Children with ADHD More Prone to Pedestrian Injury

Several studies have shown that children with developmental disabilities, such as those suffering from attention deficit hyperactivity disorder (ADHD), are at an increased risk for pedestrian injury. In the present study, a virtual pedestrian environment was created to examine how children with ADHD differed from their non-ADHD counterparts when crossing the street. Researchers also evaluated various abilities that might be deficient in children with ADHD, making them prone to pedestrian injuries. “Children with attention deficit hyperactivity disorder seem to display appropriate curbside pedestrian behavior but fail to process perceived information adequately to permit crossing safely.”

Currently, the most common cause of death in children is unintentional injury. A study by the “National Center for Injury Prevention and Control” has shown that unintentional injury is the cause of more children’s deaths than the subsequent 20 reasons for death combined. Pedestrian injury is a common form of unintentional injury. It is noteworthy that almost 12 percent of pedestrians who suffer fatal accidents are children aged between 7 and 10 years. Many of the children who suffer injuries have developmental disorders, such as ADHD. This study was carried out to identify the causes for increased occurrence of pedestrian injuries in children.

* This study involved 78 children, 39 children with ADHD and 39 non-ADHD counterparts. This study was conducted from December 2007 to January 2009.
* First, the walking speed of all participants was assessed by asking them to walk for 25 feet, four times. The virtual traffic environment was set at this speed.
* All participants were then asked to cross the simulated road 10 times. The moment the participant placed his foot on a platform, the process of crossing the road was started, and then the participant virtually crossed the road at a previously defined speed.
* Every time they crossed the road, the following were assessed: attention on the traffic, waiting duration, missed opportunities, distance from the nearby vehicle while crossing, instances of “getting hit” by a vehicle, time to spare after crossing, and delay in start of walking.

* Children with ADHD crossed the street when it was less safe to do so. Their attention to traffic and initiation of crossing were similar to their non-ADHD counterparts.
* In children with ADHD, the gap between them and a nearby vehicle was less; and, also, the overall time to spare after crossing the road was significantly reduced.
* The lower safety in the ADHD group was mainly due to executive dysfunction.

Shortcomings/next steps
In the present study, children with ADHD were compared to non-ADHD children, or peers with typical development. Future studies must include a more comparable group, such as children with other learning disabilities. There is also a need to examine the effects of drugs which are used in the treatment of ADHD. It is necessary to examine whether these drugs increase road crossing disability or improve the capacity of children.

The present study has shown that, except for the execution function, children with ADHD cross the street in the same way as their counterparts. According to researchers, this is probably because of the inability of ADHD children to process information received while looking at the traffic. They were unable to maintain an adequate pace, resulting in an unsafe crossing of the road. This study has pointed toward some clues for necessary interventions that could help prevent pedestrian injuries. Pedestrian accidents are predictable and avoidable. Measures, such as automobile and environmental modifications and educating children, need to be undertaken to prevent deaths due to pedestrian injuries.

For More Information:
Mediating Factors Associated with Pedestrian Injury in Children with Attention-Deficit/Hyperactivity Disorder
Publication Journal: Pediatrics, July 2011
By Despina Stavrinos, PhD; Fred J. Biasini, PhD; University of Alabama at Birmingham

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