I am thrilled to introduce Sherry Cramer to you. Sherry is an educational therapist with over thirty years of experience working with exceptional students. She recently published a four-part series on motivation and ADHD in the Educational Therapist Journal. It was the best piece I’d ever read in the journal, but the publication is only accessible to Association members.
I wanted more educators and parents to read what she has to say, so I’m honored that she graciously agreed to guest post. Sherry is an educational therapist after my own heart; I hope you enjoy her article as much as I do. You’ll find it chock-full of concrete, actionable strategies to help students find, increase, and maintain motivation.
We all know them – kids with ADHD who are bright, energetic, and creative – yet struggle in school. They don’t enjoy learning. They prefer easier work. They give up easily.1 By all accounts, they lack motivation.
But why? Is it due to a bad attitude? Is it laziness? No, it’s in the wiring!
Looking at the ADHD Brain
Medical technology now permits us (neuro-scientists, that is) to peek inside the brains of folks with ADHD, and what these scientists have learned can help the rest of us understand why kids with ADHD find it so hard to keep motivated in school.
Connections among various parts of the brain form circuits. Within the human brain are two circuits – the reward circuit and the executive circuit – that impact motivational behavior. Brain imaging studies have found that kids with ADHD have differences in one or both of these circuits.
The Reward Circuit
The job of the reward circuit is to help us respond positively to rewards and look forward to the future pleasure of achieving something we value.2 This helps us maintain the motivation to keep working toward long-term goals, such as getting good grades.3 In kids with ADHD, though, the reward circuit has an inadequate supply of the brain chemical dopamine.4 As a result, kids with ADHD have a reduced ability to move beyond the desires and distractions of the moment in order to keep working toward their goals. That is why those text messages will likely hijack today’s algebra homework.
The Executive Circuit
The job of the executive circuit is to help us sort out what we need to do in order to reach the goals we desire.5 It turns out that portions of this circuit are smaller,6 less active,7 and less mature in the brains of kids with ADHD.8 As a result, kids with ADHD have difficulties with brain-based executive skills (also called executive functions). These skills include sustained attention, planning, and time management.9 That is why kids with ADHD often meet with frustration and failure when trying to tackle complex tasks, like research papers.
Academic Consequences of ADHD Brain Organization
Due to these brain differences, kids with ADHD tend to lose sight of future goals in the distractions of the moment, and they are often unsure about how to accomplish goals they still wish to pursue. This puts them at a disadvantage in academic settings, especially in high school and college, where goal persistence and strong executive skills are essential
Is there anything we can do to help?
Studies of kids with ADHD have identified interventions that can increase motivation and enhance school success for kids with ADHD.
Point of Performance Supports: Leveling the Playing Field
Point of performance supports are small changes we can make in a setting or task that can make big differences for kids with ADHD.10 Such supports might include supplying noise-cancelling headphones, preparing organized work spaces, or providing checklists for complex assignments.11
The great thing about point of performance supports is that they can have immediate pay-offs. They can reduce the frustration and increase success for kids with ADHD. However, point of performance supports rely on others to make that success possible. The kids still have the same challenges in unsupported situations. Point of performance supports alone are not enough in the long run.
A helpful resource is Late, Lost and Unprepared: A Parent’s Guide to Helping Children with Executive Functioning by Joyce Cooper-Kahn and Laurie Dietzel.12 This book addresses both point of performance supports and techniques for helping kids build a repertoire of executive skills that can be used in various settings.
Meds: Ramping Up the Supply of Dopamine
Stimulant medications have been found to increase the availability of dopamine in the reward circuits of kids with ADHD.13 This can help them get past the distractions of the moment and work toward future goals, at least during the time the medications are in effect. In the school setting, kids with ADHD tend to improve academic performance when taking appropriate medications. For some kids, booster doses may be needed after school to help them maintain focus and persistence during homework/study time.
Many studies have found ADHD medications to be safe and effective,14 yet medications are not a panacea. It may take considerable trial-and-error to find the “right” medication. Some kids do not respond well to ADHD medications. Others may find that effectiveness of the medication changes over time. Parents often struggle with decisions about medication.
