Department of Developmental Psychology, University of Amsterdam, Weesperplein 4, Amsterdam, The Netherlands.
J Abnorm Child Psychol. 2012 Jul;40(5):669-81. doi: 10.1007/s10802-011-9601-8.
Visual-spatial Working Memory (WM) is the most impaired executive function in children with Attention-Deficit/Hyperactivity Disorder (ADHD). Some suggest that deficits in executive functioning are caused by motivational deficits. However, there are no studies that investigate the effects of motivation on the visual-spatial WM of children with- and without ADHD. Studies examining this in executive functions other than WM, show inconsistent results. These inconsistencies may be related to differences in the reinforcement used. The effects of different reinforcers on WM performance were investigated in 30 children with ADHD and 31 non-ADHD controls. A visual-spatial WM task was administered in four reinforcement conditions: Feedback-only, 1 euro, 10 euros, and a computer-game version of the task. In the Feedback-only condition, children with ADHD performed worse on the WM measure than controls. Although incentives significantly improved the WM performance of children with ADHD, even the strongest incentives (10 euros and Gaming) were unable to normalize their performance. Feedback-only provided sufficient reinforcement for controls to reach optimal performance, while children with ADHD required extra reinforcement. Only children with ADHD showed a decrease in performance over time. Importantly, the strongest incentives (10 euros and Gaming) normalized persistence of performance in these children, whereas 1 euro had no such effect. Both executive and motivational deficits give rise to visual-spatial WM deficits in ADHD. Problems with task-persistence in ADHD result from motivational deficits. In ADHD-reinforcement studies and clinical practice (e.g., assessment), reinforcement intensity can be a confounding factor and should be taken into account. Gaming can be a cost-effective way to maximize performance in ADHD.
视觉空间工作记忆（WM）是注意力缺陷多动障碍（ADHD）儿童受损最严重的执行功能。一些人认为，执行功能的缺陷是由动机缺陷引起的。然而，目前还没有研究调查动机对患有和未患有 ADHD 的儿童的视觉空间 WM 的影响。在除 WM 之外的执行功能中研究这一点，结果不一致。这些不一致可能与使用的强化物不同有关。在 30 名 ADHD 儿童和 31 名非 ADHD 对照组中，研究了不同强化物对 WM 表现的影响。在四个强化条件下进行了视觉空间 WM 任务：仅反馈、1 欧元、10 欧元和任务的计算机游戏版本。在仅反馈条件下，ADHD 儿童在 WM 测量上的表现比对照组差。虽然激励措施显著提高了 ADHD 儿童的 WM 表现，但即使是最强的激励措施（10 欧元和游戏）也无法使他们的表现正常化。仅反馈为对照组提供了达到最佳表现所需的充分强化，而 ADHD 儿童则需要额外的强化。只有 ADHD 儿童的表现随着时间的推移而下降。重要的是，最强的激励措施（10 欧元和游戏）使这些儿童的表现持久性正常化，而 1 欧元则没有这种效果。执行和动机缺陷都会导致 ADHD 中的视觉空间 WM 缺陷。ADHD 中任务持久性的问题源于动机缺陷。在 ADHD 强化研究和临床实践（例如评估）中，强化强度可能是一个混杂因素，应予以考虑。游戏可能是一种具有成本效益的方法，可以最大限度地提高 ADHD 患者的表现。
