Cases Of Attention Deficit Hyperactivity Disorder In Children

Attention Deficit Hyperactivity Disorder (ADHD) is a mental problem. It is exhibited by an anomaly in paying attention, extreme activity, or difficulty in controlling one’s behavior, especially that which is not normal for a person’s age. The executive functioning deficit is believed to be the primary cause of ADHD in children (Archer& Kostrzewa, 2012). The executive functioning permits individuals to control their thoughts, behavior, and emotions. As a result, it enables self-control. People with ADHD problem often indicates impairments in two executive functions such as working memory and inhibition memory (Verret et al., 2012). Specifically, the Visual-spatial type of working memory is reflected to be the most impairment tool for study. It asserts the ability to manipulate and maintain visual-spatial information. Impaired working memory establishes that a given child has trouble recalling what he or she was doing, has to do, or goal.

Theories have asserted that lack of motivation is the leading cause of ADHD in the children (Berwid & Halperin, 2012). The low levels of simulations increase the chances of ADHD in children as there are no appropriate reinforcements in place to offer normal functioning in children. Executive functioning deficits causes the perceived abnormal sensitivity to reinforcement (Weinstein & Weizman, 2012). The children would not be, therefore, capable of performing tasks under low stimulating factors and as a result leading to underperformance. Abnormal motivation is likely responsible for the weak inhibition in ADHD children. It shows that inhibitory is not a core deficit in ADHD.

The reinforcement has a substantial effect on the visual-spatial working memory (Prins et al., 2013). Therefore, it is possible that the feedback will improve substantially when the incentives are given to children who are used in the testing experiment. The problem would only arise in the case when it is unknown whether only the children with ADHD problem would react in such manner. However, through reinforcement, it would be easier to normalize the working memory.

It is noteworthy to control the form and intensity of reinforcement when doing an investigation in the children with ADHD problem. Computer gaming is an example of the reinforcer that may affect the ADHD children’s performance as compared to monetary reinforcers (Johnstone, 2013). It is worth noting that making computer games enjoyable through varying different things such as making tasks interesting and attractive can make them persist on their individual performance over time (Rapport et al., 2013). Use of monetary method may only improve their mean performance over a short time, but not over time. It is significant to study the differences of these types of enforcers in children.

Typical developing children may need less incentive to attain optimality as compared to the ADHD ones who may need much higher levels of incentives to achieve the reasonable levels (Farcas & Szamosközi, 2016). Therefore, the study aims at finding the influence of various forms and intensities of reinforcements on the visual-spatial working memory performance of the children without and with ADHD.

Research Question

Can motivation regulate memory and task endurance in ADHD Children?

Objective

• To investigate whether the divergent working memory performance of ADHD children results from aberrant sensitivity to reinforcements.
• To investigate whether aberrant reinforcement sensitivity is dependent on the form or intensity of the reinforcement.
• To examine whether the improvements on the performance persistence over time in ADHD children is linked to a particular type or intensity of reinforcement.

Methods/Design

The elementary school going children would be considered for the study. The process would be experimental in nature as well using recorded historical data. Interviews would be used to find out medical conditions of various children that would be used to conduct the study. It offers firsthand and authentic information (Englander, 2012). Also, various measurement parameters would be used to aid in the investigation. The Wechsler Intelligence Scale would then be used to assess the cognitive skills of various participating children to the study. The instrument is helpful in doing self-administration of children’s intelligence (Wechsler, 2014). The full-scale IQ gauging would be gauged with the use of parameters such as subtests, block design, and vocabulary use.

Approach

The retrospective cohort study would be used to achieve the laid out objectives. There would be ADHD children as well as those individuals without ADHD, which would act as a control group. The age group would range from 9 to 12. Based on the test inclusion, the tests would be given to the ADHD children in a serene environment in which there would be no signs of noise. The reinforcers would then be announced before the start of the session. The incentives would then include $5, $20, feedback only, and gaming. The test would then go for one month period so as to attain a comprehensive result.

