Attention deficit/hyperactivity disorder (ADHD) is a behaviour problem by which young people, especially children, find it difficult to focus their attention, either by way of being under active, or being hyper active/impulsive. Three main subgroup of ADHD are: hyperactive-impulsive ADHD, inattentive ADHD, and combined ADHD (Albeyatti, 2007). People with hyperactive-impulsive ADHD are hyperactive, impulsive or both (e.g., they are extremely noisy, self-talking, interrupt and intrude upon others, constantly moving, have difficulty waiting in queue, and normally have violent and angry behavior). On the other hand, people with inattentive ADHD are underactive and find it extremely difficult to give close attention to details (e.g., they make careless mistakes, they are forgetful and disorganized, perform very poorly in academic studies, etc.), and the combined ADHD has characterises of both hyper-impulsive and inattentive ADHD (Albeyatti, 2007). Attention deficit/hyperactivity disorder is one of the behavior problem that could be treated using behavior modification. Also, this technique is helpful in the treatment of other behavior problems, such as obsessive-compulsive disorder (OCD), self injurious behavior (SIB), autism, phobias, and generalized anxiety disorder(Martin & Pear,1988).
Behavior Modification
Behavior modification is a therapeutic approach that systematically applies learning principles of operant conditioning to change a problem behavior (Martin & Pear, 1988). These operant learning principles include positive reinforcement, negative reinforcement, positive punishment, negative punishment, extinction, continuous reinforcement schedule (CFR), and partial reinforcement schedules (e.g., fixed interval, variable interval, fixed ratio, and variable ratio). These principles can be applied with such behaviour modification procedures as prompting, shaping, differential reinforcement of other behavior (DRO), chaining, fading, token economies, etc. to change a problem behaviour. In this writing, I will discuss the treatment of ADHD with DRO, a behavior modification procedure
Treatment of Attention Deficit/Hyperactivity Disorder Using the Behaviour Modification Procedure of Differential Reinforcement of Other Behavior
As a behavior modification procedure, DRO involves reinforcing a behavior other than the problem behaviour, when the problem behaviour does not occur for a specific period of time. This reinforcement is contingent on the absence or omission of target problem behaviour and sometimes called differential reinforcement to zero responding (Cooper, Heron, & Heward, 2007). The DRO intervention is implemented in two ways: interval DRO and momentary DRO. The Interval procedure involves providing reinforcement if problem behavior does not occur throughout the entire interval, whereas the momentary DRO procedures involves delivering the reinforcement/reward if the other behavior is exhibited at the time of prompts (Daddario, Anhalt, & Barton, 2007). Once behaviour control has been established, the interval required for delivery of the reinforcement progressively increases (Daddario et al., 2007).
After diagnosing a child with hyperactive-impulsive ADHD and obtaining the baseline data that determine the average duration between behaviors or the inter-response interval (through which the schedule of reinforcement that is to be delivered if the target behaviour does not occur is ascertained, for instance, reinforcement will be delivered at the end of 5 minutes if the target behavior has not been exhibited), the hyperactive-impulsive ADHD can be corrected. At this stage, correcting hyperactive-impulsive ADHD will involve reinforcing immediately and consistently after each period of time intended for the child to be calm and focused has elapsed without symptoms of hyperactive-impulsive ADHD occurring, but withholding reward if the symptom occurs.
When the treatment is effective, there is will be a progressive increase in the period of the child’s calmness or non occurrence of hyperactive-impulsive ADHD that will elapse before reinforcement is given, until the child gets to be normally calm and focused. However, we must also note that certain medicines such as methylphenidate when coupled with behavior modification techniques can be of tremendous help in the treatment of ADHD.
Furthermore, to treat a problem behavior, the therapist conscientiously and ethically follows these stages: obtaining the consent of the client and respecting the client’s right to terminate service at any time; assessing the problem behavior to identify the cause through the analysis of the client’s current environment; collecting baseline data, describing to the client or client’s surrogate the conditions necessary for the program to be effective and those that will hamper its effectiveness; applying the treatment program, ongoing data collection; and following up the treatment after completion to determine whether or not the initial improvements reached during the treatment are maintained after the program has ended (Bailey & Burch, 2011; Martin & Pear, 1988). Finally, behaviour modification would be an effective technique because it involves rigorous and effective methods that are ethically guided and applied by therapists.
Conclusion
There is no gainsaying that behavior modification has been successfully used in correcting problem behaviors. Nevertheless, many critics have argued that the operant learning principle of reinforcement is manipulative, violates people’s autonomy, and removes internal freedom. All these objections, notwithstanding, behavior modification has been a wonderful way of replacing problem behaviors with desirable ones in many settings of life.
References
Albeyatti, A. (2007). Attention deficit hyperactivity disorder. In A. A. Hosin (Ed.), Autism ADHD, Anorexia Nervosa: Essays on Three Childhood Disorders (pp.17-52). New York: The Edwin Mellan Press.
Bailey, J. S., & Burch, M. R. (2011). Ethics for behavior analysts: 2nd Expanded. New York: Routledge.
Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis (2nd ed.). Upper Saddle River, New Jersey: Pearson Education.
Daddario, R., Anhalt, K., & Barton, L. (2007). Differential reinforcement of other behavior applied classwide in a child care setting. International Journal of Behavioral Consultation and Therapy, 3, 342-348.
Martin, G., & Pear, J. (1988). Behaviour modification: What it is and how to do it(3rd ed.).Englewood Cliff, NJ: Prentice-Hall.
Social Change 