Do reward systems work with children who have ADD?
In a word, no.
While the use of rewards may produce positive short-term improvement in behavior and are helpful in making kids feel good, they generally fail to result in long-term change.
In order for a person to change his behavior, he must stop and think before he acts. Initially, a reward may be attractive enough to motivate the ADD child to think before acting. As time goes on, however, he inevitably becomes bored with the reward; it loses its meaning and must be made more and more appealing in order to result in continued positive behavior.
From what I have seen in my patients, parents who rely on rewards to ensure appropriate behavior have to be very rich because very soon they cannot get the child’s attention with anything less than a new pony or some similar extravagance!
One of the biggest problems with the use of rewards as a technique of behavior modification is that it encourages the pattern of “I won’t do this unless I get what I want.” Without a “carrot,” the child does not behave appropriately. The real world does not work this way. We don’t have bosses who give us raises for making it to work on time, spouses who give us jewelry for making the bed, or friends who send us flowers for showing up for dinner on the right night. Rather in the real world, negative consequences occur when we fail to meet the expectations of daily living.
Some people are drawn toward the use of rewards and positive reinforcement as a means to build the low self-esteem that too often ADD children experience. In our enthusiasm to give these children a boost, we fail to appropriate that self-esteem does not come from a pat on the back, a new toy, or a dollar bill. Rather, self-esteem is an inside job–it develops from within when we face problems head on and make it through to the other side intact (even if we are stumbling), ready to face the next challenge that comes along.
Isn’t there any role for positive rewards in the management of ADD?
All of us appreciate a positive comment acknowledging our behavior, praise for succeeding at a new task, and simple expressions of affection. This is certainly true for children, adolescents, and adults with ADD.
These positives can be especially important when the ADD individual is struggling with the impact attention weaknesses have on his life.
It is important for us to actively look for opportunities to give praise, a pat on the back, a little reward, and lots of cheerleading to the ADD individual for new behaviors, successes after struggles, and valiant attempts at difficult tasks.
These positives are valued as spontaneous expressions of feelings and thoughts. It is my experience, however, that when they become a negotiating tool or a method to coerce the ADD individual into good behavior, their value is lost.