Control Participants

Exclusion

• No neurological disorder, sensory, or any motor problem
• No signs of any medication instead of methylphenidate
• Inclusion
• IQ greater than or equal to 80
• Aged between 9 and 12
• Parents’ consent to study
• ADHD Participants

Inclusion

• Diagnosed with ADHD with use of DSM-IV-TR
• Clinical score of between (95th-100th) percentile on ADHD scale
• Meeting interview parameter measurements
• Parents’ consent to study

Exclusion

• Parents rejection of the study

Data Collection

The data will be collected from various health centers that the children selected for the survey have been attending for medication. The interview would then be used in most instances for the experimentation. Therefore, the historical data would help in selecting the sample children for the study. Also, the parents would be questioned appropriately to consent to the study and other queries related to the child wellbeing. The secondary data would be used to examine each child historical clinical attendance and decision would then be made on whether to include one for the study or not. Therefore, based on the collected information, clinical tests would then occur to find out if each participant qualifies for the inclusion criteria.

Results

Reinforcers are believed to improve the persistence in the mean results for the ADHD children. In a study, Van der Donk et al. (2015), found out that gaming provides motivation for the ADHD children to improve their performance. The information retrieved from the experimentation process would entail the statistical data in which various variances would be used to access the results. Therefore, ANOVA would fit well the analysis and results in the tabulation. The counterbalancing of the test parameters would be used to control the mode in which each reinforcer would be used in the experiment. The mean performance mechanism would provide an authentic ground upon which comparison and generalization can be done.

The graphs below show the typical relationship between inattention and interference rate and between hyperactivity and interference rate. Inattention rate among ADHD children is directly correlated to interference rate. In a study, Yasumura & Inagaki (2015), found out that the rate of inattention among ADHD children increases with increase in the rate of interferences. Also, a direct correlation exists in impulsivity/hyperactivity and interference rate.

Figure 1: Correlation between Inattention and Interference rate

Source: (Yasumura & Inagaki, 2015).

Figure 2: Hyperactivity against Interference Rate

Source: (Yasumura & Inagaki, 2015).

The data results would involve comparing test results under various reinforcers provided in the exam rooms. The intensity of each reinforce would then be gauged for every person as par the output results. The visual working memory task criteria would then offer a significant result for assessing the best suitable incentive method of improving test outcome for children for both atypically developing children as well as ADHD children (Ma, van Duijvenvoorde, & Scheres, 2016). The control children are expected to score best as compared to ADHD ones. It is because they have better working memory and can perform well in tests. The feedback only mechanism is expected to provide far much better results for normal children as compared to the ADHD ones.

The incentives, whether $5, $20 or gaming is expected to improve the performance of the ADHD participants. However, gaming is supposed to provide far much better results as compared to others (Barkley, 2013). The decrease or increase in the test performance over time would be gauged depending on the results. In a study by Dovis et al. (2015), the performance results of the ADHD children persistence performance falls regardless of the continued use of incentives. Based on past studies, it is worth noting that the use of gaming would appeal more to children, especially when modifications are done to the game in such a manner that provokes the child’s interest. Therefore, there is much expectation that gaming would provide an authentic incentive to the child.

The control children as expected to have better results than the ADHD ones. The strongest incentives such as $20 and gaming are expected to normalize better results than $5 and feedback only mechanism. When the results are controlled over time, strong reinforcers would have better outcome since they offer better motivation than $5 or feedback only technique. The control children are believed to have better memory mechanisms. As a result, they would have better results even in the absence of the incentives. Feedback only mechanism is enough reinforcement for the typically developing children. They do not need to have incentives so as to perform as in the case of ADHD children.

The ADHD children indicate abnormal performance in the absence of incentives. However, when they are motivated, the performance would improve substantially. Therefore, they need incentives to perform optimally. The persistence of the performance depends on the high incentives offered to the ADHD children (Morrill, 2016). The more reinforcements provided, the greater the expected results. It can be true that the deficits, both executive and motivational give rise to the ADHD in the children.

Use of a game is more practical in real life situation than giving a child $20 every time he or she performs well. Providing incentive in the form of money may not sound well in practicality (Bioulac et al., 2014). Therefore, offering gaming opportunity for a child to better performance is a certain technique of rewarding a child for better performance (Krča, 2016).

The introduction of gaming methods in schools and homes would be a sure way of optimizing the performance of the children. It could be included in schoolwork, computer tests, or any form of information technology interventions (Frutos-Pascual, Zapirain & Buldian, 2014). The modes may entail animations, gameplay, competitions, etc. since varieties may suit a particular child’s needs and tastes (Prins et al., 2011). It is significant that the performance of the ADHD children has poor general performance than usually growing child (Epstein et al., 2011). Whether the incentives are used, the performance is still low. ADHD require constant incentives so as to have a persistence performance and it is the certain way of normalizing their tests outcome.