Positive and negative consequences, including rewards and punishments, are often used to shape children's behavior. Children with ADHD often respond differently than their peers to rewards and punishments. Positive behavior reinforcements such as rewards can work well if used quickly and often enough, whereas punishments are generally not effective.

Considering Rewards for Children with ADHD and Related Challenges

• Give rewards quickly and often when the child is learning a new behavior or skill.
• Give rewards in proportion to the child’s effort. Over-praise may undermine motivation. Watch for the child’s reaction to estimate their own perception of how much effort the skill or behavior required.
• Consider gradually reducing how often a child receives reinforcement once new behaviors are acquired. Pay careful attention to what happens to the child’s behavior and motivation level if the reward is reduced. Slowly change the frequency or intensity of reinforcement to help the child deal with the frustration of not getting a reward and to help them persist.
• Consider the use of different reinforcements for different behaviors (for example, use differently colored tokens for different behaviors). This will increase the likelihood that the child connects the reinforcement to the appropriate behavior.
• Identify creative ways to maintain high rates of immediate reinforcement (such as using check marks, stickers, gestures and nods, verbal feedback, or feedback from peers).
• Provide rewards for effort rather than success to increase motivation for effort (for example, give feedback on how hard the child is working to get something right rather than just on how right they are getting it).
• Teach children strategies of self-reward and self-praise to increase the chance the child will use the strategy when there is nobody present to reinforce it.
• Understand that the threat of losing a reward can be perceived as punishment by a child with ADHD, especially when the child does not feel confident that they can achieve the reward.
• Remember that a child with ADHD will be more likely to be able to achieve the appropriate behavior when directions are clear and not involving multiple steps.

Types of Rewards and Their Differences

Considering Punishments for Children with ADHD and Related Challenges

• Punishment is less effective for changing behavior. Whenever possible, use strategies such as careful instruction, reminders, and rewards for alternative adaptive behaviors to reduce the need to use punishment with children with ADHD.
• Expecting mild punishment, such as losing a small reward, can improve on-task behavior in children with ADHD, but only for short periods and only if the child sees the consequence as mild.
  • Use in situations where rushing or errors do not have a significant impact and the child is likely to succeed.
  • Use for short durations and monitor the emotional response of the child carefully. For example, racing against the clock to put away items may feel exciting and motivating, but racing against the clock to complete schoolwork may feel very stressful.
• Whenever possible, offer opportunities to make up for a missed reward and increase motivation to keep trying to use adaptive behavior. Help the child focus on regaining the reward or gaining an alternate reward in a timely fashion. This is especially important if the child clearly intended to gain the reward but was distracted.

Adaptive behavior: any behavior the child should be using in a specific situation to benefit themselves and others

See also

• Adapting Positive Behavior Interventions for Children with ADHD
• Using Structure and Guidance to Support Adaptive Behavior

Reference

• van der Oord, S. & Tripp, G. How to Improve Behavioral Parent and Teacher Training for Children with ADHD: Integrating Empirical Research on Learning and Motivation into Treatment. Clin Child Fam Psychol Rev 23, 577–604 (2020).