Using a Reward System to Improve ADHD Behavior

"Do a great job and you get a prize!" Sound familiar? This approach to behavioral management is used everywhere, for adults and children — whether at home or at school, in the workplace or in the gym. When it's used consistently and in a structured manner for children with special needs, it is often called "behavior management." 

Behavior management is really just as simple as it sounds:

  1. Identify the problem behaviors that should be changed
  2. Establish a set of rewards to be earned for good behavior
  3. Stick to the plan

Most of the time, behavior management systems are set up by specialists in a school setting. Ideally, they are supported at home so that children receive the same messages in different situations.

1. Identify Target Behaviors

The first step is to identify the behaviors you want to see and the behaviors you want to decrease or eliminate. Clearly defined target behaviors work best. Ideally, the behaviors should be concrete, measurable, and easy to identify. For example:

Good: "Raise your hand rather than blurting out answers in Math class today."

Bad: "Stop blurting."

2. Identify Effective Rewards

Rewards need to be motivating to be effective. It's important to identify what the child actually wants, by asking or through observation. Often, a reward can take the form of an opportunity to do something desirable — stand at the head of a line, make announcements over the loudspeaker, etc. — but it can also be something concrete such as a toy or cookie. For older children, it can be helpful to implement a token system: a child earns a sticker for each period of good behavior. When a certain number of stickers are earned the reward is implemented.

In the past, consequences were also a part of behavior management programs, but in general, a reward/no reward program is preferable. If consequences are implemented, they must be carefully selected to be a disincentive to the child without creating more problems than they solve. For example, taking recess away from a hyperactive child can create serious problems; having a child stay after school may actually feel like a reward in some cases.

3. Enforce the Plan

In order for a behavior modification plan to be successful, it must be consistently enforced. Rewards and consequences should be given as soon as possible after the target behavior has occurred. Negative behaviors must receive consequences immediately, as well (if consequences are a part of the plan). Frequent monitoring and feedback are also helpful, as is implementing the plan across settings such as school/work and home.

Behavioral Interventions for Adults

Adults can also benefit from a reward system. It is easy to get bogged down with the negative aspects of ADHD. Encouragement, focusing on the positive, and rewarding yourself for successes are all important strategies.

Use lists to help keep yourself focused and on track. Check off each item as you complete a task. Set up a color-coding system to help keep you organized. Use a daily schedule or planner, use Post-its or dry erase board for reminder notes.

No matter what age, people with ADHD can benefit from regularly scheduled breaks, frequent feedback, work given in small increments, reduce clutter and distractions, increased time to complete the work, and help in organizing tasks. These are all ways to have an influence on your environment, structuring it to give yourself the best opportunity for success.

By Keath Low
 Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD.