Poster #53 - Children With ADHD’s Reward and Punishment Sensitivity Prior to and During a Multimodal Behavioral Intervention

• In Event: 1-169 - Poster Session 04
  In Poster Session: PS 04 Section - Developmental Psychopathology

Integrative Statement

Emerging work suggest that children with disruptive behavior disorders, such as those diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD), are particularly sensitive to rewards while being less responsive to punishment (Dadds & Salmon, 2003; Lumen et al., 2005). These findings have significant treatment implications given that evidence-based interventions for ADHD, such as parent training, focus on reward driven positive parent-child interactions, and consequences (e.g. time-outs) to address negative behaviors (Kaminski et al., 2008). Multimodal interventions that target young children with ADHD and their parents, such as the Summer Treatment Program for Pre-Kindergarteners (STP-PreK; Graziano et al., 2014), have also been effective in improving children’s behavior via an implementation of both reward driven and consequences/punishment-like components. A critical component of the STP-PreK is communication between parents and teachers via the use of a daily report card (DRC; Fabiano, Schatz, & Pelham, 2014). Depending on the DRC, parents are instructed to implement daily rewards at home to reinforce positive behaviors at school, or to withhold rewards as a form of punishment of negative behaviors. The goal of the current paper is to a) examine initial differences in children with ADHD’s reward sensitivity (RS) and punishment sensitivity (PS), b) determine how initial levels of parent-rated RS and PS predict children’s DRC response, and c) examine how parenting factors (parenting style, stress) relate to children’s RS and PS.

The sample comprised 63 preschoolers (Mage= 4.78, 83% male, 84% Hispanic) diagnosed with ADHD who participated in STP-PreK. Prior to intervention, children’s RS and PS were measured via an adapted version of the Sensitivity to Punishment and Sensitivity to Reward Questionnaire for Children (SPSRQ-C) completed by parents. Parents also completed the Alabama Parenting Questionnaire and Parenting Stress Index-short form. As part of the program, parents receive individualized DRCs starting in the second week. Children that meet 75% or greater of their daily goals are given a green color, and parents are instructed to provide the most appealing reward(s) to their children at home. Children earning between 50-74% of their goals are given a yellow color and parents are instructed to provide a less appealing reward. Finally, children getting less than 50% on their DRCs are given a red color and parents are instructed to provide no reward as a consequence. DRCs were collected on 19 days in which parents wrote the rewards provided, and rated on a 5-point scale how much the child liked receiving the reward, or if applicable, how much the child disliked being punished.

Results indicated that preschoolers with ADHD were rated as having significantly higher RS compared to PS, both prior to (d = 0.82), and during treatment (d = 0.95). Additionally, higher RS prior to treatment, but not PS, significantly predicted children’s DRC response, even after accounting for ADHD and ODD symptom severity (see Table 1). Finally, more positive parenting was significantly associated with children’s RS prior to treatment while greater levels of stress was related to less PS (see Table 2). Treatment implications are discussed.

Authors

• Paulo Graziano, Florida International University
  Presenting Author

• Taylor Landis, Florida International University
  Non-Presenting Author

• Andre Maharaj, Florida International University
  Non-Presenting Author