter.

Those send signals, and they all send different signals. They're all different messengers for different reasons. You know, you use FedEx for one reason and UPS for another reason. And so ADHD has mostly to do with your dopamine, and they don't really know if people with ADHD have a dopamine deficiency or we don't take in dopamine, like the receptors are not receiving dopamine properly.

But essentially, ADHD brains don't regulate dopamine well. And so if that happens from the start also, because your neurotransmitters also help your brain development, it actually changes how your brain develops. So people with ADHD, their brains develop differently, which can include your prefrontal cortex, which is where all of your executive functioning lies.

It can include your brain stem and your basal ganglia, which is like where all your emotional reactions and your impulses, your like animal brain, it's like down here, kind of lives. And all of that looks different. So they actually see an MRI, like functional MRIs and MRIs, that [00:10:00] ADHD brains light up differently, which is also, as a side note, very interesting because kids who take stimulants, they can actually change how your brain develops.

So if you take stimulants at a younger age, can actually alleviate symptoms in the longer term because it supports healthier brain development.

Allyson Wharam: I had heard a little bit about that because there's a lot of co-occurrences with substance abuse and things like that, that actually taking stimulants or some sort of medication earlier on actually serves as a bit of a protective factor. I can't remember the exact research or where I heard that, so don't quote me on it.

But I do remember reading that somewhere and thinking that that was really interesting. I'm wondering if it's a similar mechanism

Nicole Stewart: Yeah, exactly, 'cause it, it helps with your brain development, and so then your brain is less likely to seek out maladaptive coping mechanisms because you're kind of like supporting and scaffolding in the appropriate function and structure as opposed [00:11:00] to like later being like, "Oh, let's try to fix this quickly with like a quick,"

Allyson Wharam: Mm-hmm.

Nicole Stewart: you know, something that makes you numb or whatever. So that's kind of how it works neurobiologically. So like, and I think this is such an important thing because as behaviorists, we often look at like the behavioral piece and how it shows up, but it is neurobiological. So there is actually like in the same way that diabetes is that your pancreas doesn't make insulin properly, and we treat that as a medical diagnosis, it is a medical diagnosis.

Your body operates differently when you have ADHD than when you don't have ADHD. And I think that that's something that in ABA we don't do very well. I feel like we're like, "We see a behavior, we can change a behavior," but actually, yes, and there's also neurobiology that's going on that we need to understand.

And so the way that it shows up behaviorally, we have the three different classes of diagnoses, the inattentive, hyperactive, and combined, which is where you have symptoms from [00:12:00] both inattentive and hyperactive classes, a little spicy version. Which behaviors can range from daydreaming to poor working memory, where you see like kids who can't recall, you know, you'll be like, "Oh, how was your day?"

And they're like, "Fine," because they literally can't pull up... Their brain cannot pull up a single thing that happened in their day in that moment. But then they'll be the same, I feel like these are the same kids who'll be like, "Six Tuesdays ago, it was lightly drizzling, and you promised me mint chocolate chip ice cream."

And you're like, "Well, but you can't tell me who you sat with at lunch."

Allyson Wharam: Yes. Yeah, yeah. I can relate to that a little bit though. If someone asks me, like, "Recall, like, a random memory of X, Y, and Z," I'm like, "I have never experienced anything ever in my life." Like, I just like, you know, it's

Nicole Stewart: like, "I'm brand new."

Allyson Wharam: yeah, exactly. But then randomly, you know, like based on whatever stimuli, like I actually have a very, very good memory, but it's the kind of the SDs and recruiting that information.

Yeah. That's how it shows up in kids, but we're gonna talk about a little bit what that looks like [00:13:00] in like adults and how that can show up in the workplace too.

Nicole Stewart: Yeah and I feel like that's, like, exactly it. And a lot of people with ADHD also then report, like, I work with a lot of kids who will be like, "I have a bad memory," but yet, they could give you, like, a whole detail from when they were... Like even my son, who's seven, told me a whole story.

He was like, "You know my favorite vacation we went on?" Just randomly. He was like, "Was when we went to Cape May and we did this." He was two.

Allyson Wharam: Oh

Nicole Stewart: But, like, if I had been like, "What did we do in Cape May?" He would've been like, "I, I've, I've been to Cape May?" You know? And so, like, people often then get labeled as having a bad memory because they can't recall it.

You know on computers how you have, like, how fast you can pull things up on your computer versus how much you can store on it?

Allyson Wharam: Oh,

Nicole Stewart: People with ADHD can store a lot, but they can't pull it up very fast. And so I feel like the conditions have to be correct for you to be able to pull it up.

And I feel like that, people categorize that as having a poor memory, but it's actually the ability to pull that information out of your head when it's [00:14:00] necessary. So that's, like, a big thing I see a lot of. The emotional dysregulation I see a lot of. That's not officially in the DSM-V. Hopefully one day it'll be in some type of diagnostic criteria, because I think almost everybody I see with ADHD either has, like, really large emotions.

