Shaping Tolerance for Delayed Rewards



Status:Recruiting
Conditions:Psychiatric
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:3 - 6
Updated:10/14/2018
Start Date:September 12, 2017
End Date:May 2021
Contact:Samantha Blair, PhD
Email:hs-airlab@ucdavis.edu
Phone:916-703-0325

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Feasibility of Shaping Tolerance for Delayed Rewards in Impulsive 3-6 Year Olds

Deficits in self-control are of major public health relevance as they contribute to several
negative outcomes for both individuals and society. For children, developing self-control is
a critically important step toward success in academic settings and social relationships, yet
there are few non-pharmacological approaches that have been successful in increasing
self-control. We found in our earlier studies that self-control can be increased in
preschool-aged children with high impulsivity by using games in which they practice gradually
increasing wait-time for larger, more delayed rewards. We are performing this current study
to test if this training to increase self-control can be increased using mobile app
technology, with computerized game time being used as a reward.

Problems with self-control are of major public health relevance as they are associated with
substance abuse, suicide attempts, lower academic functioning, poor financial planning, and
physical and mental health issues that impact both individuals and society. The ability to
obtain immediate rewards in our daily lives is increasing due to technological advances from
on-line games to Amazon deliveries within 1 hour after placing an order. There are fewer
opportunities for children to learn how to wait. For children, developing self-control is a
critically important step toward success in academic settings and social relationships, yet
there are few non-pharmacological approaches that have been successful in increasing
self-control.

Our objective in this current proof-of-concept study is to replicate and extend our earlier
finding (Schweitzer & Sulzer-Azaroff, 1988) in which we demonstrated that self-control could
be increased in preschool-aged children with high rates of impulsivity by using a "shaping"
procedure whereby delays to larger, more delayed rewards were gradually increased. In this
study we will aim to show that shaping self-control can be implemented using more
sophisticated experimental design and mobile app technology.

A principal goal of this R03 pilot project is to refine the procedural methods to ensure that
they are developmentally-appropriate using a well-controlled design and procedures. Our plan
is to develop and implement a mobile application ("app"), "Delay Tolerance Application"
(DelTA) that administers real-time rewards in a delay discounting procedure, in which the
child will choose between an immediate, shorter game playing and a delayed, longer version of
playing the same game.

This project will assess the feasibility of delivering the procedure via a mobile app and
test if computerized games are effective rewards in a delay discounting context for young
children (3-6 years) given that previous methods used immediately consumable rewards (e.g.,
candy). Positive findings from this proof-of-concept project will support future clinical
trial projects to improve self-control and the use of the procedure for other interventions.
The app may eventually serve as a targeted, precision intervention for children who exhibit
elevated impulsivity.

Inclusion Criteria:

- Age 3-6 years

- Hyperactivity/Impulsivity subscale scores of the ADHD Rating Scale-IV Preschool
Version (children 3 to 4 years of age) or the Attention and Behavior Scale (children 5
to 6 years of age) ≥ 90th percentile from either the parent or teacher's responses

- Physically and visually able to use the tablet, as determined by pre-assessment
performance

- Children taking psychotropic medication will be included, but must maintain the same
medication and dose over the course of the study and for each assessment and exhibit
elevated levels of impulsivity based on parent or teacher ratings while medicated.

Exclusion Criteria:

- Children with autism spectrum disorder and/or intellectual disability (by parent or
teacher report or the NIH Toolbox Picture Vocabulary Test).
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Sacramento, California 95817
Phone: 916-703-0294
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