Can Motivation Normalize Working Memory and Task Persistence in Children with Attention-Deficit/Hyperactivity Disorder? The Effects of Money and Computer-Gaming

Abstract

Visual-spatial Working Memory (WM) is the most impaired executive function in children with AttentionDeficit/Hyperactivity Disorder (ADHD). Some suggest that deficits in executive functioning are caused by motivational deficits. However, there are no studies that investigate the effects of motivation on the visual-spatial WM of children with-and without ADHD. Studies examining this in executive functions other than WM, show inconsistent results. These inconsistencies may be related to differences in the reinforcement used. The effects of different reinforcers on WM performance were investigated in 30 children with ADHD and 31 non-ADHD controls. A visual-spatial WM task was administered in four reinforcement conditions: Feedback-only, 1 euro, 10 euros, and a computer-game version of the task. In the Feedback-only condition, children with ADHD performed worse on the WM measure than controls. Although incentives significantly improved the WM performance of children with ADHD, even the strongest incentives (10 euros and Gaming) were unable to normalize their performance. Feedback-only provided sufficient reinforcement for controls to reach optimal performance, while children with ADHD required extra reinforcement. Only children with ADHD showed a decrease in performance over time. Importantly, the strongest incentives (10 euros and Gaming) normalized persistence of performance in these children, whereas 1 euro had no such effect. Both executive and motivational deficits give rise to visual-spatial WM deficits in ADHD. Problems with taskpersistence in ADHD result from motivational deficits. In ADHD-reinforcement studies and clinical practice (e.g., assessment), reinforcement intensity can be a confounding factor and should be taken into account. Gaming can be a cost-effective way to maximize performance in ADHD.

Funciones Ejecutivas Y Motivación De Niños Con Trastorno De Espectro Autista (Tea) Y Trastorno Por Déficit De Atención Con Hiperactividad (Tdah)

“…La escasa persistencia de alumnos con TDAH se materializa en el LBS en que, por ejemplo, son menos capaces de implicarse en las tareas, no les importa el éxito o el fracaso, o que a pesar de esforzarse pierden la concentración y su rendimiento se deteriora. Estudios experimentales (Dovis, Van der Oord, Wiers, & Prins, 2012) que han analizado los efectos motivacionales del refuerzo muestran que solo en los niños con TDAH, en comparación a niños sin TDAH se produce un decremento con el tiempo en el desempeño de las tareas. El feedback no es suficiente para que los niños sin TDAH logren un desempeño óptimo sino que necesitan un refuerzo extra.…”

Training of Cognitive Control in Developmental Disorders: Pitfalls and Promises

“…Moreover, the two most frequent treatments in ADHDmedication and behavioral interventions, do not intrinsically provide patients with concrete strategies or skills for coping with associated functional impairments (Chacko et al, 2014 ;Shalev et al, 2007 ;Sonuga-Barke, Brandeis, Holtmann, & Cortese, 2014 ). After the termination of these treatments, no consistent changes were recorded in the neurocognitive measures (Dovis, Van der Oord, Wiers, & Prins, 2012 ;Jarrett, 2013 ). Cognitive training , on the other hand, does aim at improving basic neurocognitive mechanisms that are related to academic skills, as well as to other skills that are impaired in ADHD.…”

Prevalence and diagnostic validity of motivational impairments and deficits in visuospatial short-term memory and working memory in ADHD subtypes

“…Research indeed shows that children with ADHD, in contrast to their TD peers, show suboptimal performance on visuospatial WM-and visuospatial STM tasks under regular reinforcement conditions (e.g., feedback-only), and require relatively high incentives (e.g., feedback ? 10 euros) to perform to their full abilities [13,33,34]. Holmes et al and Lambek et al did not control for these motivational deficits in children with ADHD (both studies used only regular reinforcement conditions), which may have resulted in an overestimation of the prevalence and diagnostic validity of WM and STM impairments in their ADHD samples.…”

“…Finally, although an abnormal sensitivity to reinforcement (as defined by Haenlein and Caul [28]) might be characteristic for children with ADHD on a group-level (for reviews [39,40]; see also [13,33,34]), the prevalence and diagnostic validity of this motivational deficit within the ADHD population is largely unknown. Only one recent study (de Zeeuw et al [23]) investigated its prevalence in children with ADHD, and found that \8 % of these children could be classified as having an abnormal sensitivity to reinforcement.…”

“…We investigated these questions by using the task scores of children with ADHD-C, ADHD-I and TD children on the visuospatial WM-and STM version of the Chessboard task [13,33]. To account for, and investigate, the motivational deficits in the ADHD samples we presented these tasks in two reinforcement conditions: a feedback-only condition and a condition with feedback and a large monetary incentive (10 euros).…”