In this episode, Kokeb McDonald sits down with occupational therapist and RITP-certified therapist Katie Williams for a candid conversation about ADHD in girls and why it’s often missed until adulthood.

Katie shares her own late diagnosis in her early forties and reflects on how it helped her reinterpret lifelong struggles with perfectionism, rejection sensitivity, sensory needs, time blindness, emotional regulation, and cycles of burnout and depression.

This episode emphasizes how ADHD can present as “hyperactive on the inside,” with masking, daydreaming, high performance at school followed by emotional crashes at home, and anxiety or depression appearing before ADHD is recognized.

Kokeb and Katie discuss social expectations for girls, the impact of negative comments and labeling, and practical therapy approaches, building rapport, supporting unmasking, parent coaching, and helping kids identify what they truly like and feel (including interoception and emotional regulation). They also highlight how therapists’ words and co-regulation shape outcomes and encourage screening when “lazy” or “not trying hard enough” becomes a repeated description.

Timestamps

00:00 Welcome + Why This Series Matters: ADHD in Girls

01:18 Katie’s Late ADHD Diagnosis & Looking Back With Clarity

02:38 Why Girls Get Missed: Internal Hyperactivity, Perfectionism & Burnout

07:07 What ADHD Really Is (Beyond the Name/DSM) + Dopamine Seeking Risks

09:30 Girls vs Boys: Daydreamers, ‘Lazy’ Labels, and At-Home Meltdowns

11:51 Social Expectations & Masking: Hygiene, Clothes, and Rejection Sensitivity

13:38 Adult Reflections: Sensory Needs, College Struggles, Time Blindness

19:13 OT Treatment Approach: Unmasking, Rapport, and Parent Coaching

24:17 Goal-Setting Challenges: Decision Fatigue, Initiation, and Letting Kids Lead

26:59 Language That Heals: Reframing, Backtracking, and the 5:1 Positivity Shift

🎯 Resources Mentioned:

📘 Integrating Primitive Reflexes Through Play and Exercise book series🔗 Learn more: ⁠r⁠⁠itp.info/books

📱 RITP App – home and school tools for therapists and families🔗 Download the app: ritp.info/app

📌 Other Resources

Learn about our upcoming LIVE WEBINAR https://ritp.info/intro-course

Learn about the RITP Clinical Foundations 3-Day Intensive http://ritp.info/3-day

Learn more about the Reflex Integration Through Play Certification program: https://ritp.info/certification

Previous episodes and resources: https://www.integratingreflexes.com/blog/