Thursday, August 12, 2010

ADHD , Motivation and Behavior modification

When it comes to the treatment of ADHD , behaviorism is very much alive. Most parenting books recommend token economy systems for ADHD kids , recommending rewards rather than punishments - honey catches more flies than vinegar.

On the otherhand , Ross Greene - Collaborative Problem solving sees challenging behavior as a learning disability , a developmental delay in the areas of frustration tolerance , flexibility and adaptability when demands for these skills outstrip the skills these kids have. These lacking skills are trained by using the collaborative problem solving process rather than rewards or punishments . There is research showing that rewards and punishments actually trigger the inappropiate behaviors the extrinsic motivation is trying to deal with.

The theory behind behavior modification was presented by Russel Barkley - see the link below 40 pgs imho page 20 onwards relevant - explaining ADHD as a deficit in self control and inhibition. If I understand him correctly the ability to inhibit response enables the 4 executive functions ,- nonverbal working memory , verbal working memory= privatization of speech, privatization of emotion which is the source of intrinsic motivation , and playing with ideas-problem solving. ADHD kids lack the ability to privatize emotion , the source of intrinsic emotion and need to be compensated by extrinsic motivation. He says cognitive therapy does not work because it assumes the presence of verbal working memory=privatization of speech. On page 28 onwards he deals with behavior modification and motivation.

Because ADHD kids  lack the capacity for intrinsic motivation , we need to create an environment which compensates with extrinsic motivation - rewards and consequences. Barkley says that Medication helps with executive functions and hyperactivity and allows us to reduce extrinsic motivation. The drug use for ADHD have minimal impact on executive test performance according to Seidman's 2006 review.
He does however mention that behavior modification only compensates and does not generalize.

S.D.T theory and research shows that extrinsic motivation undermines interest and intrinsic motivation. So while rewards may compensate in the moment , looking a little long term, the value of rewards decreases and have a negative impact.

From the Self Determined theory  site ' Some of the most surprising insights to emerge from SDT research call into question the traditional use of incentives. For example, behavioral research has shown that extrinsic rewards, like money or grades, actually undermine a person's interest in voluntarily engaging in a task. In short, rewards can backfire.

Kou Murayama from the University of Munich, Germany explored the neurobiology underlying this counterintuitive finding at the conference. In a recent study, Murayama and his colleagues scanned the brains of participants before and after completing a timed task. One group of participants was promised a reward. A second group performed the task with no incentive, although afterward they were surprised with compensation.

Using functional magnetic resonance imaging (fMRI), the study showed that entirely different areas of the brain are activated by the same task depending on whether a person anticipates a payoff or not. When focused on a reward, the brain switches off those areas associated with voluntary or self-initiated activities. '

Imho there maybe a developmental delay , but the lack of intrinsic motivation has more to do about the boring and uneganging nature of school and the parenting strategies of reward and punishments. Education and Parenting that supports children's autonomy - ( not independence but interdependence ) helps them be more self determined more intrinsically motivated. SDT says that 3 needs  - autonomy , competence , relatendness  facilitate intrinsic motivation and being determined . Cps  parenting supports the child's autonomy by addressing his concerns and inviting him to problem solve and be part of the solution , promotes competence by addressing lacking cognitive skills , and encourages ' relatedness ' through the collaborative nature of the process.   Barkley article        Executive functions - Brown and Barkley


1 comment:

  1. ADHD children have their own mind and ideas which sometimes can deal to ADHD behavior problems.