It's a sensory issue, where they either have, like, as soon as they experience an emotion, it's bigger than life. Or I also have kids who are, like, inattentive and happy as a clam and, like, experience no emotions and have, like, almost no emotional awareness, which is also not great. That's not going to be adaptive as they get older. And then I think you see a lot in girls behaviorally, they might behave, they might hold it all in at school, and I hear this so often, is that people will be like, "Well, they don't qualify for ADHD because they're perfectly behaved at school."

But, like, they're ruling the house, their emotions are ruling the house, they're falling apart. They can't do anything without 12 reminders at home. [00:15:00] They are angry at their parents all the time. They're exploding about things. They're super sensitive. They're holding it all, they're masking it all at school.

And so then, you know, you maybe do the Vanderbilt, which is the gold standard assessment, and the teacher says like, "Oh, they sit still, they do da da da," 'cause the kid's holding it all together. And I feel like that's also a problem, that behavioral contrast, I think in girls for me is a big red flag when parents are telling you this and then the teacher's like, "No, they're, they're great."

Like, I don't know. I feel like how many people listening were probably that girl?

Allyson Wharam: Oh yeah, for sure. And like with my kids it's the same. I'm like, "I'm glad, I'm so glad that they're like doing great at school." But like you see, it's like you can tell that they've been masking all day basically, that they're just like, "Okay, it's time to like let all my guards down."

Nicole Stewart: Yes. And they're, like, exhausted.

Allyson Wharam: Exhausted, yeah, absolutely.

Nicole Stewart: Yes. Yeah, I feel like ADHD shows up in a lot of different... And I'm still learning. Like, I feel like I still see different presentations, and I'm [00:16:00] still kind of learning. I think inattentive is my most curious one because I feel like the inattentive kids have a whole world in their heads that's just beautiful and wonderful

Allyson Wharam:Yeah. So my sister also has ADHD. She was diagnosed when we were younger because her symptoms I guess were like a little more obvious at the time. Mine I was still like very high achieving and so like by those external benchmarks I was doing great, so not really a problem.

Uh, I wasn't diagnosed until my late 20s. But one thing that was interesting to me, 'cause I hadn't really considered that I had it was learning more about like hyperactivity, especially in attentive type, 'cause I'm not like super energetic or anything like that, but hyperactivity can be more like internal, like your thoughts and things like that.

Allyson Wharam: And so like my brain is just like the internal dialogue is constant. And so I think that's something that like people don't realize either because especially with inattentive type, it can look like, you know, someone is not focused or someone is you know, whatever it is, or [00:17:00] low energy or, you know, so they, they can't have ADHD.

But really it's like an internal hyperactivity more than, than anything.

Nicole Stewart: Yes. And I think that that's what can be hard is because the symptoms are so variable that it's not always obvious, and then I feel like once I kind of realize like, "Ooh, you have ADHD going on," treatment needs to look a little bit different knowing how your brain operates.

Allyson Wharam: Mm-hmm.

Nicole Stewart: I feel like it does make a huge difference because I feel like no matter how it manifests behaviorally, that neurobiology is still similar.

Allyson Wharam: Yeah, and I, I do think too this is something that, like, the co-occurrence between autism and ADHD is so high, but we talk about autism quite a lot obviously in the field. And you know, I think a lot of us because of that have a good understanding of, you know, what autism looks like, how the criteria for that.

But even with the high rates of co-occurrence, I don't hear a lot of discussion [00:18:00] around ADHD. Has that been your experience as well in clinical settings?

Nicole Stewart: It has, and when I first started in the field, it was before the DSM-V had come out and people... If you had an autism diagnosis, you did not get any other type of diagnosis even. Like, they were like, "You have autism." So like, OCD-like symptoms, that's rigid behaviors. Inability to sit still, that's like lack of social skills.

Like, everything that could have be attributed to another diagnosis was just, "Nope, it's autism." And so I feel like even coming up in the field, I reflect back on my experience working with different types of kids, being like they had autism and. That this kid had autism and OCD, and this kid had autism and anxiety, and this kid had autism and ADHD.

But they all were classified as autism, and I feel like that was probably to their detriment even though, yes, ABA is individualized, but if you don't understand the neurology that's going on for each individual kid, that [00:19:00] individualization is much more trial and error, right?

Like, I feel like when you have some context clues, you can be like, "Okay, I know this is gonna work. I know this isn't gonna work." Like, I had a kid who had OCD, and he would become incredibly aggressive over trying to disrupt his compulsions, and I feel like once we acknowledged that that was actually not just autism and rigid behavior, but actually OCD and causing him significant distress, we were able to put some guar-guardrails in.

We're like, "You're allowed to have compulsions with your stuff," but not like he would want you to, like, literally if I was sitting here like this, I'd have to put my other arm here 'cause he wanted body to be symmetrical. So there we were like, "We're gonna have those battles and expose you to that because you can't be telling me what to do with my body,

Allyson Wharam: Mm-hmm.

Nicole Stewart: but you wanna go line up your toy?"

It's not just lining up toys. This is if he does not line up the toys, he is in significant distress. So, you know, we're gonna work on the ones that are impeding on your life and let you have some of the [00:20:00] compulsions that are not impeding on your life.

