For ADHD, rewards function similarly to drugs

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A 9-year-old boy with ADHD. Image: Steve Liss / Time Life Pictures / Getty Images

A study from researchers at Nottingham University published in the journal Biological Psychiatry and highlighted by the BBC suggests that children with attention deficit hyperactivity disorder (ADHD) may benefit from immediate rewards in similar ways that they do from medications such as Ritalin. In the study, researchers set out to examine how rewarding good behavior could impact brain function. Children participating in the study played a computer game devised by the researchers while their brain activity was monitored by electroencephalogram (EEG). In the game, they were supposed to catch aliens of a certain color, but not those of another. The researchers found that instant rewards did improve the children’s performance in the same way that their medication did, though to a lesser degree. That is, both children taking Ritalin and those playing for incentives—in one scenario, researchers amplified both rewards and punishments in the computer game by five—showed signs of “normalized” activity in the same brain regions.

Researchers say that these findings indicate that reward systems could potentially be used in concert with medication—enabling physicians to reduce dosage of drugs like Ritalin and Adderall and augment treatment with incentive programs. Yet, even as they expressed enthusiasm for this possibility, the study authors recognized that real-world implementation could be a challenge, as effective programs would require nearly constant oversight. As Nottingham researcher Chris Hollis told the BBC: “We know that children with ADHD respond disproportionately less well to delayed rewards—this could mean that in the ‘real world’ of the classroom or home, the neural effects of behavioral approaches using reinforcement and rewards may be less effective.”