The ADHD Challenge: Motivate Me!

adhdFor some of us, there’s that little nagging thought in the back of our minds every time our child has a hard time in school or does less-than-great on an assignment or test. Could there be a real problem? Should we have her tested?

For others, we’ve already gone down that road and been assigned that dreaded ADHD (or ADD, or AD/HD, or whatever the prevailing acronym was at the time) diagnosis. Some were relieved to have an answer, some were freaked out by the label. For many, it meant medicating our pint-sized little one with stimulants.

Whether you fall on the skeptical side of the ADHD epidemic debate, or are a true believer, there’s some new information that’s worth considering as we continue to search for the cause and best approach to kids who have trouble focusing, at school and at home.

New research, published in the Sept. 9th issue of the Journal of the American Medical Association suggests that the key difference in those children identified may be a problem of motivation.

The study, conducted by Dr. Nora D. Volkow, director of the U.S. National Institute on Drug Abuse, found that kids with ADHD have brains that respond differently to the common neurotransmitters that provide a feeling of reward, which is what typically motivates us to continue an activity. When motivation is lacking, inattention and hyperactivity often follow.

The targeted neurotransmitter, which is just a fancy name for a chemical that carries impulses between brain cells, is called dopamine. It’s not known whether the problem comes from a reduced amount of dopamine, or some other difference in dopamine pathways, but the result is impaired sensitivity to reward and motivation.

So how does this translate to real life in the classroom? When a child is involved in a focused task, brain cells are firing at a rapid rate, encouraging progress from one step of the job to the next. Connections between cells are helped along by dopamine, which acts as a kind of chemical cheerleader — “Yay, you’re doing great, you’ve almost got this one licked, keep it up, isn’t this fun??”

If there’s not enough dopamine around, or if the cheering isn’t quite loud enough, the brain loses interest in the task and starts to look around for something better to do, like fidgeting or drawing pictures of superheroes. The medications we use to treat ADHD work by acting on dopamine pathways and cranking up the cheer volume, so the brain hears “WOW, this math problem rocks!” In other words, they increase motivation — at least according to this study.

The authors note that children with ADHD can concentrate on tasks they like and find engaging, such as computer games. The trick is to bring that same level of engagement into the classroom. “The finding should be considered a wake-up call for teachers”, Nancy Volkow said. Knowing that the problem is one of motivation, teachers could devise methods to provide “extra engagement” for these children.

Can we find a way to replace some of that chemical cheerleader in the classroom? Rather than throwing drugs at the problem, teachers take note: motivate me!

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Ellen and Rachel are two old friends and “expert” mamas—one a pediatrician and one a family therapist—with fifty years of parenting experience between them.

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