Credible sources of information are critical. An excellent discussion of medication issues is available in Russel Barkley’s book Taking Charge of ADHD: The Complete Authoritative Guide for Parents.15 Look for the most recent edition for up-to-date information.
Behavior Modification: Leveraging the Here and Now
Kids with ADHD seem to be stuck in the present moment. Their need for immediate payoffs makes behavior modification—the carefully planned use of rewards and consequences – a powerful intervention for kids with ADHD.16 Behavior modification can be helpful in increasing desired behaviors, like time-on-task, and in reducing problem behaviors, like missing assignments.
However, the motivation created by behavior modification may only last as long as rewards are provided. Rewards and consequences are not really effective in helping kids with ADHD develop the kind of long-term, internal motivation that is needed for real academic success.17
The book From Chaos to Calm: Effective Parenting of Challenging Children with ADHD and Other Behavior Problems by Janet Heininger and Sharon Weiss offers a real-life perspective on behavior modification from the point of view of a parent and a behavior specialist.18
SO – point-of-performance supports, medication, and behavior modification seem to be helpful for kids with ADHD in specific situations for the short term, but they rely heavily on someone or something outside the kids, and they don’t really promote long-term motivation.
Are there any interventions that promote long term motivation?
Self-Management: Learning to Become Your Own Boss
While still providing adult support, self-management shifts more responsibility to kids. Self-management rests on helping kids with ADHD work toward goals by learning to accurately monitor (notice) their own behavior.19 For instance, a student with ADHD, who is tempted to play online games rather than complete the computer-based lesson he has been assigned, might help develop a plan to record whether he is on-task when given a signal by his teacher. The student later compares his record to his teacher’s record to determine its accuracy. He may also reward himself – if that is part of the plan – for accurately recording his own behavior and showing improvement.20, 21
The real advantage of self-management is that it helps kids with ADHD focus on behavioral expectations, pay attention to their own behavior, and learn to recognize when that behavior is (or is not) on target. Well-designed self-management programs give kids a say in planning all aspects of the program.22 Thus, self-management can help kids with ADHD learn to work as part of a team, set their own goals, and take more responsibility for their own behavior.
More information on designing self-management (self-monitoring) programs can be found in How to: Teach Students to Change Behaviors through Self-Monitoring on the Intervention Central website.23
If-Then Plans: Keeping a Mind’s Eye on the Future
If-then plans (also know as implementation intentions) help kids with ADHD develop specific plans for dealing with obstacles that are likely to get in the way of reaching a future goal.24
To illustrate, a teen with ADHD puts off the online lessons which substitute for school on “snow days.” She figures she has all day to do the work. These lessons take much longer than typical after-school homework assignments, so she often runs out of time and doesn’t complete everything.
An if-then plan could solve the problem: If we have an online-learning day, then I will ask Mom to wake me up by 9 AM, and I will start my assignments by 10 AM.
If-then plans seem simple, but they can be powerful. They support the reward circuit by keeping the goal in mind and the executive circuit by figuring out how to deal with potential pitfalls. If-then plans can help kids with ADHD learn that there are ways, often simple ways, to solve problems. With practice, kids with ADHD can learn how to develop their own if-then plans, a skill that they can continue to use as they deal with motivational challenges in the future.
Heidi Halvorson describes if-then plans in her book 9 Things Successful People Do Differently.25
Executive Strategies: Filling the Tool-Box
Even though executive skills do not come naturally to many kids with ADHD, they can learn to use executive strategies to deal more effectively with the demands of school.26 For example, a student with ADHD who has problems getting started on homework may be taught how to organize and set up everything needed for his homework as soon as he gets home, to take a break and do something he enjoys, and then to start doing the homework at a designated time.27 This strategy can make his (and his parents’) after-school hours run more smoothly and increase his chances of completing homework.
Helping kids with ADHD learn practical executive strategies provides them with the tools they need to be more successful in school (and in life). Strategy routines can be targeted to address the specific needs of individual kids with ADHD and can be tweaked to fit personal and family situations. Though specific routines can be taught, kids with ADHD are often more motivated by coaching approaches, which offer suggestions and options but leave much of the decision-making up to the kids. Since executive skills are life skills, many of the strategies and routines can be modified and practiced in a variety of settings.
