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Reinforcement Enhances Vigilance Among Children With ADHD: Comparisons to Typically Developing Children and to the Effects of Methylphenidate

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Abstract

Sustained attention and reinforcement are posited as causal mechanisms in Attention-Deficit/Hyperactivity Disorder (ADHD), but their interaction has received little empirical study. In two studies, we examined the impact of performance-based reinforcement on sustained attention over time, or vigilance, among 9- to 12-year-old children. Study 1 demonstrated the expected vigilance deficit among children with ADHD (n = 25; 12 % female) compared to typically developing (TD) controls (n = 33; 22 % female) on a standard continuous performance task (CPT). During a subsequent visit, reinforcement improved attention more among children with ADHD than controls. Study 2 examined the separate and combined effects of reinforcement and acute methylphenidate (MPH) on CPT performance in children with ADHD (n = 19; 21 % female). Both reinforcement and MPH enhanced overall target detection and attenuated the vigilance decrement that occurred in no-reinforcement, placebo condition. Cross-study comparisons suggested that the combination of MPH and reinforcement eliminated the vigilance deficit in children with ADHD, normalizing sustained attention. This work highlights the clinically and theoretically interesting intersection of reinforcement and sustained attention.

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Notes

  1. Although a1500-ms response window is typical (e.g., Halperin et al. 1991; Huang-Pollock et al. 2006), the vast majority of hits occur within the first 1 000 ms (e.g., 98 % in Study 1 Baseline CPT), suggesting that the response window change did not have a major impact on the data.

  2. For fully within-sujects comparisons, d = d 3’√2, where d3’ = (mean-0)/standard deviation (Cohen 1988).

  3. Finally, false alarm rates were higher, on average, among children with ADHD that received reinforcement first compared to children with ADHD that received the reinforcement second (means [SDs] = 1.80 [1.28] and 1.09 [.90], respectively, p = .03), whereas reinforcement order did not affect the false alarm rate in controls (p = .55); Group × Reinforcement Order, F (1, 54) = 4.5, p = .04; all other reinforcement order effect ps > .18).

  4. At the request of a reviewer, we compared the two subsamples in supplemental analyses. Hit rates were comparable during the baseline condition of Study 2 (no reinforcement + placebo condition, p = .20).

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Acknowledgments

We thank Dominica Vito for coordination of the project, Mark Kogutowski for computer programming, and Sarah Spencer and Mike Strand for their assistance with data collection. We appreciate the time and effort taken by the families who participated in these studies. This research was supported by grants from the National Institute of Mental Health (R01MH069434 and 3R01MH069434-04S1) to Larry Hawk

Conflict of Interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Psychology, University at Buffalo, 206 Park Hall, PO Box 604110, Buffalo, New York

    Michelle G. Bubnik, Larry W. Hawk Jr., William E. Pelham Jr., James G. Waxmonsky & Keri S. Rosch

  2. Center for Children and Families, University at Buffalo, SUNY, Buffalo, New York

    Larry W. Hawk Jr., William E. Pelham Jr. & James G. Waxmonsky

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  1. Michelle G. Bubnik
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  2. Larry W. Hawk Jr.
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  3. William E. Pelham Jr.
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Correspondence to Larry W. Hawk Jr..

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Bubnik, M.G., Hawk, L.W., Pelham, W.E. et al. Reinforcement Enhances Vigilance Among Children With ADHD: Comparisons to Typically Developing Children and to the Effects of Methylphenidate. J Abnorm Child Psychol 43, 149–161 (2015). https://doi.org/10.1007/s10802-014-9891-8

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