(PS6-91) Reward and Punishment Experiences in the Daily Lives of Children with Attention Deficit Hyperactivity Disorder (ADHD)

Altered sensitivity to reinforcement and punishment is reported in experimental studies of learning and response allocation in children with ADHD, and the neurobiological basis of these alterations are hypothesized. Recommended psychosocial interventions for ADHD, e.g., behavioral parent training, emphasize the use of stimulus control and the timely delivery of reward and mild punishment (i.e., response cost) to increase the occurrence of appropriate behaviors and reduce undesired actions. However, these programs do not specifically address altered reinforcement sensitivity in those with ADHD and therefore may not be optimized.

To incorporate empirical findings on altered reinforcement sensitivity into interventions, we first need to understand how parents of children with ADHD apply behavioral consequences in the daily lives of their children, difficulties they have in doing so, and how children experience these consequences. Finding reward opportunities for children with behavioral difficulties can be challenging. Therefore, this study aimed to collect qualitative data on the daily use and experiences of reward/punishment for families of children with ADHD. Children's reward preferences and their parents' knowledge of these were also explored.

Semi-structured interviews were conducted with children being assessed for ADHD (n = 15, mean age = 8.48, SD = 1.60, female n = 7) and their primary caregiver (n = 15, mean age = 39.07, SD = 4.32, female n = 15) by trained clinicians. The ADHD symptoms of these children were elevated (Conners Comprehensive Behavior Rating Scales Parent Report, mean T score Inattention = 78.53/Hyperactivity/Impulsivity = 70.67). Each interview lasted 20-30 minutes, and the questions included how parents use reward and punishment to encourage or reduce certain behaviors in different situations (e.g., transition from one activity to another) and how their children react to the availability and delivery of the consequences (e.g., when they have to wait for rewards). Data analysis is ongoing to evaluate the consistencies between these real world experiences with experimental research findings. The implications for parent behavioral management training for ADHD will be discussed.