Like, that makes a huge difference in treatment, and I feel like it took a long time and a lot of aggressive behavior to get there, which is not healthy for him or for anybody else. So yeah. I do see, you know, that was a long time ago. I still see, and this is like what I feel like I'm trying to change and why I do trainings for organizations because I do a training, whether it's executive functioning or emotional regulation or just about ADHD, and people will be like, "I did not realize some of the things that I'm doing for my clients who have both diagnoses that are harmful for them." And I feel like that's... You don't know what you don't know.

Allyson Wharam: Yeah. Yeah, and you know you talked about it like diagnostically in terms of everything just kind of lumped into autism, but also clinically, like you were saying too, it's easy to just write those things off. And not to dismiss the neurobiological aspects of autism as well, and the complexities of that diagnosis, but obviously it becomes more complex when you add in those co-occurrences.

So [00:21:00] with that, you mentioned executive functioning and emotional regulation, which I wanna revisit. But also just some of the strategies. Well actually let's start with talking about executive functioning and emotional regulation and kind of operationalize those because I think those are also terms that are thrown around a little bit, but like

Nicole Stewart: They sure are.

Allyson Wharam: what do they mean?

How do we operationalize that? So could you define executive functioning and kind of how you think about that and talk about that behaviorally?

Nicole Stewart: Yeah. So I think of executive functioning, like the way that I boil it down the easiest way, is that it is the CEO of the brain. And so it is everything that allows you to have higher order thinking. And so that can be task initiation. There's so many different ways. Like, some people say you have five executive functions, some people say you have seven, some people say you have twelve.

There's, like, all these different ways to break them down. It encompasses, like, a whole bunch of different skills like initiation, working memory, cognitive flexibility, inhibition, planning, emotional regulation. I think a lot of times we think of executive functioning as [00:22:00] organization planning and task management.

It also is impulse control, and task persistence, and task initiation. All of those go into being able to execute higher level skills, whether it's, like, getting somewhere on time, or making a plan with friends, or driving. Like, all the skills that are required for driving like, managing distractions, not being impulsive, you know?

Imagine if you were just like, "Oh, I wanna get to where I'm going and I'm gonna run through a red light." Like, you have to have really good executive functioning to be a good driver. And so that's kinda like the big umbrella term, and that kind of is your higher level brain.

Your executive functioning doesn't fully develop until you are 25, and so people with ADHD have up to a three-year delay, which means that somebody, a child who is 10 may have the executive functioning of a seven-year-old. My son is gifted and has ADHD, so he has some skills where he's at the age-- he's [00:23:00] almost 12.

He has some skills where he's at the age of, like, a 15, 16 year old, and then other skills where he's at the age of a 6, 7, 8 year old, 9 year old. And those kids really can struggle because the expectations for them can feel really confusing, where, like, a lot of times we are like, "Oh," like he's always been the kind of kid, like, we used to joke 'cause he spoke really young.

We used to joke he could say, like, Shakespearean soliloquies when he was, like, 18 months old. But you expect more from him behaviorally when you can carry on conversations about politics with a three-year-old.

And then you're like, "Why are you freaking out about a sock?"

Allyson Wharam: Yeah. Yeah. I think that is definitely something that I see. And I see that a lot, like in my work in schools too. It's especially, you know, with supporting inclusion and things like that. It's almost easier in a lot of aspects to get buy-in from teachers for supporting students with really high support needs than getting that buy-in for those students who like on the surface [00:24:00] look like, or you know, are, are performing in a specific way.

Their expectations based on some things that they're seeing don't match developmentally some of the other skills. And so that can be a lot harder because I think people struggle with the contrast there and the differences.

Nicole Stewart: Yes, and kind of like, "Oh, I don't know if they really need it." And you're like, "Well, no, they do because , the only reason they're doing okay is 'cause they're holding it in in a maladaptive way." Like they're not creating sustainable coping skills. They're just trying to get through the day with you at this point, and that's not healthy and we need to come up with a better solution.

And I feel like there are a lot of teachers who just can't see what they can't... Again, like you don't know what you don't know. You can't see what you can't see. And it's also, I mean, teachers are spread way too thin as is, so I

Allyson Wharam: Yes. Yeah, not to dismiss that,

Nicole Stewart: yeah, I think it's also so hard.

Allyson Wharam: yeah, it is, it is. And having that variety of needs. So, emotional regulation is a part, like you said too, that I think people don't realize is an aspect of both executive [00:25:00] functioning and then a difficulty, especially with, you know, you have impulsivity and all of that that comes in with ADHD as well.

So talk to me a little bit about emotional regulation.

Nicole Stewart: Yeah. So, I mean, I feel like on the surface, emotional regulation is, like, the ability to be able to stay calm and persist through challenging emotions. I feel like people with ADHD often have these, like, big waves of emotions, and whether it's an impulsive thing or, you know, where they experience anger very quickly and very almost impulsively.

Like I have some clients that I work with where somebody can bump into them and that sets off almost like a fight or flight. This is something that I haven't looked into research about it yet, but something that I am noticing a lot of the clients that I work it's almost like their fight or flight alarm systems are very sensitive and, like, rigged to go off very quickly.

And so, it's like somebody bumps into them and their body interprets that as [00:26:00] danger, and so they go into anger or running away. I have a lot of kids who run out of classrooms and it's because your central nervous system takes over and that adrenaline kicks in, and maybe it has something to do with how your body processes dopamine.

