Cognitive control and motivation in children with ADHD: How reinforcement interacts with the assessment and training of executive functioning

This dissertation focuses on the interaction between two neuropsychological processes that are proposed to play a pivotal role in explaining the problems of children with ADHD: executive functioning (EF) and motivation. We examined the effects of reinforcement on assessment and training of EF in children with ADHD. Visuospatial working memory (WM) is considered the most impaired EF in children with ADHD, and is composed of short-term memory and a central executive.
Conclusions: (1) both executive- and motivational deficits give rise to the visuospatial WM deficits of children with ADHD, (2) within both the combined subtype (ADHD-C) and the inattentive subtype of ADHD (ADHD-I) only a minority of children has motivational deficits, (3) even with these motivational deficits taken into account, the majority of children with ADHD-C and 33.3% of children with ADHD-I are impaired on visuospatial WM, (4) in contrast to children with ADHD-C, children with ADHD-I seem unimpaired on visuospatial short-term memory; only an impaired central executive and motivational impairments give rise to their deficits in visuospatial WM, (5) visuospatial WM and motivation represent independent neuropsychological domains, (6) problems with task-persistence in children with ADHD-C result primarily from motivational deficits, (7) gamification can maximize performance in children with ADHD-C, (8) gamification of a WM-training can improve motivation and training-performance in children with ADHD, and can enhances the efficacy of training, and (9) in multiple EF-training, not the training of EF, but mainly nonspecific treatment factors seem related to the far transfer effects that are found on EF and behavior.