ADHD

ADHD

Children with ADHD may respond to instant rewards in the same way as they do to medication according to a study was carried out by Dr Madeleine Groom and colleagues from the University of Nottingham, the University of Oxford and Simon Fraser University in Canada published in the medical journal, Biological Psychiatry.

In the study children with attention deficit hyperactivity disorder (ADHD) were assessed through a computer-based task that offered them extra points for less impulsive behaviour. This important study, albeit small, furthers our understanding of how ADHD affects particular brain activity and the way that interventions such as medication and motivational conditions can alter that response. The increased incentive offered in the task improved areas of brain activity that are usually affected by the disorder, having an effect similar to that of medication. However, there are some limitations, including that the behavioural response of the child does not appear to have been assessed, and that the reward scenario used may not be easily transferable to everyday life.

Given the nature of the study and that the researchers say that their tasks were not designed “to replicate behavioural modification programs used in clinical practice”, the direct implications of these findings are unclear and require further research. Parents should not alter their child’s medication without consulting their doctors.

The researchers say that ADHD is thought to be caused by executive deficits (deficiencies in the part of the mind that controls attention and functioning) and/or by changes in motivational style and reward processing. They say that some of the effects of motivational incentives have not been studied. In this observational study, the researchers enrolled children with ADHD and a similar group of normally developing children, and compared their performance in various tasks.

This study has demonstrated that motivation and reward can affect certain brain responses in children with ADHD. It has made efforts to quantify these responses and to compare them to the responses seen with medication. However, the rewards given, i.e. extra points in the task, cannot easily be transferred to everyday situations nor can they be taken to imply that other forms of rewards given by parents or teachers would have similar results. Also, although the study measured the effects of the motivation and reward situation on the electrical impulses of the child’s brain, the actual feelings and behavioural inclinations of the child do not appear to have been monitored, either in the short or long term.

Given the nature of the study and the researchers’ own caution that their tasks were not designed “to replicate behavioural modification programs used in clinical practice”, the direct implications of these findings for the treatment of children with ADHD are unclear.

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Written by Dr Martin Harris, Doctor and Mohel for Jewish Circumcision Clinic in London Bris Mila Brit Milah.
www.circumcisionlondon.co.uk

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Contact Dr Martin Harris