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Behavioral Reinforcement Strategies for Children with ADHD
The April 1998 issue of Behavior Modification (pages 143-166) includes an interesting article on the effectiveness of different reinforcement strategies for children with ADHD. The study provides very important data that can be used by parents and teachers to develop more effective behavioral interventions.
In this study, the authors investigated how two types of reinforcement strategies - partial reinforcement and continuous reinforcement - effected children’s learning a list of spelling words. In the continuous reinforcement condition, children were reinforced (i.e. receive a desired reward) after each word that they spelled correctly. In the partial reinforcement condition, the rewards were administered on an intermittent basis rather than after each correct response.
Twenty-two children with ADHD and 20 children without ADHD participated in the study. During the spelling task, the authors monitored children’s facial expressions to assess their frustration level, the number of words they learned to spell correctly, and their degree of persistence. This allowed the authors to determine whether the two types of reinforcement schedules - partial or continuous - had similar or different effects on the frustration, learning, and persistence of children with and without ADHD.
The results were clear cut: children with ADHD who received partial reinforcement displayed higher levels of frustration and lower levels of persistence than children in any other group (i.e. children with ADHD who received continuous reinforcement or children without ADHD who received either partial or continuous reinforcement.) For children without ADHD, the type of reinforcement did not have a significant impact on their performance. Although ADHD children spelled fewer words correctly than control children regardless of which reinforcement they received, those given partial reinforcement learned the fewest words of all.
What do these results imply for parents day to day efforts to effectively manage their child’s behavior? The biggest implication, I think, is that these results underscore the need for children with ADHD to receive VERY frequent positive feedback in order to encourage and sustain good behavior. If you are trying to promote the development of a particular behavior in your child (e.g. complying with your requests) it is important that he or she receive some type of reinforcement virtually each and every time they comply. Providing reinforcement on a more intermittent or partial basis will not be as effective in promoting the behavior you are trying to develop.
This is one reason why it can be so difficult and frustrating for parents who are trying to teach their child appropriate behavior. Obviously, it is difficult and demanding to reward a child each and every time they do something right. For children without ADHD, this continuous reinforcement is not necessary (i.e. recall that they did just as well in the partial reinforcement condition as in the continuous reinforcement condition). For a child with ADHD, however, it really can be.
This is also why it is common for parents to feel that strategies which worked well with their other children do not work at all for their child with ADHD. This study demonstrates that the conditions under which children with ADHD learn most effectively are very different from the conditions required by other children.
For this reason, it is often very important for parents to learn the specialized child management strategies that are often helpful and necessary to promote better behavior in children with ADHD. Discussing this in detail is beyond what I can do in the newsletter, and consulting with an experienced child mental health professional to assist you in developing a behavioral plan that is targeted to your child’s unique needs can be a tremendous benefit. This can be quite helpful in preventing the development of more serious behavioral difficulties down the road.
Note: This article originally appeared in Attention Research Update, an online newsletter written by Dr. David Rabiner, a Duke University psychologist and former member of CHADD's Professional Advisory Board. You can learn more about Attention Research Update and sign up for a free subscription at www.helpforadd.com.