Understanding the Roadside Behaviour of Children with DCD and/or ADHD: An Exploratory Sequential Design Study

Abstract

Background Navigating roads safely is a complex task, requiring a high level of perceptual-motor skills including selecting safe crossing sites, perceiving and responding to approaching vehicles, and selecting safe crossing gaps. This places pedestrians as a vulnerable group at the roadside. However, previous research has identified that children with neurodevelopmental disorders (NDDs), particularly Developmental Coordination Disorder (DCD) and Attention Deficit Hyperactivity Disorder (ADHD), are at an even higher risk of pedestrian injuries. To address the pressing issue of pedestrian safety for children with DCD and children with ADHD, this thesis aimed to investigate the unique challenges they encounter at the roadside.

Methods Employing an exploratory sequential mixed methods design, the research initially explored, qualitatively, the perspectives of 14 parents of children with DCD and/or ADHD aged 7 – 17 years (Phase one; see Chapter four). This informed subsequent quantitative analysis focused on examining the specific behaviours of 35 children with DCD or ADHD and typically developing (TD) peers aged 11 – 16 years during simulated road crossing tasks including identification of safe crossing sites, looming detection, and temporal gap acceptance (Phase two; see Chapter six, Chapter seven, & Chapter eight). By combining these qualitative and quantitative approaches, this study provides a comprehensive understanding of the challenges faced by children with DCD and/or ADHD at the roadside.

Findings Phase one generated three themes. The first theme related to the challenges experienced by children with DCD and/or ADHD at the roadside from a parent’s perspective; parents favoured designated crossings, perceiving them as safer options for their children compared to uncontrolled locations due to increased risk concerns. The second theme focused on parental concerns and influence children's road safety, highlighting increased monitoring and a more protective approach to road crossing. The third theme introduced parental strategies for promoting road safety, balancing children's independence with their safety needs. In relation to Phase two (Chapter six), the results from the first task of selecting crossing sites revealed that all groups including children with DCD, Children with ADHD, and TD children were able to accurately identify safe and unsafe crossing locations. Nonetheless, noticeable differences were observed in their visual attention strategy. Based on descriptive analysis, the results from the looming detection task tentatively showed that children with DCD and ADHD had less refined looming detection thresholds in comparison to their Typically Developing (TD) peers in some viewing conditions. Further the gap acceptance task revealed that children with DCD or ADHD had more near misses compared to the TD group. There was also variability in these tasks when comparing children with DCD and children with ADHD reflecting the distinct challenges that children with different neurodevelopmental disorders may have at the roadside.

Conclusion This study has given the parents of children with DCD and/or ADHD a voice to convey the experiences they feel that their children face at the roadside. The issue of vulnerability of these children at the roadside was further investigated through the series of lab-based tasks, these findings have added to our knowledge and understanding about the road crossing difficulties that may be experienced by children with DCD or ADHD. The findings revealed that secondary school aged children with DCD or ADHD still have limitations in their ability to accurately judge approaching traffic, potentially due to perceptual-motor deficits, compared to their TD peers potentially leading to increased risk of accidents. This study has valuable insights and makes recommendations to improve pedestrian safety education and for the development of related interventions.