Maybe kids with ADHD have too much adrenaline as a result of not enough dopamine. Who knows? Like, somebody scientific could study that better than I can. But that's like a quick impulse that happens in your body before you even process that you've been bumped into.

Allyson Wharam: Mm-hmm.

Nicole Stewart: Then it often gets worse in those instances because then people are like, "What are you doing? Like, why are you running out of the classroom? You're fine. He just bumped into you." So, then you build a lot of shame, and then it creates this cycle where now kids are worried, "I'm gonna go through this response again."

And so, it almost creates this hypervigilance or it creates the space where kids go into it quicker because they're already on edge. They're starting on [00:27:00] edge of like, "Oh God, if somebody bumps into me, I hope I don't freak out." Now I'm thinking about that, now I'm stuck on that. And so then they're more likely to freak out because they're already on edge.

And so there's that, and then there's also kids who maybe are just really sensitive. There's rejection sensitivity, so there's people who may internalize, and this is not everybody with ADHD. I feel like there's some people with ADHD who like are like, "Whatever, it's fine." And then there's others who internalize even neutral comments as negative.

And I see this a lot where, you know, I'll work with kids who have siblings, and they'll be like, "Well, mom went to, you know, my brother's basketball game because mom loves them more." And it's not even... No. Like, it's not even about you. And so it's teaching those kids a lot of those strategies of cognitive behavioral therapy of like, okay, what is the thought?

What are the behaviors around it? What are you doing? Like, how do we actually shift this so that when you have these thought patterns, you can shift it into healthier, [00:28:00] more adaptive ways. And I think like with younger kids, the emotional regulation, it has to start with emotional recognition. We are terrible, I think, as adults.

I think adults don't talk about feelings that much, and then we're like, "We don't know why he gets angry all the time." Or like, you know, "We don't know why he's..." Is he angry? Is he sad? I think, you know, like for something like my 12-year-old, every emotion looks like anger. For my eight-year-old, every emotion looks like sadness.

So he has to learn to be able to say like, "I'm not sad, I'm angry," or, "I'm disappointed," or, "I'm hurt." Kids have to learn to recognize what they're feeling, how it feels inside their body, and then identify a coping skill that helps them with that specific emotion. And I think that's another thing we often do is that we just throw coping skills at kids, right?

Like we'll be like, "Go to the calm corner. Here's a sensory bottle. Take deep breaths." But like, I don't know, what do you do when you're sad? Not to put you on the spot.

Allyson Wharam: Oh, what do I do? Well, this [00:29:00] is also like, okay, again, I've never had a thought, uh, ever in my mind. Um, no, no, no, it's okay. I definitely, I listen to music. It depends though. Like, sometimes I like over-process verbally with other people, and then other times I'm like, it's just all very internal.

But definitely like music. I don't know. I like to drive. I'm very like, uh, I like to spend time alone, but I also have three kids, so like that's also not really, uh, possible. But it's, um, but yeah, I think those are like my, my typical go-tos.

Nicole Stewart: Yeah. What do you do when you're angry?

Allyson Wharam: The same stuff. But I also, as an adult, like you, you talked about like difficulty articulating emotions and I, like I agree that like even as adult, like if, if you don't learn how to do that when you're really young, like it all feels the same. I also am like an overanalyzer. I remember one time, she was a PhD clinical psychologist at one of the ABA organizations I worked at [00:30:00] really early in my career, and there was a difficult situation with one of the clients, um, that was just really heavy and she was like, "Well, how do you feel about that?"

And I just like sat there and like just like re-explained the situation. I like said nothing about how I was actually feeling. She's like, "No, no, no, like how do you feel about that?" And I was like, it didn't occur to me that I could have

Nicole Stewart: Feelings about it?

Allyson Wharam: any of this. Like, let me just talk about what the situation is and, and explain it again.

Nicole Stewart: Yeah. Yeah, but you do have some feeling about it. That you're gonna feel some way about it, and your body is processing it in some way. And so it is, it's like learning how to identify all that. But it's interesting because most people do manage sadness and anger. Like, I feel like when I'm angry, I have to like yell or do something very kinetic

Allyson Wharam: Hmm

Nicole Stewart: like when I'm sad, I like to do...

Maybe like I lay in bed, or I cry, or I take a bath or, you know, I might call a friend. Even like if you call a friend for sadness versus anger, like sadness might just be like all self-pity talk

versus anger might be more like, "Why? How [00:31:00] dare they? Da, da, da, da." Like the talk is different.

You know, it's a different tone. There's a lot more curses when I'm angry.

Allyson Wharam: Yeah. No, for sure. And that really is probably where I'm like, eh, I either don't talk about it or I talk about it a lot. If I'm angry, I probably tend to talk about it a lot. I don't think I actually with sadness, like, that's more internal typically.

Nicole Stewart: Yeah. And then so like I think oftentimes we give to kids, we say like, "Here you go, have some sensory bottles, use a fidget, do this, take a walk." And like what they really need to learn is when my heart is racing, that means I'm angry, and when I'm angry, I need to go rip up paper or something to feel better, versus like when my hands feel heavy, that means I'm feeling sad and I need to go lay down for 10 minutes.

