Primary among children with attention deficit hyperactivity (ADHD) is the impaired ability to respond to rewarding and punishing stimuli. Parents and teachers of children with ADHD often report that these children are not motivated by the promise of a reward for good behavior. Likewise, they are often undeterred from engaging in negative behaviors even when threatened with punishment. This has been the case with some children with ADHD, but not all. In fact, the use of stimulant medication has been shown to have some effect on this process. But the direct influence on reward/punishment processing and on positive/negative feedback in children with ADHD is unclear. Yvonne Groen of the Department of Clinical and Developmental Neuropsychology at the University of Groningen in the Netherlands wanted to explore this deficit in children with ADHD more thoroughly.
Groen recently conducted a study involving 17 typically developing children (TD), 15 children with ADHD who were taking Methylphenidate (Mph) and 15 with ADHD who were not on medication (Mph-free). She assessed their evaluations of immediate and delayed rewards and punishments. She also measured how well they responded to feedback as persistent and intense positive feedback has been shown to improve behavior and emotional regulation in children with ADHD. Groen discovered that when compared to receiving no feedback whatsoever, children who received positive feedback outperformed children who did not, regardless of whether they had ADHD or took Mph. Additionally, all the positively reinforced children responded more accurately and reacted more cautiously to prompts than the children who received no feedback.
When she compared the groups of children, Groen found that the TD and Mph-free children had the most accurate responses to the prompts when they were provided with rewards versus punishments. However, all the ADHD children with and without Mph did show improvement in accuracy with promise of reward or punishment. But continuous positive reinforcement and promise of positive reward was more motivating for the ADHD children and led to more focus on accuracy than with Mph. In sum, the findings from this study show that ADHD children with and without Mph are able to identify positive and negative feedback immediately, but have difficulty evaluating delayed feedback. This was especially evident in the ADHD children with comorbid psychological conditions. Groen added, “This may explain the often observed positive effects of continuous reinforcement on performance and behavior in children with ADHD.”
Reference:
Groen Y, Tucha O, Wijers AA, Althaus M. (2013). Processing of continuously provided punishment and reward in children with ADHD and the modulating effects of stimulant medication: An ERP study. PLoS ONE 8(3): e59240. doi:10.1371/journal.pone.0059240
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.
