Dovis, van der Oord, Wiers, & Prins (2012). Can motivation normalize working memory and task persistence in children with attention-deficit/hyperactivity disorder? The effects of money and computer-gaming.” – Article summary

Visuospatial working memory (WM) is the most impaired executive function in children with ADHD. Incentives improve the working memory performance of children with ADHD but does not normalize it. Children with ADHD showed a decrease in performance over time. The strongest incentives normalized the persistence of performance in children with ADHD. Executive and motivational deficits give rise to visuospatial working memory deficits in ADHD. The problems in task persistence result from motivational deficits.

Executive functions allow individuals to regulate their behaviour, thoughts and emotions. It allows for self-control. Children with ADHD show impairments in behavioural inhibition and working memory, especially visuospatial working memory. Visuospatial working memory refers to the ability to maintain and manipulate and reorganize visual-spatial information. An impairment of this leads to a child with ADHD having problems remembering what he was doing and what he has to do to reach the goal.

However, it is also possible that motivational deficits are a core problem in ADHD. This states that children with ADHD are less stimulated by reinforcement than typically developing children. This leads to the children being not motivated enough to function on a normal level. Deficits in executive functioning are believed to be the result of the abnormal reinforcement sensitivity.

The elevated reward threshold states that children with ADHD could reach optimal or normal performance but require much higher levels of reinforcement to reach this than for typically developing children.

The difference between ADHD children and typically developing children was smaller when incentives were used. Incentives improved the performance of children with ADHD. Children with ADHD showed lower performance in all conditions than the controls. For the children with ADHD, only strong incentives (e.g. money or gaming) can reduce the effects of time (i.e. playing for a long time) on task performance.

Children with ADHD showed a decrease in performance over time and strong incentives were unable to normalize their performance. However, strong incentives were able to normalize their persistence of performance. This means that the children with ADHD’s performance persisted longer over time with stronger incentives. The typically developing children did not show a drop in performance over time.

Children with ADHD required stronger incentives to reach a better performance and controls only needed feedback as an incentive to reach optimal performance. This provides evidence for the abnormal reinforcement sensitivity of children with ADHD. It is possible that the effects of reinforcement differ per executive function.

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