July 25th, 2011
12:01 AM ET
Teaching your child to safely cross the street is hard enough, but when your child has ADHD, attention deficit hyperactivity disorder, you may need to worry more about his or her safety. A new study finds children with ADHD are at greater risk when crossing the street. Experts suggest these children have more problems remembering visual tasks and managing their time as they do them.
Accidents are the leading cause of death in children and those with ADHD are much more likely than their peers to be involved. Crossing the street is no exception so researchers decided to create a virtual reality simulation of an intersection and asked children ages 7 – 10 to cross the street.
Before the testing began, researchers at the Injury Control Research Center at the University of Alabama measured the walking speed of 78 children; half had both the inattentive and hyperactive symptoms of ADHD and were not taking medication. The other 39 children had no developmental issues. The children stood on a platform that represented a curb in front of three large screens that took up much of their field of vision, on which a busy street scene was projected. The child's challenge was to decide when it was safe to cross. When the child stepped off the "curb," a very lifelike avatar appeared on the screen and crossed at that child's pre-recorded speed.
The experts wanted to know if the children with ADHD were at increased risk of injury, whether they failed to look left to right before crossing, darted out into the street, or had more close calls than their peers. What they found surprised them. The children with ADHD did look both ways before stepping off the curb, but left significantly less time to make a safe crossing. They had far more close calls than their typically developing peers. But they weren't necessarily just taking more risks. Researchers thought there might be more to the issue.
"We think that perhaps there is a problem with their timing ability," explains Despina Stavrinos, assistant professor at the University of Alabama at Birmingham Transportation Center. "Lots goes on when crossing the street. You have to be able to time the cars coming through the crosswalk, time your own ability to cross the street. We believe that kids with ADHD have real trouble with estimating or making those appropriate judgments when deciding to cross."
They seem to see what's going on, but they don't appear to process it like other children. Leading ADHD expert and author Dr. Russell Barkley speculates it has to do with working memory, the part of the thinking process that helps a child remember what he's doing, especially something that's visual, a known problem area for those with the disability. He says a child with ADHD can accurately tell you how long something takes, for example if he sees you do a task that takes 5 seconds and another that takes 10, the child can distinguish between the two. But when asked to duplicate the task in that same amount of time something goes awry and he often can't do it.
"A child can perceive a time interval correctly, but as he tries to use that interval to get things done in time, he feels he has more time than he does," explains Barkley. "He winds up taking more time than he should. There is a breakdown in knowing and doing, in perceiving and using."
These new findings are particularly timely as families get ready for the start of a new school year. According to the American Academy of Pediatrics children are usually ready to safely cross the street on their own by age 10. But as the study suggests children with ADHD may need more of our attention.
Stavrinos suggests more safety training and says parents can practice with their child. Stand in a parking lot or sidewalk near a busy intersection and have your child tell you when he thinks it's safe to cross. You and he can then go over his choices and offer guidance when the decisions are too risky.
But even this may not be enough according to Barkley because the underlying issue of timing may be due to a disconnect in the child's brain when it comes to actually doing a task.
"You need closer accountability, closer supervision of the children and maybe reducing their ADHD symptoms through medication," says Barkley.
He suggests that parents or other adults walk with their children as they go to and return home from school.
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