Like learning what actually helps them feel better based on those exact feelings and differentiating, being able to give it to them. Also, I think like ABA, we often have to be like, "Well, use your words." [00:32:00] Like we often, we have to give them access to it contingent on the feeling, not contingent on the request to start so that they can build that association and then you can eventually be like, "Okay, now you're old enough that you can let us know when you need it."

Allyson Wharam: Mm-hmm. Yeah, and it's so tricky with feelings too, because obviously it's like there's so much to those, like, private events where it's like I can guess you know, how you might be feeling based on this, or I can talk about what that looks like, but it requires so much internal tacting for them of how they're actually feeling and being able to discriminate that.

Again, it's, like, tricky even as an adult sometimes. And yeah, I think that that is a piece that sometimes we jump to. Like, here is just a coping strategy rather than really matching it to what is relevant to the function of what is actually going on for you. Are there any other strategies, doesn't have to be related to emotional regulation, but that you see underutilized with this population?[00:33:00]

Nicole Stewart: You know, that's a hard question. I think that it's more that it's using the strategies in the most effective way or almost like being very technological with how we use strategies, 'cause I think, like I told you before we hopped on here, but I put the questions that you sent me into AI, and it spit out, like, one of the questions you asked is about default ABA strategies that are more or less effective, and it spit out, like it's ineffective to use long reinforcement schedules and high repetition drill formats, and people with ADHD need shorter task intervals.

And I was like, "No, you're wrong, AI."

Allyson Wharam: Mm-hmm.

Nicole Stewart: It's just there's so much more nuance to that, and I just find that the number one strategy that I have found to be effective when somebody has ADHD is pairing, and to have a good relationship. If I am conditioned as a reinforcer, then anything else is much more likely to be effective.

We can use long reinforcement schedules. [00:34:00] We can do discrete trials. We can have challenging tasks. If a child does not want to work with me or does not have a positive relationship with their parents, none of it works is how I kind of feel. It's all less effective.

Everything we do is less effective. And so I think, like, that is the number one strategy that I use and I don't think I've ever done it intentionally. I feel like I've always just been like, "Well, I have to get kids to like me to learn from me." And I over time I've realized, like, oh, that's because I know that these kids are less likely to have behavioral problems and less likely to be oppositional and less likely to have behaviors that seek reinforcement in appropriate ways when we have a positive relationship.

Allyson Wharam: Mm-hmm. Yeah. And, you know, your response to that question is funny too, because I actually debated even putting it in there because I was like, that's also not really how behavior work. We don't just throw strategies at the wall. Like, you have ADHD, here's the strategy. But yeah, I wonder if there is anything that is more or less common.

But with that [00:35:00] being said, I think one thing that you were talking about earlier, and I was thinking about this. Again, I'm not well-versed on, on the research. This is more like my experience and then just like articles, uh, not journal articles, but just other things that I read related to ADHD.

Um, but I saw something related to the amount of corrective feedback by age, I don't even remember, it was like 12 or 18 or whatever. The amount of corrective feedback that someone with ADHD gets in childhood is completely disproportionate to the amount of corrective feedback that someone without ADHD tends to get.

Allyson Wharam: And again, I don't remember the exact numbers, but it was like according to this article, a pretty astronomical difference. And so hearing that and hearing you talk about, again, the emotional regulation, the, like, rejection sensitivity, the interpreting the external feedback in certain ways, I was thinking about it in the context of that, but also in the context of what you're talking about in terms of pairing, and then again, that that is so much more important and relevant because if that has been [00:36:00] someone's experience, is that so much of their interactions, not just with adults, but with peers also is correction or, like, you're doing too much, or I don't like that, or, you know, whatever it happens to be then yeah, it becomes even more important to have that strong rapport and trust that that's not gonna be the core of your relationship.

Nicole Stewart: Yes, 100%. I feel like that it's something, I think it's like four times as much corrective feedback or five times as much corrective feedback. And it's because, you know, you might have the same expectations. If somebody who has inattentive ADHD, let's say you have two children and you tell them both to go put their shoes on, your typically developing three-year-old maybe needs two reminders.

Your ADHD six-year-old maybe needs seven reminders. And so now they've been told more, I should've used cleaner numbers. Now they've been told more than twice as much to go get their shoes. You're probably getting exasperated. You're probably having some kind of tone, but they're struggling to do it [00:37:00] because maybe they got distracted by something else.

Maybe they struggle to get started with tasks. Maybe they finished something that they were enjoying doing, and they're experiencing a big feeling about that. Maybe they're hungry, and they're experi- you know, like there could be all these other internal events that are going on. Maybe they're realizing they have to pee, or you know, also oftentimes, like they might be low in dopamine in that moment, and so getting all of those corrections gives their brain some type of feedback and then creates that system where they're more likely to happen.

But like no kid enjoys getting told seven times to put their shoes on. Even if that becomes a pattern, that's not because that kid wants to be told seven times or wants to be dependent on you to put their shoes on in that type of way. They want to be able to put their shoes on more easily. I feel like there's very, you know, there's very few kids who are like, "Yeah, it's fine that you had to tell me seven times."

