目的： 奖惩是儿童教育教学过程中经常使用的教学手段。研究旨在探讨奖惩在改善注意缺陷多动障碍（attention deficit hyperactivity disorder,ADHD）儿童注意品质问题中的作用。
方法： 研究选取ADHD儿童32名,对照组儿童33名。采用视听跨通道oddball范式,考察奖惩对ADHD儿童过滤新异刺激的影响。
结果： 儿童类型的主效应显著（F（1,63）=14.522,p=0.001,ηp2=0.187）,相比于正常儿童,ADHD儿童的反应时更短,对奖惩更为敏感;奖惩和新异分心刺激的交互效应显著（F（1,63）=10.285,p=0.002,ηp2=0.140）,对新刺激分心时,奖励更有助于儿童的表现,而在标准刺激分心时,惩罚更有助于儿童的表现;儿童类型与时间间隔交互效应显著（F（1,63）=5.458,p=0.023）,ADHD儿童早期对奖惩反馈的选择性注意相对完整,正确率高于后期反馈;奖惩与时间间隔、儿童类型的交互效应显著（F（1,63）=5.760,p=0.019）,在反应早期及时呈现奖赏刺激,奖励对ADHD儿童的强化作用高于正常儿童。
结论： 奖惩可以调节分心刺激对于ADHD儿童的认知加工。且相比于惩罚,奖赏能更好地引导ADHD儿童将注意从新异分心刺激转移到目标刺激。新异分心刺激与目标刺激的时间间隔恰当时,奖赏能够唤起ADHD儿童完成目标任务的认知状态,提高反应准确性。
Objective: Reward and punishment are commonly used means for children education. To explore the role of reward and punishment in improving the quality of attention in children with attention deficit hyperactivity disorder (ADHD).
Methods: There was a selection of 32 children with ADHD and 33 children for the control group in the study. The effects of reward and punishment on the filtering of novel distractors in children with ADHD were investigated by using the cross-modal oddball task.
Results: The main effect of children type was significant (F(1,63)=14.522, p<0.000, ηp2=0.187). Children with ADHD had a significantly faster reaction time and were more sensitive to reward and punishment compared to normal children. The interaction between reward and punishment and novel distractors was significant (F(1,63)=10.285, p=0.002, ηp2=0.14). In novel distraction, rewards were conducive to children’s performance. However, punishments were more conducive to children performance in standard distraction. The interaction between children type and time interval was significant (F(1,63)=5.458, p=0.023 ). Selective attention of children with ADHD in early stage towards reward and punishment feedback was relatively intact, and the accuracy was higher than the feedback in the late stage. Reward and punishment’s interaction with the time interval and type of children was significant (F(1,63)=5.760, p=0.019). When reward stimulation was timely presented in the early stage of response, the reinforcement effect of reward on children with ADHD was significantly higher than that of normal children.
Conclusions: Reward and punishment can regulate the cognitive processing of distracted stimuli in children with ADHD. Compared with punishment, reward can better guide children with ADHD to shift their attention from novel distractors to target tasks. When the time interval between the novel distractors and the target task is appropriate, the rewards can arouse the cognitive state of children with ADHD to complete the target task and improve the response accuracy.
[1] 金颖, 刘翔平, 李开强, 兰彦婷. (2013). 工作记忆负荷对注意缺陷多动障碍儿童过滤新异分心刺激能力的影响. 心理学报, 45(9), 961-969. doi: 10.3724/SP.J.1041.2013.00961
[2] 汤路瀚, 韩煜昉, 余鸽, 蓝慧燕, 徐方忠. (2020). 多动症儿童持续反应抑制与注意缺陷冲动行为障碍的关系. 中国学校卫生, 41(5), 736-738+743. doi: 10.16835/j.cnki.1000-9817.2020.05.027
[3] 文萍, 陈昱翀. (2016). 注意缺陷多动障碍4岁幼儿的抑制控制与工作记忆. 中国特殊教育,9, 55-59. doi: 10.3969/j.issn.1007-3728.2016.09.009
[4] 肖宏, 刘斌, 曹爱华. (2020). 注意缺陷多动障碍儿童强化敏感性的研究进展. 中国儿童保健杂志, 28 (7), 769-773. doi: 10.11852/zgetbjzz2019-1401
[5] 肖英霞, 张莹瑞. (2014). 注意缺陷多动障碍的ERP研究. 中国特殊教育, (6), 47-53. doi: 10.3969/j.issn.1007-3728.2014.06.008
[6] 徐岩, 周晓林, 王玉凤. (2004). 分心刺激对注意缺陷多动障碍患儿注意维持的影响. 中华儿科杂志, 42(1), 44-48. doi: 10.3760/j.issn:0578-1310.2004.01.013
[7] 祝雨, 罗翔升, 郭晓杰, 陈彦博, 郑苏丽, 刘璐, .. 孙黎. (2021). 注意缺陷多动障碍儿童选择性注意受损的脑影像学特征. 中国心理卫生杂志, (11), 947-953. doi: 10.3969/j.issn.1000-6729.2021.11.011
[8] American Psychiatric Association.(2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing, Inc.
