Behavioral treatment of attention-deficit hyperactivity disorder in the classroom. The use of the attention training system.

Two first-grade boys with ADHD wore small boxes on their desks. The box flashed green when the child was looking at work. It blinked red and took a point away when he looked away for more than three seconds.

Teachers also tried adding a quick rehearsal drill: before work they said, “Eyes on paper,” and had the child repeat it. The study flipped back and forth to see which parts really helped.

The flashing box alone shot on-task time from 30 % to 90 %. Hyperactive behaviors like tapping and humming dropped by half.

Adding the rehearsal drill gave no extra gain. Math problems finished faster, but scores did not change much.

Pilowsky et al. (1998) looks like it disagrees. They saw kids with ADHD give up when rewards came only sometimes. The trick is schedule type: response-cost gives clear immediate feedback every time attention drifts, while partial reward delays it.

Cullinan et al. (2001) extends the idea. After kids learned to pick bigger later rewards, they could wait 24 hours. Both studies show contingencies work; one uses teacher tokens, the other teaches child self-control.

Chen et al. (2001) used the same ABAB flip design. They built math speed, we built attention. Together they show brief reversals can spot what really drives ADHD gains.

You can install a simple response-cost light in any classroom. It cuts ADHD off-task behavior in half without extra staff or medication. Skip the added rehearsal; just set the box, start with easy work, and let the immediate loss of points do the teaching.