I feel like then that [00:38:00] becomes, "Why can't I do it? Why is it so hard? Why does mom always have to tell me? Mom's so mad at me. I can't do anything correctly." And then like now how many corrections are they getting from themself in their brain?

Allyson Wharam: Mm-hmm.

Nicole Stewart: Like, uh, I don't know. I feel like we should study that.

Allyson Wharam: Yeah. Yeah, the again, that hyperactivity and what is happening internally. Yeah. No, that's really interesting. I do wanna shift 'cause we're, like, getting closer to time and I wanna hear more about the work that you're doing with organizations. And then I also wanna talk a little bit about, like, how organizations could potentially support their staff with some of these things as well.

So in terms of that work, what are some common mistakes, and some of these are, might be things that we've already touched on, but what are some of the common mistakes that you see technicians or behavior analysts making when working with learners with ADHD?

Nicole Stewart: I think that it's the lack of individualization and the lack of recognition of ADHD as a reason to modify how you [00:39:00] implement programming. And so, you know, like let's say you have a kid who does have autism and ADHD and you're doing discrete trials and you're finding that they're shutting down, it's not necessarily like, "Oh, I need to have a denser schedule of reinforcement or more frequent tokens or a bigger reinforcer."

Maybe the task itself needs to be more enjoyable. Maybe the materials need to be more novel. Maybe you need to be switching up how you present things in a different way, which I think is hard in the tiered model of ABA because you can't change-- I feel like we get into discrete trials 'cause the materials are easier to prep, it's easier to give instructions to your technicians, things like that.

But sometimes it's just like the task itself, because ADHD is, has interest-based motivation, if the task itself is not interesting, no amount of external motivation is going to sustain a level of interest in that task long term. And I think like oftentimes when I see kids not mastering things, if a kid has ADHD, I often am like, "Do they not know it or are they not showing and I think that performance, [00:40:00] the skill deficit versus performance deficit is often unrecognized

Allyson Wharam: Yeah, absolutely. That's been my experience as well. And how, on the organizational level then, can organizations begin to build practices that are more ADHD aware into their training systems, their supervision systems, making sure that their clinicians are aware of this stuff rather than just relying on individual clinicians to figure this out?

Nicole Stewart: Well, I think the first step is get more training in ADHD because I think that's been a huge benefit to the organizations that I have worked with, where even just saying like when their BCBAs and their RBTs understand the needs of their clients better, then they are able to individualize better as well.

So I think that that's just a huge thing is like creating systems so that... And, and not just ADHD, OCD, anxiety, I think all comorbid disorders deserve additional training so that we can individualize. I just think ADHD is the biggest comorbid disorder that [00:41:00] kids with autism face, so I think it deserves like its own special spotlight, and I think is maybe the highest priority to start with 'cause you'll probably have the most kids who have autism and ADHD if you're working in more traditional models of ABA.

Um, and then I think it's also, even if you don't know, like maybe you don't know if a kid has ADHD or not, I also think, you know, when you're thinking about behavior intervention plans, it really is like thinking about the scaffolding and generalization and sustainability and that we're not just throwing more and more in, and that if something isn't working, may not be like, oh, we need a bigger...

Again, we don't necessarily need a bigger reinforcer. Maybe the contingencies aren't clear, or maybe this is somebody who needs visual feedback instead of verbal feedback. So I think that those are big pieces. I also think reducing the response effort because [00:42:00] the ADHD brain gets reinforced by being oppositional or by being defiant or by getting any type of negative attention, that is actually reinforcing, like it's, I guess it's automatically reinforcing in its own way.

And so if you can make those response efforts to engage in, instead of making it a fight to go take a break because you're engaging in aggressions, what are we gonna do so that you go take a break? You know? So that I'm not forcing you to take a break because that's in the behavior plan. Or I'm forcing you to say that you need to take a break before you can take a break.

Like, "Oh, it looks like you're feeling angry right now, I'm gonna give you a break." Like I feel like you have to give kids access to the terminal expectation to regulate themselves before you can expect them to ask for it or know that they need it. And I think oftentimes we focus a lot on the FCT piece because we don't wanna reinforce like, oh, if you engage in aggression and I give you a break, you escaped from the demand. [00:43:00] You know? But like, if you engage in aggression because you are dysregulated or because you're having an emotional issue or because this demand is too hard, aggression equals break, and then you can learn to ask, you can learn, we can back that up eventually.

Allyson Wharam: Mm-hmm. Yeah, so like contacting the reinforcer essentially to understand so that becomes more clear. Yeah. I also wonder if it would be valuable to folks, I recently recorded an episode with Steve Ward that talks about efficiency alternatives to just kind of blunt and in general looking at like the efficiencies of behavior response effort, things like that.

It's not ADHD specific, but I think it is something that's relevant to what you're talking about that I think would, you know, just apply across learners in general. One other kind of question that I have is around supporting staff as well. One thing I see people talk about sometimes is, you know, like we work with learners with developmental [00:44:00] disabilities and autism and ADHD but then when it comes to actually supporting staff in the workplace that have those same diagnoses and, you know, similar struggles related to those things, that there is not a lot of understanding on the staff side of things.

