Can motivation normalize working memory and task persistence in children with attention-deficit/hyperactivity disorder? The effects of money and computer-gaming

The study aimed to investigate the impact of motivation on visual-spatial working memory (WM) in children with and without Attention-Deficit/Hyperactivity Disorder (ADHD). This aspect of executive function is notably impaired in children with ADHD. While some research suggests that these deficits in executive functioning might be linked to motivational deficits, this specific area has not been thoroughly explored, particularly in relation to visual-spatial WM. Previous studies examining the influence of motivation on other executive functions have yielded inconsistent results.

In this experimental study, the effects of various reinforcers on WM performance were examined in a group of 30 children diagnosed with ADHD and 31 control children without ADHD. The participants underwent a visual-spatial WM task in four different reinforcement conditions: receiving feedback only, earning 1 euro, earning 10 euros, and playing a computer-game version of the task.

The study revealed that in the feedback-only condition, children with ADHD showed poorer WM performance compared to the control group. Interestingly, incentives did significantly improve WM performance in children with ADHD. However, even the strongest incentives, such as 10 euros and the gaming condition, failed to bring their performance up to the level of the control group in the feedback-only condition. It was also noted that only the children with ADHD experienced a decline in performance over time. Notably, the more substantial incentives, including 10 euros and gaming, were able to normalize the persistence of performance in these children, while a smaller incentive like 1 euro did not have a similar effect.

The study's findings suggest that both executive and motivational deficits contribute to visual-spatial WM deficits in children with ADHD. It appears that the problems with task persistence in ADHD are largely due to motivational deficits. This implies that in ADHD-reinforcement studies and clinical practices, like assessments, the intensity of reinforcement can be an important factor to consider. The use of gaming as a reinforcement method emerged as a potentially cost-effective approach to enhance performance in children with ADHD. These conclusions offer valuable insights into the nuances of ADHD and the role of motivation in managing its symptoms.

Many with ADHD struggle with executive functions, including working memory and impulsivity. These struggles can manifest as challenges in controlling attention and inhibiting impulses, leading to difficulties in work and academic settings. This study adds to the body of knowledge by highlighting the potential of motivational incentives to improve specific cognitive functions in children with ADHD.

Another study, conducted by Huang-Pollock et al. in 2007, explored the effects of motivation on inhibitory control in ADHD. They found that while children with ADHD typically had more difficulty with inhibitory control, those with the inattentive subtype of ADHD showed improvement in response to rewards. This reinforces the notion from the current study that motivation, in the form of rewards, can indeed have a positive impact on certain symptoms of ADHD.