ADHD

Updated 12 July 2017

Positive reinforcement helps kids with ADHD perform better

For kids with ADHD, recognition for good work or behaviour is a stronger motivator than it is for peers without the condition.

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A little recognition for a job well done means a lot to children with Attention Deficit/Hyperactivity Disorder (ADHD) - more so than it would for typically developing kids.

That praise, or other possible reward, improves the performance of children with ADHD on certain cognitive tasks, but until a recent study led by researchers from the University at Buffalo, it wasn't clear if that result was due to heightened motivation inspired by positive reinforcement or because those with ADHD simply had greater room for improvement at certain tasks relative to their peers without such a diagnosis.

"Our results suggest that the motivation piece is critical," says Whitney Fosco, a graduate student in the Department of Psychology in the UB College of Arts and Sciences. "Kids with ADHD showed more improvement because they are more motivated by the opportunity to gain rewards, not because they simply did worse from the beginning."

Watch: ADHD is a difference in cognition not a disorder

The findings come out of a novel study published in the journal Behavioural and Brain Functions that collectively examined two leading theories on ADHD, combining what previous work had mostly looked at separately.

One of those theories suggests that lower-than-average cognitive abilities contribute to symptoms associated with ADHD, such as inattentiveness. The other theory favours motivation over ability, focusing on whether kids with ADHD have an increased sensitivity to reward.

"When asking whether the performance difference we see is the result of ability or motivation, this research has more of an answer than any study that comes before it," says UB psychologist Larry Hawk, the paper's principle investigator.

The results of the research conducted by Hawk, Fosco, UB graduate student Michelle Bubnik and Keri Rosch of the Kennedy Krieger Institute in Baltimore, Maryland, have clinical parallels as well.

Behavioural therapy, which uses positive consequences to increase the likelihood of achieving certain behaviours, is among the leading psychosocial interventions for children with an ADHD diagnosis.

The authors point out that the benefits of reward are not specific to children with ADHD.

"The major difference is that typically developing kids usually perform well even when simply asked to do their best," says Fosco. "But kids with ADHD typically need an external or an additional reinforcement to perform their best."

It's a tricky area of research area, according to Hawk, since some of the subjects are being tested on tasks on which they have a demonstrated history of poor performance.

There is also a degree of variability between the two groups. The authors say that having a diagnosis of ADHD doesn't necessarily mean that a child will perform poorly on any given task, and neither does the absence of a diagnosis mean that the child will perform well on any given task.

"You can't say kids with ADHD respond more to reinforcement because they were doing poorly to begin with," says Hawk. "We showed that was not true. It was greater motivation to obtain external rewards that drove the effects we observed."

Read more:

Kids with ADHD may benefit from more family-centred care

Fidgeting may help kids with ADHD learn

A better night's sleep  may help kids with ADHD

Image: Children's drawing from Shutterstock

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ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation (www.gb4adhd.co.za) She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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