Predicting Daily Report Card Treatment Response in Early Childhood ADHD: The Relative Importance of Reward vs. Punishment Sensitivity.
Article
Graziano, Paulo A, Goldhagen, Eva L, Hernandez, Melissa L et al. (2026). Predicting Daily Report Card Treatment Response in Early Childhood ADHD: The Relative Importance of Reward vs. Punishment Sensitivity.
. Journal of Clinical Child & Adolescent Psychology, 1-14. 10.1080/15374416.2026.2745073
Graziano, Paulo A, Goldhagen, Eva L, Hernandez, Melissa L et al. (2026). Predicting Daily Report Card Treatment Response in Early Childhood ADHD: The Relative Importance of Reward vs. Punishment Sensitivity.
. Journal of Clinical Child & Adolescent Psychology, 1-14. 10.1080/15374416.2026.2745073
OBJECTIVE: The daily report card (DRC) is one of the few school interventions that may be effective for children with ADHD. The current study examined individual differences in young children with ADHD's reward and punishment sensitivity and how that may relate to their treatment response via the DRC within the context of the Summer Treatment Program for young children with ADHD transitioning to and from kindergarten (STP-K). METHODS: The current sample included 132 children with ADHD (73.5% boys; Mage = 5.52, SD = 0.69, 85.6% Latinx) who participated in the STP-K for seven to eight weeks. Children's reward and punishment sensitivity were obtained via parent report prior to and during the STP-K. RESULTS: Children with ADHD's heightened sensitivity to rewards relative to punishment was evident not only via baseline parent report (d = 0.65) but was significantly accentuated during treatment as part of the DRC implementation (d = 1.60). DRC implementation data demonstrated high parental adherence (95%), a diverse use of reinforcement strategies and, crucially, no evidence of reward habituation. Lastly, pre-treatment reward sensitivity, but not punishment sensitivity, emerged as a significant predictor of DRC treatment response. CONCLUSIONS: Our study provides meaningful data backing both theoretical and clinical notions documenting a greater reward versus punishment sensitivity reinforcement style among young children with ADHD. These findings further solidify school-based interventions for young children with ADHD in terms of documenting the short-term effectiveness of a positive/reward-based DRC for improving children's behavioral functioning in the classroom.
