Attention deficit hyperactivity disorder [ADHD] is one of the most common psychiatric disorders of childhood with poor prognosis if not treated effectively. Recommended psychosocial evidence-based treatment for preschool and school-aged children is behavioral parent and teacher training [BPT]. The core elements of BPT are instrumental learning principles, i.e., reinforcement of adaptive and the ignoring or punishment of non-adaptive behaviors together with stimulus control techniques. BPT is moderately effective in reducing oppositional behavior and improving parenting practices; however, it does not reduce blinded ratings of ADHD symptoms. Also after training effects dissipate. This practitioner review proposes steps that can be taken to improve BPT outcomes for ADHD, based on purported causal processes underlying ADHD. The focus is on altered motivational processes (reward and punishment sensitivity), as they closely link to the instrumental processes used in BPT. Following a critical analysis of current behavioral treatments for ADHD, we selectively review motivational reinforcement-based theories of ADHD, including the empirical evidence for the behavioral predictions arising from these theories. This includes consideration of children’s emotional reactions to expected and unexpected outcomes. Next we translate this evidence into potential ADHD-specific adjustments designed to enhance the immediate and long-term effectiveness of BPT programs in addressing the needs of children with ADHD. This includes the use of remediation strategies for proposed deficits in learning not commonly used in BPT programs and cautions regarding the use of punishment. Finally, we address how these recommendations can be effectively transferred to clinical practice.

注意缺陷多动障碍 [ADHD] 是儿童期最常见的精神疾病之一，如果治疗不当，预后不佳。推荐的学龄前和学龄儿童的心理社会循证治疗是行为父母和教师培训 [BPT]。BPT 的核心要素是工具性学习原则，即强化适应性和忽视或惩罚非适应性行为以及刺激控制技术。BPT 在减少反对行为和改善育儿实践方面具有中等效果；然而，它不会降低 ADHD 症状的盲法评分。训练后效果也会消散。该从业者审查提出了可采取的措施，以根据 ADHD 潜在的因果过程来改善 ADHD 的 BPT 结果。重点是改变的动机过程（奖励和惩罚敏感性），因为它们与 BPT 中使用的工具过程密切相关。在对 ADHD 的当前行为治疗进行批判性分析之后，我们有选择地回顾了基于动机强化的 ADHD 理论，包括这些理论产生的行为预测的经验证据。这包括考虑儿童对预期和意外结果的情绪反应。接下来，我们将这一证据转化为潜在的 ADHD 特定调整，旨在提高 BPT 计划在满足 ADHD 儿童需求方面的即时和长期有效性。这包括针对 BPT 计划中不常用的拟议学习缺陷使用补救策略，以及关于使用惩罚的警告。最后，