Reinforcement Contingency Learning in Children with ADHD: Back to the Basics of Behavior Therapy.

Reinforcement deficits in ADHD may affect basic operant learning processes relevant for Behavioral Treatment. Behavior acquired under partial reinforcement extinguishes less readily after the discontinuation of reinforcement than behavior acquired under continuous reinforcement, a phenomenon known as the Partial Reinforcement Extinction Effect [PREE], which has great relevance for the emergence of behavioral persistence. The present study examined acquisition and extinction of operant responding under partial and continuous reinforcement in children with and without ADHD. In addition, we evaluated the effectiveness of gradual stretching the reinforcement rate during acquisition for remedying potential acquisition or extinction deficits under partial reinforcement in ADHD. In an operant learning task designed to mimic the task confronted by an animal in a Skinner box, 62 typically developing and 49 children with ADHD (age: 8-12) were presented with a continuous, partial or gradually stretching reinforcement scheme followed by extinction. Both groups of children acquired the instrumental response more slowly and exhibited more behavioral persistence (reduced extinction) when responding was initially reinforced under partial relative to continuous reinforcement, with no differences between groups. Progressive ratio stretching resulted in faster acquisition than partial reinforcement yet promoted equal behavioral persistence, again without differences between ADHD and TD groups. Unlike suggested by previous research, children with ADHD exhibit neither an acquisition deficit under partial reinforcement nor a deficit in PREE. Of relevance for Behavioral Treatment, gradual reinforcement stretching can be used to facilitate response acquisition over purely partial reinforcement while maintaining equal behavioral persistence upon reward discontinuation.