A wide range of resources for teaching executive strategies is available. The Seeing My Time program by Mary Dee Sklar focuses largely on time management. 28 The books Smart but Scattered and Smart but Scattered Teens by Peg Dawson and Richard Guare present techniques for developing a variety of executive skills. 29, 30
Appropriate interventions can improve motivation in kids with ADHD, but such motivation may be inconsistent unless it is grounded in a positive social environment.
What can we do to help real motivation take root?
Real motivation – motivation from within the individual – thrives in social environments that encourage positive relationships, competence, and autonomy.31
- Develop positive relationships with kids with ADHD. Empathize with their struggles while focusing on their strengths. Take an interest in their interests. Give them opportunities to shine. Honor them for what they do well.
- Help kids with ADHD become more successful. Teach kids with ADHD what they need to know – academic skills, social skills, executive skills. Help them see errors as guidelines for what to learn next rather than reasons to feel shame. Give them challenges and then use feedback to guide them toward successfully meeting those challenges.
- Respect the need of kids with ADHD to choose their own paths. Find out what they value. Listen to what they want. Empower them by providing choices. Trust them to make their own decisions (and to learn from their own mistakes).
If we provide a nurturing, manageable, trusting environment, motivation will grow.
About Sherry Cramer
Sherry Cramer is a professional member of the Association of Educational Therapists (AET). Her work with students addresses a wide range of educational needs though she is especially interested in developing literacy and school success skills (motivation, study strategies, and executive functions). Prior to establishing her private practice in Fort Wayne, Indiana, Sherry spent more than 30 years as a special education teacher. She is a past president of the Learning Disabilities Association of Indiana, and a recipient of the Shirley Luhn Steele Excellence in Education Award from the Indiana Branch of the International Dyslexia Association. Additional information about Sherry’s educational therapy services can be found at www.els-morethantutoring.com.
- Research References
1 Carlson, C. L., Booth, J. E., Shin, M., & Canu, W. H. (2002). Parent-, teacher-, and self-rated motivational styles in ADHD subtypes. Journal of Learning Disabilities, 35(2), 104-113.
2 Wightman, R. M., & Robinson, D. L. (2002). Transient changes in mesolimbic dopamine and their association with ‘reward.’ Journal of Neurochemistry, 82(4), 721-735.
3 Habor, S. N. (2010). Convergence of limbic, cognitive and motor cortico-striatal circuits with dopamine pathways in primate brain. In L. L. Iversen (Ed.), Dopamine Handbook (pp 38-48). Oxford: Oxford University Press.
4 Volkow, N. D., Wang, G. J., Kollins, S. H., Wigal, T. L., Newcorn, J. H., Telang, F., Folwer, J. S., Zhu, W., Logan, J., Ma, Y., Pradhan, K. Wong, C., & Swanson, J. M. (2009). Evaluating dopamine reward pathway in ADHD: Clinical implications. Journal of the American Medical Association, 302(10), 1084-1091.
5 Balleine, B. W., Delgado, M. R., & Hikosaka, O. (2007). The role of the dorsal striatum in reward and decision-making. The Journal of Neuroscience, 27(31), 8161-8165.
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7 Cortese, S., Kelly, C., Chabernaud, C., Proal, E., Di Martino, A., Milham, M. P., & Castellanos, F. X. (2012). Toward systems neuroscience of ADHD: A meta-analysis of 55 fMRI studies. American Journal of Psychiatry, 169(10), 1038-1055.
8 Shaw, P., Eckstrand, K., Sharp, W., Blumenthal, J., Lerch, J. P., Greenstein, D., … & Rapoport,J. L. (2007). Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proceedings of the National Academy of Sciences, 104(49), 19649-19654.
9 Dawson, P., Guare, R., & Guare, C. (2016). Smart but Scattered Kids.
Retrieved from http://www.smartbutscatteredkids.com/About/terms
10 Barkely, R. A. (n d.). The important role of executive functioning and self-regulation in ADHD. Retrieved from http://www.russellbarkley.org/factsheetsADHD_EF_and_SR.pdf
11 McCloskey, G., & Lennon, L. (2010). Applying an executive function framework in educational therapy. In M. Ficksman & J. U. Adelizzi (Eds.), The Clinical Practice of Educational Therapy: A Teaching Model (pp. 147-185). New York: Routledge.
12 Cooper-Kahn, J., & Dietzel, L. (2008). Late, lost and unprepared: A parents’ guide to helping children with executive functioning. Bethesda, MD: Woodbine House.
13 Shiels, K., Hawk Jr, L. W., Reynolds, B., Mazzullo, R. J., Rhodes, J. D., Pelham Jr, W. E., … & Gangloff, B. P. (2009). Effects of methylphenidate on discounting of delayed rewards in attention deficit/hyperactivity disorder. Experimental and Clinical Psychopharmacology, 17(5), 291-301.
14 Brown, T. E. (2005). Attention deficit disorder: The unfocused mind in children and adults. New Haven, CN: Yale University Press.
15 Barkley, R. A. (2013). Taking charge of ADHD: The complete, authoritative guide for parents (3rd ed). New York, NY: Guilford Press.
16 Luman, M., Oosterlaan, J., & Sergeant, J. A. (2005). The impact of reinforcement contingencies on AD/HD: A review and theoretical appraisal. Clinical Psychology Review, 25(2), 183-213.
17 Deci, E. L., Koestner, O., & Ryan, R. M. (1999). A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. Psychological Bulletin, 125(6), 627-668.
18 Heininger, J. E., & Weiss, S. K. (2001). From chaos to calm: Effective parenting for challenging children with ADHD and other behavioral problems. New York, NY: Perigee Books.
19 Gureasko-Moore, S., Dupaul, G. J., & White, G. P. (2006). The effects of self-management in general education classrooms on the organizational skills of adolescents with ADHD. Behavior Modification, 30(2), 159-183.
20 Barkley, R. A. (2006). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (3rd ed.). New York, NY: The Guilford Press.
21 Intervention Central. (n. d.). How to: Teach students to change behaviors through self-monitoring. Retrieved from https://www.interventioncdiventral.org/print// self_management_self_monitoring
22 Briesch, A. M., & Chafouleas, S. M. (2009). Review and analysis of literature on self-management interventions to promote appropriate classroom behaviors (1988-2008). School Psychology Quarterly, 24(2), 106-118.
23 Intervention Central. (n. d.). How to: Teach students to change behaviors through self-monitoring. Retrieved from https://www.interventioncentral.org/print/self_management_self_monitoring
24 Gawrilow, C., Gollwitzer, P. M., & Oettingen, G. (2011a). If-then plans benefit delay of gratification performance in children with and without ADHD. Cognitive Therapy and Research, 35(5), 442-455.
25 Halvorson, H. G. (2012). 9 things successful people do differently. Boston, MA: Harvard Business Review Press.
26 Dawson, P., & Guare, R. (2010). Executive skills in children and adolescents: A practical guide to assessment and intervention (2nd ed.). New York, NY: Guilford Press.
27 DiFrancesca, S. (1985). Straight A’s: How to help your child improve school grades: A step-by-step program you can use at home to help your child. San Diego, CA: Learning Process Center.
28 Sklar, M. (2013). Seeing my time. Portland, OR: Aguanga Publishing.
29 Dawson, P., & Guare, R. (2009). Smart but scattered: The revolutionary “executive skills” approach to helping kids reach their potential. New York, NY: Guilford Press.
30 Guare, R. & Dawson, P. (2009). Smart but scattered teens: The” executive skills” program for helping teens reach their potential. New York, NY: Guilford Press.
31 American Psychological Association (2004, July, 21). Increasing student success through instruction in self-determination. Retrieved from http://www.apa.org/research/action/success.aspx
- Photo Attributions
“A Sunflower” is copyright (c) 2005 Jon Sullivan and made available under a Creative Commons Attribution 2.0 License: https://creativecommons.org/licenses/by/2.0/legalcode.