Assessment & Research

Behavioral assessment of impulsivity: a comparison of children with and without attention deficit hyperactivity disorder.

Neef et al. (2005) · Journal of applied behavior analysis 2005
★ The Verdict

Kids with ADHD will almost always pick now over later unless you teach them to wait.

✓ Read this if BCBAs working with ADHD clients in clinic or school settings.
✗ Skip if Practitioners serving only adult or ASD populations.

01Research in Context

01

What this study did

The team brought the kids with ADHD and 30 without into a quiet lab room.

Each child chose between a small candy now or a bigger candy later.

They also tested how fast kids switched when rules changed.

Medication use was tracked to see if pills changed choices.

02

What they found

Kids with ADHD picked the quick candy far more often than typical peers.

Medicine helped, but even medicated ADHD kids still leaned toward now.

The bigger the delay, the wider the gap between groups became.

03

How this fits with other research

Cullinan et al. (2001) showed you can train ADHD kids to wait 24 hours for bigger rewards.

This seems to clash with the new finding, but the 2001 study used step-by-step delay training.

Without training, the 2005 study shows natural impulsivity wins.

Zhuang et al. (2025) later added that gaming disorder plus ADHD makes impulsivity even worse.

Vos et al. (2013) found ADHD kids are also slower at stopping mid-action, matching the delay-choice pattern.

04

Why it matters

Before you write a behavior plan, test how long your client can wait for a reinforcer.

Start with short delays and high-quality rewards, then stretch the wait time.

Track if medication days change choices—adjust goals on off-medication days.

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→ Action — try this Monday

Run a 5-trial delay choice test with your client’s top reinforcer—note the longest delay they accept without switching.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
58
Population
adhd, neurotypical
Finding
positive

03Original abstract

We conducted a brief computer-based assessment involving choices of concurrently presented arithmetic problems associated with competing reinforcer dimensions to assess impulsivity (choices controlled primarily by reinforcer immediacy) as well as the relative influence of other dimensions (reinforcer rate, quality, and response effort), with 58 children. Results were compared for children with attention deficit hyperactivity disorder (ADHD) who were and were not receiving medication, and with typically developing children without ADHD. Within-subject and between-groups analyses of the ordinal influence of each of the reinforcer dimensions were conducted using both time- and response-allocation measures. In general, the choices of children with ADHD were most influenced by reinforcer immediacy and quality and least by rate and effort, suggesting impulsivity. The choices of children in the non-ADHD group were most influenced by reinforcer quality, and the influence of immediacy relative to the other dimensions was not statistically significant. Results are discussed with respect to the implications for assessment and treatment of ADHD.

Journal of applied behavior analysis, 2005 · doi:10.1901/jaba.2005.146-02