Hyperactive kids need clear rules to adapt to new situations: study

Children with ADHD can have trouble adapting to new situations or new rules. (Lisa5201/Istock.com)

Recently published research reveals that hyperactive children don't have the ability to adapt to new situations when new rules aren't explained to them, even if they are rewarded. Children affected by the condition don't have the same means of adapting their behavior using the system of rewards that usually guides people.

Children suffering from Attention Deficit Hyperactivity Disorder (ADHD) can display disruptive or inappropriate behaviour in certain situations and may seem unable to follow rules. However, a new study from the Okinawa Institute of Science and Technology Graduate University in Japan may help explain why children with the disorder have difficulty adapting their behavior.

Researchers ran a game-based test with 167 English-speaking children aged between 8 and 13 years old, more than half of whom were diagnosed with ADHD.

The children were asked to play a simple game, deciding whether there were more blue or red faces in a ten-by-ten grid of mixed blue and red faces on a screen in front of them. The researchers told the children that right answers would be rewarded with verbal praise and a plastic token, but not every time. The reward was not given systematically with each correct answer.

At the beginning of the game, children were rewarded more frequently for correct "blue" answers. After 20 rewards, the game switched to rewarding children more often for correct "red" answers. Then, after another 20 rewards, the game switched back to rewarding "blue" correct answers more of the time.

At first, the scientists saw that children tended to pick the "blue" answer when in doubt, as it was the most often rewarded. When the reward system switched to favor "red" answers, differences in behaviour started to emerge. The children without ADHD showed a clear bias for "red" answers, whereas those with ADHD only shifted their answers slightly towards "red."

The difference became even more striking when the game reverted back to rewarding "blue" answers. The children without ADHD adapted their behaviour to favour "blue," whereas children suffering from ADHD showed very little change in their pattern of answers.

The experiment suggests that children with ADHD are less able to adapt when rules or situations change with no explanation.

The researchers recommend that parents with children affected by the disorder explain the rules, requirements and limits of each new situation. "For these children, we need to make explicit what the requirements are in any given situations. So, we are not relying on them to identify what the conditions are, but we are actually explicitly telling them: this is what you will be rewarded for. And we also need to tell them when we are no longer going to reward them for that," said Professor Gail Tripp, one of the study's authors.

Rules should be kept short, precise and minimal to help children stay focused and attentive. The fewer rules there are to remember, the more likely a child is to take them on board and actually follow them. It's also important to make sure rules and instructions are suitable for a child's age and abilities.

Attention Deficit Hyperactivity Disorder is a brain-based biological disorder that affects around 5 per cent of children worldwide and results from an imbalance of certain neurotransmitters in the brain. It occurs more frequently in boys than girls and is usually diagnosed before the age of 12.

Treatment strategies generally include medication, behavioral and cognitive therapies, family therapy and changes in education and lifestyle.

The study is published in the "Journal of Child Psychology and Psychiatry."