ADHD, Motivation & Bribes: How much is enough?

ADHD motivation and bribes

ADHD, Motivation & Bribes: How much is enough?

Dr Shelley Hyman

Research suggests that many of the difficulties children with ADHD face in their every-day lives are related to deficits in motivation and executive functioning.

Some researchers have suggested that children with ADHD are less likely to be motivated by reinforcement than children without ADHD. Consequently, under low-stimulating conditions with minimal reinforcement, children with ADHD tend to underperform on executive functioning tasks because they are unable to motivate themselves to perform to the best of their abilities.

Executive functioning refers to the regulation of cognitive control processes such as response inhibition or working memory. In particular, children with ADHD appear to struggle with visual-spatial working memory, which is the ability to process and restructure visual-spatial information.

Research also shows that reinforcers such as computer gaming may influence the performance of children with ADHD. Tasks such as computer games are often more engaging through their dynamic visual and audio stimulations, which may encourage children with ADHD to persist in their performance over time.
Dovis and colleagues (2011) conducted a study that explored this interaction between motivation and executive functioning in children with and without ADHD.

They aimed to investigate the effects of varying intensities and forms of reinforcement on visual-spatial working memory performance. In order to test this, they compared the performance of children who were motivated through four different types of positive reinforcement; feedback only, feedback and a small monetary incentive (1 Euro), feedback and a large monetary incentive (10 Euros) and a computer game version of the visual-spatial working memory task.

As hypothesised, they observed that children with ADHD performed significantly worse when compared against children without ADHD. Performance actually worsened over time for children with ADHD, in comparison to the improved performance over time of children without ADHD.

They found that whilst receiving feedback was sufficient reinforcement for children without ADHD, this was not the case for children with ADHD. They also noted that whilst incentives slightly improved the performance of children with ADHD, even the strongest incentives (10 Euros and gaming) were unable to stabilise their performance completely.

However, the strongest incentives (10 euros and gaming) were effective in normalising the ‘persistence’ or motivation of children with ADHD to complete the task, whilst small incentives (1 euro) did not have this effect. Interestingly, they also found that gaming motivated children to complete the task just as much as 10 euros did.

This finding has important practical implications because in real life, it is not always possible (or plausible) to reward a child with money every time they perform to the best of their abilities. Instead, it may be more cost-efficient to utilise game-like strategies at home, computer gaming at school and more computerised testing or interventions, in order to optimise performance.

Reference

  • Original Article: Dovis, S., Van der Oord, S., Wiers, R. W., & Prins, P. J. (2012). Can motivation normalize working memory and task persistence in children with attention-deficit/hyperactivity disorder? The effects of money and computer-gaming. Journal of Abnormal Child Psychology, 40(5), 669-681.
Dr Shelley Hyman

About Dr Shelley Hyman

Senior Clinical Neuropsychologist. BSc (psychol) Hons, MClinNeuropsych, PhD (Med) MAPS CCN. Founder and director of the centre that was founded in 2006.