title: Mediating factors associated with pedestrian injury in children with attention-deficit/hyperactivity disorder.
abstract: OBJECTIVE
  Unintentional injury is the leading cause of pediatric mortality. One leading cause of unintentional injury is pedestrian injury. Children with developmental disabilities, particularly those with attention-deficit/hyperactivity disorder-combined type (ADHD-C) seem to have increased pedestrian injury risk. This study examined (1) the differences in pedestrian behavior between children with ADHD-C and normally developing comparison children and (2) the mediating factors that might link ADHD-C with pedestrian injury risk.
  
  
  METHODS
  A total of 78 children aged 7 to 10 years (39 children with ADHD-C diagnoses and 39 age- and gender-matched typically developing children) participated. The main outcome measure was pedestrian behavior, as measured in a semi-immersive, interactive, virtual pedestrian environment. Key pedestrian variables related to different aspects of the crossing process were identified: (1) before the cross (ie, evaluating aspects of the crossing environment); (2) making the cross (ie, deciding to cross and initiating movement); and (3) safety of the cross (ie, safety within the pedestrian environment after the decision to cross was made).
  
  
  RESULTS
  Children with ADHD-C chose riskier pedestrian environments to cross within (F(1,72) = 4.83; P < .05). No significant differences emerged in other aspects of the crossing process. Executive function played a mediating role in the relationship between ADHD-C and the safety of the cross.
  
  
  CONCLUSIONS
  Children with ADHD-C seem to display appropriate curbside pedestrian behavior but fail to process perceived information adequately to permit crossing safely.
authors.affiliation: Department of Psychology, University of Alabama at Birmingham University Transportation Center, Birmingham, AL 35294-2041, USA. dstavrin@uab.edu
authors.forename: Despina
authors.initials: D
authors.lastname: Stavrinos
authors.forename: Fred J
authors.initials: FJ
authors.lastname: Biasini
authors.forename: Philip R
authors.initials: PR
authors.lastname: Fine
authors.forename: J Bart
authors.initials: JB
authors.lastname: Hodgens
authors.forename: Snehal
authors.initials: S
authors.lastname: Khatri
authors.forename: Sylvie
authors.initials: S
authors.lastname: Mrug
authors.forename: David C
authors.initials: DC
authors.lastname: Schwebel
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control / Q000523:psychology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000523:psychology*; D016022:Case-Control Studies; D002648:Child; D003198:Computer Simulation; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D010775:Photic Stimulation / Q000379:methods*; D012307:Risk Factors; D014584:User-Computer Interface; D016138:Walking / Q000523:psychology*