Rewards & Consequences

It’s Not Bribery. It’s Brain Chemistry.

“The anticipation of a reward creates dopamine, one of the neurotransmitters not playing nice in our kids’ brains. By coaxing the creation of dopamine, we’re helping to gas up the prefrontal cortex so that it can sit still, pay attention, keep hands to self. But the anticipation of a negative outcome creates no dopamine. No dopamine, no gas, no working brain.”

My youngest daughter has been struggling in her quest to lose a few pounds, so her older sister suggested an unusual method — something she’d seen on Comedy Central. Essentially, you set a desired target for yourself, and if you don’t meet it within the agreed-upon time, a third party will send a pre-arranged, extremely embarrassing photo of you to someone important — say, your boss. How ingenious, I thought, because it plays on the fear center of the brain, wired for our very survival.

There’s just one problem: No matter how dire the consequences, threats, and punishments — like blasting out your most embarrassing photo — this strategy just doesn’t work effectively on a child with ADHD. No matter how many times you try.

It’s hard for most adults to understand this because consequences, threats, and punishments do work on us. We show up to work on time because we don’t want to get fired. We take out the trash because we don’t want overflowing garbage. We go to bed instead of watching one more “Naked and Afraid” episode because we don’t want to be grumpy-tired the next day. We fill up the gas tank so we don’t wind up stranded on our long journey.

Why does this work for us, but not for our kids with ADHD?

Risk vs. Reward in a Preoperational Brain

When an adult considers consequences, they engage a part of the brain called the prefrontal cortex. It is responsible for critical thinking, for weighing information from other parts of the brain, such as the fear center — the amygdala — and for deciphering the abstract grays of a situation and not just the tangible, immediate black-and-white. In other words, the prefrontal cortex will stop an adult from late-night chocolate cake grazing, acknowledging the future threat of the embarrassing photo hitting the boss.

But the prefrontal cortex doesn’t reach its full operational capacity until adulthood. So, information from the amygdala may not get properly deciphered, causing irrational responses, like big tantrums. Until the teen years, childhood thinking ranges from sensorimotor to pre-operational to concrete operational – fancy words coined by developmental psychologist Jean Piaget to mean that the young brain is mostly pre-logic and egocentric, capable of just a black-and-white, tangible immediacy. In other words — Yum, chocolate cake, right now! (What embarrassing photo? No idea what you mean, don’t care.)

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Then, fold in a sprinkle of ADHD. What we know of the ADHD brain using PET scans and magnetic resonance imaging is that the prefrontal cortex is even less developed — by up to three years — and, also less stimulated than it’s neurotypical cousin due to a lack of certain neurotransmitters. In other words, formal operational thinking is even further delayed.

How Rewards Kick Start the ADHD Brain

What this really means is that the ADHD brain is not unwilling, but rather absolutely unable, to conceptualize the abstract threat of losing that cherished privilege — that video game or that favorite toy.

Which is why therapist after therapist encourages the use of rewards. My clients sometimes fight this — I fought this myself — because it feels like we’re bribing our children to behave. Why should we pay them when they don’t hit their brother? That’s bananas!

Despite how it feels, here’s why it works:

The anticipation of a reward creates dopamine, one of the neurotransmitters not playing nice in our kids’ brains. By coaxing the creation of dopamine, we’re helping to gas up the prefrontal cortex so that it can go the distance we’re asking it to go — to sit still, pay attention, keep hands to self. But the anticipation of a negative outcome creates no dopamine. No dopamine, no gas, no working brain.

[Behavior Chart and Reward Ideas That Work

The ultimate delivery of the reward they earned creates dopamine as well, further aiding the brain in the operational thinking required to remember that there is an enjoyable consequence to good behavior.

Rewards don’t have to be expensive, tangible items to be effective. They can be your encouraging words, time spent with a loved one, a ticket worth ten minutes of screen time. They simply need to be meaningful to your child.

If it still feels like bribery, consider this: while the threat of getting fired might keep you on-time at work, your prefrontal cortex still has the concrete expectation that you will be paid for doing your job. Accessing operational thinking in an under-functioning prefrontal cortex is hard work for our children. By rewarding them, we are teaching our kids that hard work pays off. Now, go reward your terrific parenting with some well-earned chocolate cake. Never mind about that silly photo!

Rewards and ADHD: Next Steps


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