By Ron Bashian, MD, ACO Research Committee

Introduction

In my years of pediatric practice, before becoming an ADHD coach, the concept of motivation always intrigued me. What catches the attention of children, enlists their enthusiasm, makes them want to persevere, stick to it, and do as well as they can? We coaches speak about identifying our “passions” – to know them in our guts and taste their sweetness. We realize that our strengths are not only areas where we can excel, but also what energize us.[i]

But motivation is not an executive function construct, amenable to neuropsychological documentation from the prefrontal cortex and its neuronal projections. Nor is it some satellite of the amygdala. Its complexity is shaped by multiple factors that are, at least currently, unmeasurable. It is constantly shaped, very environmentally sensitive, and very fragile.

Barkley speaks of motivation as a self-directed appraisal, with distinct emotional elements. This fits into his overarching theme of self-regulation, in which a lack of inhibition is the major premise in his model of ADHD. [ii]

This is in contrast to Brown who, taking from his six-part executive function model, enumerates activation and the sustaining of effort as keys to motivation. Furthermore, he cites Diamonds’ suggestion that those with ADHD are more likely bored than they are distracted. Any subsequent detachment resulting from boredom may, then, be more the issue than inhibition. [iii]

In yet another re-framing, Tuckman sees how easily ADHD could be perceived as strictly a motivation problem (if only you tried harder, listened better, etc.). He sees the difficulties for someone with ADHD as being both ADHD and motivation.[iv]

Adding to that view, Michelle Garcia Winner has spoken convincingly of the crippling effects on an individual with social thinking deficits, which are common in ADHD.[v]  Repercussions on motivation are disastrous.

ERIC – ADHD and Motivation Literature Search

The Educational Resource Information Center (ERIC) is an established and respected resource for references in the educational and psychological literature. My search (ADHD AND Motivation) provided thousands of results. However, filtering these to peer-reviewed, full text journals, from 2000 to 2013 narrowed this down to 41 results.

First, it is exceedingly informative to become aware of the variety of original research into the topic of ADHD and motivation. Incentive types include monetary, social, peer-related, immediate, negotiated, and delay aversion.  Incentive variables include modulation, frequency, amplitude, timing, valence, delay aversion, and conditioning – on or off medication, with or without neurocognitive considerations.

Second, it would be beyond the skope of this article to review the entire body of original research into ADHD and motivation. I have chosen just one article to review because I found it particularly thought provoking when it comes to its application to coaching.

Attributional Responses to Students with ADHD who Fail

The article I chose discusses attribution theory and its application to pre-service teachers (in training) in college training programs. Why this article? While fully valuing specific motivational theories and applications, I see the more urgently instrumental seed of motivational erosion stemming from unspoken assumptions – which include even the assumptions of intelligent and, themselves, highly motivated educators. And coaches know how blinding and corrosive can be the effects of assumptions.

Also, my attention was caught by the last word in the article: Attributional Responses to Students with Attention-Deficit-Hyperactivity Disorder Who Fail by Wood and Benton (2005).[vi]  Knowing how important a strengths-based approach is to living well with ADHD, I wanted to explore the precepts, as well as the outcomes, in this investigation into ADHD and motivation.

Discussion:

So, what does this article have to say – and how surprised should we be by it?

The study used a vignette-oriented approach, the previously validated Clark’s (1997) instrument, pilot tested with graduate students and elementary student teachers. Vignettes were given to a total of 49 pre-service teachers, who had successfully completed at least one undergraduate course in special education.

Vignettes of a student (of average ability and effort) who had just failed a test, male or female, with or without ADHD, and taking or not taking medication were presented – in a study allegedly looking for the response to a student who had failed a classroom test.  In fact, the study was assessing pre-service teacher feelings, expectations, likelihood to punish, likelihood to tolerate, and their estimate of future failure for students.

It was not surprising that more positive feelings (indicating increased tolerance) were associated with both girls and boys with ADHD. What was of more interest was that expectations were higher and tolerance less for students on medication. Boys on medication were punished more often than girls on medication. Yet – strictly within the ADHD category, and disregarding medication status – girls were more likely to be punished than boys. Additionally, a tendency towards an expectation of future failure for girls with ADHD was noted.

The authors speculate as to whether future expectations are lower for girls because they are often diagnosed later than boys, due to the fact that girls with ADHD are usually less hyperactive and disruptive. Additionally, there may be a concern that girls are more seriously affected before evaluation or diagnosis – for the reason that threshold symptoms in a non-hyperactive student may be higher before concern is raised.  Regardless of reason, the authors speculate as to whether a teacher’s inadvertently communicating a lower sense of future success for a girl lowers her personal effort or perseverance in the classroom.

Pre-service teachers’ greater likelihood to punish boys on medication than girls indicates, as per Clark’s earlier work, a likely interpersonal attribution – namely that students off medication cannot control the cause of failure. However, the authors do not speculate on the cause of this gender difference.

In their discussion, the authors acknowledge both limitations to and possible flaws in their study. However, their conclusions can reasonably be generalized. What attributions, concerning controllable or uncontrollable behavior, do parents and teachers ascribe to those with ADHD?  How important is it that educational courses include material that highlights possible differential responses of teachers to male versus female students? How aware are teachers of inadvertent signals affecting the motivation of a student?

So, perhaps we need to put our coaching hats back on. These are questions relevant to each of us, too, as coaches. What attribution assumptions may we have? How might they be manifested, even inadvertently? And what is the effect of these on others – clients, students, our children, or ourselves?


Ron Bashian, MD, is both a pediatrician, who has worked for years with young people with ADHD, and an active ADHD coach getting certified by traditional training and hours. You can contact him at ronsb@msn.com or through his website at validationcoaching.com



[i] Linley, A. et al. (2010). The Strengths Book. CAPP press, UK, first pages.

[ii] Barkley, Russell A. (2012). Executive Functions – what they are, how they work, and why the evolved. The Guilford Press, 87-90.

[iii] Brown, Thomas E. (2013). A New Understanding of ADHD in Children and Adults – executive function impairments. Routledge, pp. 22, 58-59 (citation to Diamond).

[iv] Tuckman, A. (2009). More Attention, Less Deficit: Success Strategies for Adults with ADHD. Specialty Press.

[v] Winner, Michelle Garcia. (2013). CHADD Annual International Conference, November 7-9, keynote handout: https://www.socialthinking.com/images/handoutWinner_Keynote_11-13_CHADD.pdf

[vi] Wood, James G., and Benton, Stephen L. (2005). Attributional Responses to Students with Attention-Deficit-Hyperactivity Disorder Who Fail. Teacher Education and Special Education, Volume 28, No. ¾, 153-162.