Reward Effects on Cognition, Motor Skills, and Motivation in Children (ADHD)

The Effect of Reward on Cognitive Functioning, Motor Skills, and Motivation in 8- to 10-Year-Old Children With Attention-Deficit/Hyperactivity Disorder (ADHD)

This interventional study aimed to aimed to evaluate the effects of rewards on cognitive function, motor skills, and motivation in 8- to 10-year-old children with ADHD following 3- and 6-week interventions.

Study Overview

• Status: Completed
• Conditions: Attention-Deficit/Hyperactivity Disorder (ADHD)
• Intervention / Treatment: Other: Conventional Physiotherapy group; Other: Reward based physiotherapy group

Detailed Description

Research problem: children with Attention-Deficit/Hyperactivity Disorder (ADHD) are inattentive and distractible, which often makes it difficult for physiotherapists to keep them interested, as prolonged activity often causes boredom.

The aim of this study was to determine the effects of reward on cognitive function, motor skills and motivation in 8-10 year old children with ADHD after 3 and 6 week interventions.

Objectives of the study:

1. To compare the cognitive function of children receiving conventional physiotherapy with that of children receiving reward therapy. 2. To compare the motor skills of the children receiving conventional physiotherapy with those of the children receiving the reward. 3. To compare the motivation of children receiving conventional physiotherapy with that of children receiving rewards.

The hypothesis of the study is that exercise with rewards improves cognitive function, motor skills and motivation better than conventional physiotherapy in children aged 8 to 10 years with attention deficit disorder.

Research methods: the study included 60 boys diagnosed with ADHD. Age: 8-10 years. Subjects were randomly divided into reward and conventional physiotherapy groups. In both groups, subjects performed exercises for balance and coordination for 3 times per week for 45 min, but in one group subjects received a reward using virtual reality.

• Study Type: Interventional
• Enrollment (Actual): 67
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Lithuania
  • Kaunas, Lithuania, 44221
    • Department of health promotion and rehabilitation

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Diagnosis of ADHD confirmed by a neurologist;
2. male gender;
3. age between 8 and 10 years.
4. ability to read and write;
5. patient's willingness to attend physiotherapy sessions;

Exclusion Criteria:

1. claustrophobia;
2. neurological disorders (e.g., autism spectrum disorder, depression, obsessive-compulsive disorder, Tourette's syndrome);
3. chronic medical conditions (e.g., cancer, diabetes, cardiovascular diseases);
4. previous treatment for ADHD (e.g., pharmacological therapy, cognitive behavioral therapy) within the last six months;
5. Medication use.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Conventional outpatient PT group (n=30).; Conventional outpatient PT group received typical physical exercises with duration of 6 weeks	Other: Conventional Physiotherapy group; Participants in the regular physical therapy group performed balance and coordination exercises three times a week without the use of rewards. These subjects completed only physical exercises, without engaging in game-like interactive tasks using virtual reality (VR) glasses. Each session was conducted at the same time for each subject, with a potential variation of ±1 hour.
Experimental: Reward-based PT group; This group received reward based virtual reality exercises with duration of 6 weeks. Reward was extra exercises using virtual reality	Other: Reward based physiotherapy group; Subjects in the reward group performed balance and coordination exercises three times a week, with the inclusion of rewards. At the end of each exercise session, participants engaged in game-like interactive tasks using virtual reality (VR) glasses. Exercise sessions were conducted at the same time for each subject, with a permissible variation of ±1 hour.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Static balance	was assessed with The Abili Balance Analyzer platform. The software associated with the platform provided an overall stability index based on the tests conducted: Very Good: 0.8; Good: 0.8 to 1.8; Poor: >1.8.	At baseline and after 6 weeks
Attention task with spatial numbers	Number of mistakes and Speed coefficient was recorded.	At baseline and after 6 weeks
Attention task with spatial figures	Number of mistakes and Speed coefficient was recorded.	At baseline and after 6 weeks
Easy figural memory task	Number of mistakes and Speed coefficient was recorded.	At baseline and after 6 weeks
Hard figural memory task	Number of mistakes and Speed coefficient was recorded.	At baseline and after 6 weeks
Visuo-Constructional Ability task	Number of successful attempts and duration (in seconds) was recorded	At baseline and after 6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pediatric motivation Scale (PMot)	Participants were instructed to respond to the questions by selecting a visual image that best represented their emotional state. Each visual image was assigned a numerical value, ranging from 1 (very poor) to 6 (excellent), for statistical data analysis and outcome evaluation (numeric value).	At baseline and after 6 weeks

Collaborators and Investigators

• Sponsor: Lithuanian Sports University
• Investigators: Principal Investigator: Vilma VD Dudoniene, PhD, Lithuanian Sports University; Study Chair: Vilma Dudoniene, PhD, Lithuanian Sports University

Study record dates

Study Major Dates

• Study Start (Actual): January 15, 2023
• Primary Completion (Actual): January 15, 2024
• Study Completion (Actual): May 15, 2024

Study Registration Dates

• First Submitted: January 15, 2025
• First Submitted That Met QC Criteria: January 22, 2025
• First Posted (Actual): January 29, 2025

Study Record Updates

• Last Update Posted (Estimated): August 29, 2025
• Last Update Submitted That Met QC Criteria: August 25, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: motivation; attention; motor skills; reward-based therapy
• Additional Relevant MeSH Terms: Mental Disorders; Neurodevelopmental Disorders; Attention Deficit and Disruptive Behavior Disorders; Attention Deficit Disorder with Hyperactivity
• Other Study ID Numbers: Lithuanian Sports University

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The consent form of the informed person states that the individual data of the subjects will not be disclosed, but can only be used to summarized.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No