So, I'm not sure if this is something that you like really address in your work or not, so feel free to kind of direct me another way. But is there any way that you've found that organizations can better support their staff with ADHD as well?

Nicole Stewart: Yeah. So I do adult ADHD coaching, so I work with adults and that kind of came out of my experience being a BCBA supervisor and realizing that a lot of my trainees are likely neurodivergent and then having to teach them soft skills, executive functioning skills, time management skills, emotional regulation.

Like, you can't bring, you can't bring your breakup into a meeting with a parent. You can say like, "Hey, just so you know, I'm going through a personal thing, and so if I seem off, it has nothing to do with your child." But you can't show up cr- you know, like things like that, like, you know, bringing in some of that stuff.

So like a [00:45:00] lot of breaking down those skills and teaching those things. So I feel like I have like the one-on-one support. I haven't quite evolved into like how systems should look for ADHDers, if that makes sense. But I do think from a teacher perspective, universal design for learning is always going to be best when you're implementing training systems.

And so having trainings that are interactive, that are multi-sensory, that focus on what the interest of the audience is, are going to bring in your ADHDers who are, you know, if you're giving an all-staff presentation, just giving a lecture is not universal design for learning. You wanna make sure that you are presenting in a multi-sensory way and that you are in-- You're an instructional designer, so you know.

Preaching to the choir here. But you wanna make sure that you are reaching every single learner because that way, like what I do for somebody with ADHD is going to also reach everybody else more effectively as well. So I think that that's a big piece when you're designing trainings. I also think having really clear contingencies [00:46:00] helps people with ADHD.

Setting really clear expectations, having things in writing, having follow-ups, having follow-up notes, and I think a lot of times people assume, I've done a lot of work in supervision, I think a lot of times, again, people assume if staff are not performing, it's a skill deficit.

Or actually, you wanna know what? I think a lot of times with adults, I'm gonna reverse that. I think a lot of times with adults, we assume it's a performance deficit. I think we assume adults are making a choice not to do something, that adults are like, "Oh, well, that person doesn't like my behavior plan, so they're not gonna do it."

And I actually think when you are working with staff especially with ADHD, but in general, you also need to look at like, is it a performance deficit? And if so, like why are they not performing this skill? And then if it's a skill deficit, they actually need to be taught the skill. And I think like a lot, oftentimes ADHDers need things broken down a lot more because maybe they're missing, like you said, like a lot of people weren't diagnosed.

Maybe they're still [00:47:00] undiagnosed. They might be missing some of those foundational skills. And so you going at rapid fire being like, "Okay, so you're gonna present and you're gonna put these two things in a three stimulus array," your ADHDer might be like, "Where am I? I don't even know where the materials come from.

What am I doing?" Like, and now they've missed four directions because they're trying to figure out where you got those materials from.

Allyson Wharam: Mm-hmm. Yeah, they may be attending to some other stimulus in the environment. And one other thing that I'll add that I think people may not understand is, like, the urgency and having a clear deadline actually is a helpful thing for folks with ADHD because so much of what our brain is looking for is, like, that external check for something.

And so having either frequent feedback or you know, really specific deadlines and not just a deadline for the sake of a deadline, but a deadline that, you know, again, has feedback around it is important. So something like stuff in notes where it's, like, a recurring task, what do your feedback [00:48:00] loops look like?

What do your expectations look like? All of that. Is it really clear to that person?

Nicole Stewart: I think with something like session notes too, I find ADHDers need routines for those kind of things that like, all right, every Monday you get 30 minutes, and then on Tuesday morning we're going to be checking them. So, the more routinized you can make and more systematized I think you can make things, because I also think, like, ADHDers and people with autism benefit from the almost, like, the motor memory of just like, I sit down at my desk and now I do this task, and then

I do it. It's like low 'cause you reduces your working memory, it reduces your task initiation, it reduces your planning, it automates a lot of it. So it takes a lot of the executive functioning pieces out of the task and makes it a lot easier for it to get done.

Allyson Wharam: Yeah. Yeah, because the caveat of that is if you just have, like, this open-ended time, it's maybe unlikely, at least in my experience. You know, having again those, like, really clear SDs. My impulse is always [00:49:00] to, like, not have a very consistent routine. Like, I think that I wanna be able to just, like, do whatever whenever, because a lot of it is interest-based, and so I can really hyperfocus and get stuff done, like five times the amount of work, um, as someone else might be able to get done in those two hours.

But then I'm, like, useless for the next three hours after that, you know? So there is that, like, internal, just from that learning history, desire to, to keep things really open-ended. And at the same time, especially for those kind of monotonous tasks that are not gonna be very interesting, having a pre-built routine can be really helpful, because otherwise it's, can be more difficult to initiate some of those things.

Nicole Stewart: Yes, totally. And I think also to your point of like you can hyperfocus on certain things and not on others, like I do think giving, especially BCBAs, it's harder with techs because like you gotta be where you gotta be. Like you, can't be like, "Oh, you're in the mood to be with a client at 6:00 in the morning."

It doesn't work that way.

Allyson Wharam: Yeah.

