Road crossing behaviour and ADHD

Do you remember your Green Cross Code? If you lived in the UK during the 1970s or 1980s you'll probably remember the towering figure of Dave Prowse, he of Darth Vader, as the Green Cross Code Man and his message about pedestrian safety when crossing the road.

Over the years quite a bit of Government information and education combined with a fair bit of nudge theory has helped to improve child safety whilst crossing our ever busier roads. The fact remains however that quite a few children do still get hit by cars when crossing the road. The reasons why are complicated. Drivers not adhering to the speed limit, children being children and running across the road without looking. Lots of reasons. With all the recent chatter on wandering and autism (including that new ICD code), one could perhaps also see how specific groups of children might be at an increased risk of injury as a result of things like crossing the road.

A new-ish study* published in the journal Pediatrics looked at road crossing behaviour in children diagnosed with ADHD. The study by Stavrinos and colleagues used an artificial 'virtual' environment to analyse the road-crossing behaviours of 78 children (aged 7-10 years), half of whom were diagnosed with ADHD (ADHD-combined type), half of whom served as asymptomatic controls. Their results:

• Children from both groups looked left and right before crossing. They also waited before crossing.
• Children from the ADHD group tended to pick riskier places to cross, for example between parked cars.
• The ADHD group had more 'close calls', so picking more risky moments to cross than the non-ADHD group.

The authors note that the children with ADHD were "...looking.. but they are failing to see". A few explanations have been put forward to account for the results; ranging from medication wearing off to problems with executive functioning (things like planning behaviour and impulse control). One perhaps can't rule out the artificial nature of the experimental conditions as potentially also having some bearing on the results; a danger-free road crossing virtual experiment is a little different from the 'real' world. Whatever the reason for the results, there are perhaps some important lessons that can be gleaned from such research. How we structure our roads and their surrounding environment, our developing educational material and strategies specifically for those with ADHD and other developmental conditions about risk in this and other similar situations, and also how we build our cars and educate our drivers to ensure that, should the worst happen, the car gives as much protection to the pedestrian as possible.

In the end remember: stop, look, listen think.

* Stavrinos D. et al. Mediating factors associated with pedestrian injury in children with Attention-Deficit/Hyperactivity Disorder. Pediatrics. July 2011