My youngest daughter has been struggling in her quest to lose a few pounds, so her older sister suggested an unusual method — something she’d seen on Comedy Central. Essentially, you set a desired target for yourself, and if you don’t meet it within the agreed-upon time, a third party will send a pre-arranged, extremely embarrassing photo of you to someone important — say, your boss. How ingenious, I thought, because it plays on the fear center of the brain, wired for our very survival.

There’s just one problem: No matter how dire the consequences, threats, and punishments — like blasting out your most embarrassing photo — this strategy just doesn’t work effectively on a child with ADHD. No matter how many times you try.

It’s hard for most adults to understand this because consequences, threats, and punishments do work on us. We show up to work on time because we don’t want to get fired. We take out the trash because we don’t want overflowing garbage. We go to bed instead of watching one more “Naked and Afraid” episode because we don’t want to be grumpy-tired the next day. We fill up the gas tank so we don’t wind up stranded on our long journey.

Why does this work for us, but not for our kids with ADHD?

Risk vs. Reward in a Preoperational Brain

When an adult considers consequences, they engage a part of the brain called the prefrontal cortex. It is responsible for critical thinking, for weighing information from other parts of the brain, such as the fear center — the amygdala — and for deciphering the abstract grays of a situation and not just the tangible, immediate black-and-white. In other words, the prefrontal cortex will stop an adult from late-night chocolate cake grazing, acknowledging the future threat of the embarrassing photo hitting the boss.

But the prefrontal cortex doesn’t reach its full operational capacity until adulthood. So, information from the amygdala may not get properly deciphered, causing irrational responses, like big tantrums. Until the teen years, childhood thinking ranges from sensorimotor to pre-operational to concrete operational – fancy words coined by developmental psychologist Jean Piaget to mean that the young brain is mostly pre-logic and egocentric, capable of just a black-and-white, tangible immediacy. In other words — Yum, chocolate cake, right now! (What embarrassing photo? No idea what you mean, don’t care.)

[Read this Next: ADHD Minds Are Trapped in Now (& Other Time Management Truths)]

Then, fold in a sprinkle of ADHD. What we know of the ADHD brain using PET scans and magnetic resonance imaging is that the prefrontal cortex is even less developed — by up to three years — and, also less stimulated than it’s neurotypical cousin due to a lack of certain neurotransmitters. In other words, formal operational thinking is even further delayed.

How Rewards Kick Start the ADHD Brain

What this really means is that the ADHD brain is not unwilling, but rather absolutely unable, to conceptualize the abstract threat of losing that cherished privilege — that video game or that favorite toy.

Which is why therapist after therapist encourages the use of rewards. My clients sometimes fight this — I fought this myself — because it feels like we’re bribing our children to behave. Why should we pay them when they don’t hit their brother? That’s bananas!

Despite how it feels, here’s why it works:

The anticipation of a reward creates dopamine, one of the neurotransmitters not playing nice in our kids’ brains. By coaxing the creation of dopamine, we’re helping to gas up the prefrontal cortex so that it can go the distance we’re asking it to go — to sit still, pay attention, keep hands to self. But the anticipation of a negative outcome creates no dopamine. No dopamine, no gas, no working brain.

[Read this Next: ADHD Minds Are Trapped in Now (& Other Time Management Truths)

The ultimate delivery of the reward they earned creates dopamine as well, further aiding the brain in the operational thinking required to remember that there is an enjoyable consequence to good behavior.

Rewards don’t have to be expensive, tangible items to be effective. They can be your encouraging words, time spent with a loved one, a ticket worth ten minutes of screen time. They simply need to be meaningful to your child.

If it still feels like bribery, consider this: while the threat of getting fired might keep you on-time at work, your prefrontal cortex still has the concrete expectation that you will be paid for doing your job. Accessing operational thinking in an under-functioning prefrontal cortex is hard work for our children. By rewarding them, we are teaching our kids that hard work pays off. Now, go reward your terrific parenting with some well-earned chocolate cake. Never mind about that silly photo!

Rewards and ADHD: Next Steps

• Understand: The Delicate Balance of Rewards and Consequences
• Read: Motivating Kids with External Rewards
• Download: Everything You Need to Know About CBT

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Q: “My son, Jake, is 15 and I am so frustrated that he doesn’t seem to remember anything I say to him. It’s like he has selective hearing. I’ll ask him to do things or remember to check on his sister or even meet me after school and it’s as if he never heard me in the first place. It makes me really angry. Is it ADHD? Can you help me figure this out?” – Remembering Mom

Hi Remembering Mom:

What you are describing is working memory, which is an executive functioning skill often impacted by ADHD. It’s the ability to hold on to new information and have it stored in the brain so you can pull it out and use it (even at a later time) when needed. I equate working memory to a two-lane highway: Information coming in must tether itself to the brain; and information must be ready to go out when prompted.

I teach parents about working memory with this example: Your student is in math class at 8 am and learning fractions. At that time and in that moment, he understands what is being taught. Now fast forward to 8 pm. Your student opens up his math homework, looks at it, and says, “I have no idea what this is. I never learned it.”

Did he hear it? Yes. Did he learn it? Yes. Did he remember it? No. What is actually happening is that the information or instructions he was given earlier in the day did not “superglue” to his brain. It boomeranged right out. So what might look like “selective hearing” is really his brain’s inability to solidify and hold on to information. When you are telling him something you want him to do later on in the day, he is hearing you… at that moment. He’s just not remembering later on.

So how do you help your child to remember?

[Read: Why Working Memory Fails and How to Bolster It]

1. Break down information. Any instructions or requests should be given in bite-sized pieces. If you’re giving your son multi-step directions or instructions, give them one at a time so he has a chance to process each one.

2. Limit the “oh by the ways” and “don’t forgets.” Your child is running out the door (or you are) and you call out, “Oh, by the way, don’t forget to meet me at 3 pm by the side door of the school!” The likelihood that your child will remember that information is pretty slim. As much as you can (and I know this is a tricky one), try to find quiet and distraction-free times to impart instructions. Aim for the night before if you can. And to ensure that your son hears you, make sure you are in the same room and have his full attention. Better yet, write it down.

And a tip within a tip. Don’t demand eye contact. Many children with ADHD cannot auditorily and visually process at the same time. Your son may need to move around to fully listen and be engaged.

3. How is he going to remember? Are y0u asking your son, “How are you going to remember that?” You son needs a scaffolding method to remember information. So asking HOW does just that. Perhaps he can use the Notes App on his phone, set a reminder or an alarm, or even take a picture of written instructions. Encourage him to find a strategy that works for him.

[Read: 15 Memory Exercises for Forgetful Kids]

4. Repeat it backwards. I learned this method from a middle school teacher! She explained that when she wants her students to truly solidify information she has taught, she has them repeat it to her backwards. Her reasoning? That the brain has to work harder to recall information when it remembers backwards, so it’s more likely to stick. So instead of asking your son to repeat back to you what you just said, ask him to do it backwards. I use this trick with all of my student coaching clients, and it works!

Good Luck!

Selective Hearing or ADHD: Next Steps

• Self-Test: Could Your Child Have a Working Memory Deficit?
• Read: “I Remembered Not to Forget!” How to Improve Working Memory in Children
• Read: 10 Ways to Improve Your Teen’s Executive Skills

ADHD Family Coach Leslie Josel, of Order Out of Chaos, will answer questions from ADDitude readers about everything from paper clutter to disaster-zone bedrooms and from mastering to-do lists to arriving on time every time.

Submit your questions to the ADHD Family Coach here!

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.