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Attention Deficit Hyperactivity

 

Disorder (ADHD) and Motivational

 

Implications

 

28/01/2026

 

1. How the ADHD brain works 

2. The impact of stimulant medication

3. The behavioural differences associated with ADHD

4. The impact of behavioural support

5. The INCUP framework.

 

1.  How the ADHD brain works

 

The brain operates as a network, with different areas responsible for different functions, and these areas are in constant communication with one another. However, this act of communication is heavily reliant on chemical neurotransmitters, to transmit information from one area of the brain to another. 

 

Individuals with ADHD have an impairment of proper communication between the prefrontal cortex and the basal ganglia.

The prefrontal cortex is the area of the brain responsible for the functions of motivation, planning, decision-making, working memory, attention, organisation, impulse control, and flexible thinking. 

The basal ganglia is the area of the brain responsible for the functions of action selection and execution, procedural learning, habit-building and regulating reward-based behaviours – whilst also planning and sequencing movements. 

 

The prefrontal cortex communicates with areas of the basal ganglia, which then the basal ganglia processes the value of the action and then selects accordingly, sending this message back to the prefrontal cortex (in simple terms). 

This is what should happen in the ADHD brain. However, the key difference within the ADHD brain is too little baseline amounts of chemical neurotransmitters dopamine and noradrenaline. This means the prefrontal cortex and the basal ganglia cannot communicate with one another reliably – and as dopamine is primarily responsible for the communication between these two brain areas, the brain cannot reinforce useful actions nor suppress ineffective ones reliably. This is why ADHDers ambitious and conscious goals cannot be translated into efficient, learned, and appropriately timed actions – and as a result, there is less coherence in our behaviour. 

 

If you imagine this through the analogy of team-sports, if a team of players (for example, in football or basketball) do not communicate with one another for an entire game – this would ultimately lead to confusion amongst the players in the team, and a very unfortunate loss of the game. This is the brain difference in ADHDers explained in a nutshell.

 

2. The impact of stimulant medication

 

Stimulant medication is therefore the key which is used to unlock this goal-oriented behaviour. Stimulants are clinically prescribed psychoactive drugs which boost neurotransmitter levels. Many neurotypicals might enjoy caffiene, which is a naturally occurring stimulant in coffee – providing that gentle boost in productivity, etc. 

For ADHDers, there are a range of stimulants which can be clinically prescribed, such as methlyphenidate or lisdexamfetamine. These are much stronger, and work much more precisely in increasing chemical neurotransmitters dopamine and noradrenaline in the brain. The increase in dopamine, only once sufficient, leads to huge improvements in all of the functions mentioned previously – such as motivation, planning, decision-making, habit-building, regulating impulses, etc. This is because the prefrontal cortex and basal ganglia can now essentially communicate properly. 

However, one downside of these stimulants, is that they do not permanently treat ADHD, and there additionally is no "cure" for ADHD. Looking at the bigger picture through, as these stimulants work 8-12 hours in a day once taken, these can provide much of the functional improvement required for ADHDers to thrive in their health, social life, work and education. After a prolonged period of taking this medication however, comes the risk of a tolerance developing – where functionality decreases as medication becomes weaker in effect – in which a break from 2-14 days off the medication should be taken to restore functionality. 

 

3. The behavioural differences associated with ADHD

 

As mentioned previously, there are a variety of functional differences associated with ADHD, such as a lack of motivation, planning, organisation, coherence in decision-making, impulse control etc – as a result of the differences in the brain. This outwardly appears as hyperactivity, impulsivity, or inattentiveness – as the ADHD brain is essentially constantly making attempts to bring forth the level of stimulation required to focus on a task, or to work towards a goal. 

However, some ADHDers may experience "hyperfocus" – an informal term to describe an intense, prolonged concentration on a specific task or interest. This causes a person to become so engrossed in a task they ignore their surroundings, time, and even basic needs such as eating or sleeping. Learning, in particular, can be a very rocky and unsteady process for ADHDers, as interest may peak for one moment, and then dip in another. ADHD also does not mean someone is less intelligent – there are simply just differences in the brain which get in the way of this intelligence being fully "accessed".  

 

4. The impact of behavioural support

 

Some behavioural support, such as adapting teaching, with timers or keeping students sat away from doors or windows, is unfortunately very unlikely to properly support individuals with ADHD in their learning in most cases. Cognitive behavioural therapy (CBT), provided outside of the classroom, can offer better long-term benefits in behavioural areas, such as organisation, emotional control, or esteem.

 

74% of those with untreated ADHD have poorer overall outcomes, compared to neurotypical peers. This statistic is significant, because of an estimated 5% prevalence rate of ADHD within the UK population – only about 1 in 9 are formally diagnosed (take this with a pinch of salt, as it may not be entirely accurate). 

This means 74% o