ADHD: A Path to Success
Chapter 4 of
first 6 Chapters
The Conditioned Attentional Avoidance Loop Model
(continued)
They do this much like a baby turning its head away from something it does not like. Thus, ADHD is not a deficit, defect, or deficiency. It is a highly skilled, coping mechanism that, at the moment, serves the child.
The thought of doing math makes him angry and depressed, feelings he would just as soon avoid. Although he dislikes the feelings he experiences during math class, he cannot physically avoid being in math class every day. He finds that if he fantasizes about skate boarding, being in math class does not feel as bad.
PAIN-FREE MATH CLASS
Over time, due to negative reinforcement, he learns to fantasize sooner, better, and more automatically. He effectively develops greater protection from the feelings he used to get from math class.
Negative reinforcement is an often-misunderstood concept. Unlike common usage, it is not equivalent to punishment. It is like lying on the beach in the sun until you are very hot and uncomfortable, then terminating this aversive overheating, by getting in the cold water. This temperature change is experienced as positive change. This positive feeling of cooling off thereby reinforces dunking in the water when you have become too hot.
Therefore, negative reinforcement is the cessation of aversive stimuli, which by contrast to the aversion, is experienced as a positive or reinforcing change.
There are at least two other positive feedback loops that further exacerbate this process of learned attentional avoidance.
First, the refinement of attentional avoidance further reduces a child's awareness of, and participation in, schoolwork. The child eventually begins to slip involuntarily into conditioned attentional avoidance and, as a result, he spends more and more time in his "own little world."
Second, the teacher is shaped into being more demanding and coercive through negative reinforcement because of the short-term positive benefit of such efforts. This short-term success shapes increasing long-term negativeness in the teacher.
The first process works like this:
As the teacher becomes more determined and insistent that the child do his work "or else," the experience of being in school becomes more negative to the child. So any mental escape he manages (and he will escape many times) is even more negatively reinforcing than it had been previously. That's because it affords successful escape from an increasingly noxious situation.
Second, this negative reinforcement teaches faster and stronger attentional avoidance so that, next time, the teacher must be even more demanding to get the same result.
The escalation of the teacher trying to control the child and the decreasing functioning of the ADHD child is a regularly observed pattern in school settings. Yet, the cause and effect relationship between these two sets of behaviors is not generally understood.
In summary, the ADHD child's decreasing performance elicits more negative feedback from the teacher. The more negative feedback used by the teacher to exact (temporary) compliance and improved performance, the more negative reinforcement the child has for learning more effective attentional avoidance skills. The child is then in a downward spiral that feeds on itself.
There is also a more general and damaging level of conditioning going on with the ADHD child.
With practice, the child learns to detect, earlier and earlier, links in the chain of events that typically lead to the aversive situation, such as a math assignment.
By sensing and reading the cues earlier and earlier — in fact, even before the original problem shows itself — the escape trigger is pulled sooner and an increasing portion of the child's world is subject to involuntary, conditioned attentional avoidance. He automatically "checks out" in a wider variety of situations as time goes on.
Continuing the above example, the child now learns to avoid not only math but also the math book, math homework sheets, the math teacher who gives him these materials, and the math classroom.
Bottom line — his avoidance coping mechanism is being triggered by a multitude of stimuli, which makes him mentally absent more often, in fact, most of the time, which, in turn, makes his performance deteriorate further.
Children's Limited View of Time
For all of us, immediate rewards and punishments rule our behaviors more than distant gratifications and retributions. Therefore, the arrangement of events in time is critical to development of ADHD.
Take the drinker, for example. At the party last night, the alcohol relaxed him, made him feel more social, and generally made the evening more fun. The reinforcers for drinking were significant and immediate.
The next morning, he had a hangover with dry cottonmouth, a headache, the sensation of cotton candy for brains, and a roiling stomach. The next morning, he felt miserable. But that was many hours after the behavior of drinking, so it had little effect on the drinking behavior.
How many people would drink if they got the hangover first, immediately after drinking, and the next morning they felt great? Not many. Next morning's good feelings would be so remote that they would be unlikely to reinforce drinking. But the close proximity of drinking and the hangover would likely suppress drinking.
When the temporal sequence of the same reinforcers and punishers is changed, the effect on the behavior they follow also changes. For young children, this effect is exaggerated, which makes them particularly vulnerable to certain contingencies.
Young children view time quite differently than adults. At the developmental stage between the ages of five and nine, when children are most often developing ADHD, the idea of long-term consequences has little meaning to them. Next week is as far away as next year. Managing the aversiveness of experience here and now is all that matters. Thus, the fact that their attentional avoidance strategies are eventually going to be very costly to them is meaningless.
Attentional patterns leading to ADHD are likely to begin to form long before adults in the child's world begin to notice them. Once the child discovers attentional escape and negative reinforcement they tend to continue.
These attentionally avoidant patterns work when they are first learned and continue to work long after they should have been replaced with more effective strategies. It is difficult for the child to give up something that has worked so well for so long.
At this developmental stage, children are very responsive to short-term rewards and thereby more vulnerable to problems like ADHD that are shaped by an emphasis on short-term contingencies. They are not developmentally ready to use the thinking patterns, i.e., choices that we attempt to impose on them.
Avoidance Conditioning: The Horse Grows Bigger
Avoidance conditioning in children is similar to adult phobic behavior. For example, consider the behavior of the patient who has a horse phobia. The more successful he is at avoiding horses, the more he feels compelled to avoid them.
For the phobic person, being thrown off a horse may have started out as only mildly anxiety producing. As the actual experience gets more remote because of successful avoidance of horses, the memory of being thrown off the horse gets progressively worse. The recall experience elicits more and more fear than the original experience did.
This increased aversiveness of the memory of being around horses makes it more reinforcing to successfully avoid horses, which in turn makes being around horses more fearful, and so on so that a vicious circle develops.
The exact same process unfolds with the regard to the ADHD child.
What was initially a mildly aversive school situation becomes successively more disturbing after many opportunities for successful avoidance. The ADHD child may have started out mildly frustrated or anxious in math class, but after successfully spacing out in class for a while, the remembered experience of math class may be worse than the previously experienced reality of it. It is like being thrown off a horse.
Folk wisdom tells us to climb immediately back on the horse before fear has a chance to grow. And that folk wisdom is very accurate.
Computer Aided Emotional Restructuring provides an efficient psychological tool to climb back on the math horse. At first, the CAER ride on the math horse is emotionally evocative, just like climbing back on a real horse might be. Children often express anger, fear, anxiety, and depression as they mentally re-experience their academic phobias.
But CAER makes it much easier to stay in the saddle until the emotional bucking stops and the scary math beast is tamed and finally becomes emotionally flat.