Nicole Stewart: But for BCBAs, I think where you can give [00:50:00] flexibility and say, "Okay, your authorization is due on this date. I don't care how you get your authorization hours done, as long as it's handed in and ready, and ready to go on this date." Um, some people wanna do it late at night. Some people wanna do it early in the morning.

Some people do it like, I think every BCBA, especially with ADHD, works differently. And so I think giving people the flexibility instead of saying like, "All right, Allyson, you're booked for this kid at this time," you might be like, "Ooh, but that time of the day is my best thinking time,

Allyson Wharam: Mm-hmm.

Nicole Stewart: best visual analysis time," and now you've taken that.

And so I think also working to help people find where their strengths are and help people find when they are at their best and creating systems that kind of emphasize that I think is also really helpful.

Allyson Wharam: Yeah, I totally agree. And, you know, I wanna just, like, tie a quick bow too on what you were talking about with universal design for learning or UDL because I think what we were talking about with UDL, what we're [00:51:00] talking about here, you already mentioned this, having these supports in place for individual-- Like, part of the aspect of universal design for learning or universal design in general in any sort of environment is that you're creating opportunity for multiple means of engaging with the tasks or content and express what they're doing.

And so when you're doing that, you're doing that foundationally in the design of things. When we think about accessibility, sometimes we think about, like, "Oh, someone might be deaf, so we're gonna add on, like, closed captioning." You know, we're thinking about, like, this individual, it's an afterthought, basically.

We have the design done, and then it's like, okay, now we need to add on these couple of things just in case someone with a disability needs to engage with this. The difference with universal design for learning is, like, the design itself is accessible. You're thinking about all of the different variations in humans and how they're gonna be approaching whatever task that is from the very beginning.

And so, [00:52:00] like, curb cuts are the common example

Nicole Stewart: ramps I feel like is one. Yeah

Allyson Wharam: Yeah, it's, you know, something that helps if you have a wheelchair or some sort of accessibility need in terms of mobility. But it also is helpful for, like, wheeling packages on a trolley and having a stroller and, or scootering or, you know, whatever.

And so something that might benefit someone specifically with a disability can also be, like, really just beneficial overall. And so, yeah. So just one other thing as we're talking about, like, these are ADHD kind of specific considerations. They're also things that might really benefit your staff as a whole, ADHD or not.

Okay. We've covered a lot. So I wanna give you a chance. Is there anything that we didn't talk about that you wanted to say or share with folks?

Nicole Stewart: Yeah, I mean, there's always more. I could talk about ADHD. I guess ADHD is, like, my hyper-focused special interest over here. I just think ADHD is very [00:53:00] misunderstood. I'm even right now working with a family on their IEP, and the IEP is all creating crutches for the child of like, "Oh, because you have ADHD, you need this thing."

And it's like, actually, how are you teaching them the executive functioning, or how are you actually teaching them to be able to do this skill at the same level as their peers because they're capable of it, rather than just bolstering in some type of support so that your job is a little bit easier?

Um, and I think that that's, like, a big differentiation. There's times where I think kids need, you know, a visual schedule versus, like, kids need to learn how to do a routine, and you can give them a routine and learn how to do it. And I think, like, there's a time for the scaffolding in, and then there's a time for actually like, "Okay, now we're gonna teach you this skill."

And I think oftentimes we stop at the scaffolding and we've taught kids like, "Okay, you have to eat three meals a day, and you have to eat healthy and blah, blah, blah," but we actually haven't taught them how to eat healthy. We've just... You know, it's like the thing, like, if you catch a fish, you eat for a [00:54:00] day.

I think we often catch fish for people with ADHD.

Allyson Wharam: Mm, mm-hmm. Yeah,

Nicole Stewart: Yeah,

Allyson Wharam: Yeah, no, I think that's something important to think about with any learner too is just, like, yes, like thinking about reasonable accommodations and at the same time are you giving them the tools to self-manage, to build those skills, to have, you know, that foundation especially when we're talking about children.

Where can folks go to learn more about you and the work that you're doing?

Nicole Stewart: Yes. So you can go to my website, which is nicolestewartbcba.com. Um, I'm on Instagram, although I'm not always the best about being active on Instagram, @mom_the_behaviorist.

And then I also have CEUs on ADHD on BehaviorLive, so you can always search for Nicole Stewart on BehaviorLive. And then I do on-demand business courses to help people launch their own private practice similar to what I'm doing.

So learning about ADHD, learning about how to have a private practice, how to manage a private practice, all of that stuff. So I have a live one coming up [00:55:00] in June, but there's also always on-demand options as well. And there's CEU. Everything's behavior analytic in nature 'cause everything's focused on, like, behaviors.

I focus everything on beha- everything is a behavior. So it's all for CEUs as well, so people can check those out if they're interested in doing what I do

Allyson Wharam: Yeah, and we'll link all of that in the, the show notes as well for folks to check out. Yeah. Well, thank you so much for being here. Obviously, this is something that is a little close to home, so it was fun to talk about it and hear your perspective and, yeah, thanks for doing the work that you're doing

Nicole Stewart: Yes, of course. You too. Thank you. I appreciate being here. [00:56:00]