[9] Chang L., Wang M., & Tsai P. (2016). Diagnostic accuracy of rating scales for attention-deficit/hyperactivity disorder: A meta-analysis.Pediatrics, 137(3), e20152749. doi: 10.1542/peds.2015-2749
[10] Dekkers T. J., Agelink van Rentergem, J. A., Koole A., van den Wildenberg W., Popma A., Bexkens A., .. Huizenga H. M. (2017). Time-on-task effects in children with and without ADHD: Depletion of executive resources or depletion of motivation?Eur Child Adolesc Psychiatry, 26(12), 1471-1481. doi: 10.1007/s00787-017-1006-y
[11] Dvorsky, M. R., & Langberg, J. M. (2014). Predicting impairment in college students with ADHD: The role of executive functions.J Atten Disord, 23(13), 1624-1636. doi: 10.1177/1087054714548037
[12] Escera C., Alho K., Winkler I., & Näätänen R. (1998). Neural mechanisms of involuntary attention to acoustic novelty and change. J Cogn Neurosci, 10(5), 590-604. doi: 10.1162/089892998562997
[13] Furukawa E., Alsop B., Shimabukuro S., & Tripp G. (2019). Is increased sensitivity to punishment a common characteristic of attention deficit/hyperactivity disorder? An experimental study of response allocation in Japanese children.Atten Defic Hyperact Disord, 11(4), 433-443. doi: 10.1007/s12402-019-00307-6
[14] Groen Y., Tucha O., Wijers A. A., & Althaus M. (2013). Processing of continuously provided punishment and reward in children with ADHD and the modulating effects of stimulant medication: an ERP study.PLoS One, 8(3), e59240. doi: 10.1371/journal.pone.0059240
[15] Gumenyuk V., Korzyukov O., Escera C., Hämäläinen M., Huotilainen M., Häyrinen T., .. Alho K. (2005). Electrophysiological evidence of enhanced distractibility in ADHD children.Neurosci Lett, 374(3), 212-217. doi:10.1016/j.neulet.2004.10.081
[16] Kollins S. H., Shapiro S. K., Newland M. C., & Abramowitz A. (1998). Discriminative and participant-rated effects of methylphenidate in children diagnosed with attention deficit hyperactivity disorder (ADHD).Exp Clin Psychopharmacol, 6(4), 375-389. doi: 10.1037/1064-1297.6.4.375
[17] Iaboni F., Douglas V. I., & Ditto B. (1997). Psychophysiological response of ADHD children to reward and extinction.Psychophysiology, 34(1), 116-123. doi: 10.1111/j.1469-8986.1997.tb02422.x
[18] Luo Y., Weibman D., Halperin J. M., & Li X. (2019). A review of heterogeneity in attention deficit/hyperactivity disorder (ADHD).Front hum neurosci, 13, 42. doi: 10.3389/fnhum.2019.00042
[19] Parmentier F. B., Elford G., Escera C., Andrés P., & San Miguel I. (2008). The cognitive locus of distraction by acoustic novelty in the cross-modal oddball task.Cognition, 106(1), 408-432. doi: 10.1016/j.cognition.2007.03.008
[20] Pievsky, M. A., & McGrath, R. E. (2018). The neurocognitive profile of attention-deficit/hyperactivity disorder: A review of meta-analyses.Arch Clin Neuropsychol, 33(2), 143-157. doi: 10.1093/arclin/acx055
[21] Pretus C., Picado M., Ramos-Quiroga A., Carmona S., Richarte V., Fauquet J., & Vilarroya Ó. (2020). Presence of distractor improves time estimation performance in an adult ADHD sample.J Atten Disord, 24(11), 1530-1537. doi: 10.1177/1087054716648776
[22] Seipp, C. M., & Johnston, C. (2005). Mother-son interactions in families of boys with attention-deficit/hyperactivity disorder with and without oppositional behavior. J Abnorm Child Psychol, 33(1), 87-98. doi: 10.1007/s10802-005-0936-x
[23] Tosto C., Hasegawa T., Mangina E., Chifari A., Treacy R., Merlo G., & Chiazzese G. (2021). Exploring the effect of an augmented reality literacy programme for reading and spelling difficulties for children diagnosed with ADHD.Virtual Real, 25(3), 879-894. doi: 10.1007/s10055-020-00485-z
[24] Zentall, S. S., & Zentall, T. R. (1983). Optimal stimulation: A model of disordered activity and performance in normal and deviant children.Psychol Bull, 94(3), 446-471. doi: 10.1037/0033-2909.94.3.446
