How does attention deficit hyperactivity disorder affect children's road-crossing? A case-control study.

Objective: Children diagnosed with attention-deficit/hyperactivity disorder (ADHD) may have particularly high pedestrian injury risk given their deficits in attention, inhibition, and concentration. The aims of this study were a) to assess differences in pedestrian skill between children with ADHD and typically-developing children and b) to examine relations between pedestrian skill and attention, inhibition, and executive function among children with ADHD as well as among typically-developing children.Methods: A sample of 50 children with mean age of 9 years participated, 56% of them diagnosed with ADHD. Children completed IVA + Plus, an auditory-visual test evaluating impulse response control and attention and then engaged in a Mobile Virtual Reality (MVR) pedestrian task to assess pedestrian skills. Parents completed the Barkley's Deficits in Executive Functions Scale-Child & Adolescents (BDEFS-CA) to rate children's executive function. Children with ADHD engaged in the experiment off any ADHD medications.Results: Independent samples t-tests indicated significant differences between the two groups in all IVA + Plus and BDEFS_CA scores, supporting the clinical diagnoses of ADHD and the distinction between the two groups. Independent samples t-tests also indicated differences in pedestrian behavior: Children in the ADHD group had significantly higher numbers of unsafe crossings in the MVR environment. Partial correlations within samples stratified by ADHD status indicated that for both groups of children, there were positive correlations between unsafe pedestrian crossings and executive dysfunction. There were no relations between IVA + Plus attentional measures and unsafe pedestrian crossings in either group. A linear regression model predicting unsafe crossings was significant, with children with ADHD more likely to cross in a risky manner after controlling for executive dysfunction and child age.Conclusions: ADHD children exhibited riskier street-crossing behavior in the MVR, confirming an increased risk of pedestrian injury among children with ADHD compared to typically-developing children. Risky crossing among the typically-developing children and ADHD was related to deficits in executive function. Implications are discussed in relation to parenting and professional practice.

Road-Crossing Behavior in Complex Traffic Situations: A Comparison of Children With and Without ADHD.

All children are vulnerable to pedestrian injuries, but previous research suggests children diagnosed with ADHD may have elevated risk. Child pedestrian injury risk also increases with increasing traffic volume and speed. The current study examined three hypotheses: (a) Pedestrian behavior of children with ADHD is riskier than that of typically-developing children; (b) Children's pedestrian behavior is riskier with increased traffic complexity; and (c) Pedestrian behavior of children with ADHD is influenced more by complex traffic situations than behavior of typically-developing children. A sample of 38 children ages 8-12 years, 45% diagnosed with ADHD, completed 21 virtual street-crossings, 7 in each of three levels of traffic complexity. Outcome measures included unsafe crossings, ratio of looking at traffic by time, start-delay to enter the road, time to contact with oncoming vehicles, and time waiting to cross. A repeated measure MANOVA and follow-up tests showed that all children had more unsafe crossings, shorter start-delays and shorter TTCs when exposed to increased traffic complexity compared to lighter traffic. Children with ADHD had more unsafe crossings than typically-developing children. Further, compared to typically-developing children, ADHD children had comparatively more unsafe crossings, lower time to contact and longer wait-time in more complex traffic environments. Executive function deficits among children with ADHD likely influence their behavior in complex traffic environments. Implications of the results for policy-making and preventive strategies are discussed.

Differential effects of stimulant versus opiate drugs on driving performance.

BACKGROUND AND AIMS: Pharmacological differences among different drug classes influence human cognition, visual, and motor behavior in different ways. These differences impact driving safety, and therefore individuals who use stimulant and opioid drugs might experience different patterns in driving safety and impairment in driving performance. This study examined the effect of long-term use of stimulant drugs and of opiate drugs on driving performance, hazard perception, visual search skills and psychomotor skills related to driving. METHODS: A total of 75 individuals, including 28 predominantly stimulant users, 22 predominantly opiate users and 25 healthy non-drug users, participated. Driving performance and psychomotor skills were assessed via a 15-minute drive in a simulator; hazard perception was assessed via a computerized task; and visual search skill was assessed by eye tracking. RESULTS: ANOVA analyses indicate both stimulant and opiate users drove at higher speeds and experienced more crashes than the healthy non-drug users. Stimulant but not opiate users violated red light regulations more often than the healthy non-drug users. In the hazard perception task, stimulant drug users performed more poorly than both opioid drug users and healthy non-drug users. Specifically, they had lower saccade movement scores and higher average fixation times. CONCLUSIONS: Results confirm that both stimulant drug users and opiate drug users show impaired driving performance compared to healthy non-drug users. Stimulant drug users possessed poorer hazard perception skills compared to the opiate users and the control group, perhaps as a result of cognitive deficits created by the drug use.

Children's Road-Crossing Behavior: Emotional Decision Making and Emotion-Based Temperamental Fear and Anger.

OBJECTIVE: Child pedestrian injuries represent a global public health burden. To date, most research on psychosocial factors affecting children's risk of pedestrian injury focused on cognitive aspects of children's functioning in traffic. Recent evidence suggests, however, that emotional aspects such as temperament-based fear and anger/frustration, as well as executive function-based emotional decision making, may also affect children's safety in traffic. This study examined the role of emotions on children's pedestrian behavior. Three hypotheses were considered: (a) emotion-based temperament factors of fear and anger/frustration will predict children's risky decisions and behaviors; (b) emotional decision making will predict risky pedestrian decisions and behaviors; and (c) children's pedestrian decision making will mediate relations between emotion and risky pedestrian behavior. The role of gender was also considered. METHODS: In total, 140 6- to 7-year-old children (M = 6.7 years, SD = 0.39; 51% girls) participated. Parent-report subscales of Child Behavior Questionnaire measured temperamental fear and anger/frustration. The Hungry Donkey Task, a modified version of Iowa Gambling Task for children, measured children's emotional decision making, and a mobile virtual reality pedestrian environment measured child pedestrian behavior. RESULTS: Greater anger/frustration, lesser fear, and more emotional decision making all predicted poorer pedestrian decision making. The mediational model demonstrated that pedestrian decision making, as assessed by delays entering safe traffic gaps, mediated the relation between emotion and risky pedestrian behavior. Analyses stratified by gender showed stronger mediation results for girls than for boys. CONCLUSIONS: These results support the influence of emotions on child pedestrian behavior and reinforce the need to incorporate emotion regulation training into child pedestrian education programs.

Feasibility of using a computer-assisted working memory training program for healthy older women.

Interventions for age-associated cognitive impairment are of increasing significance as populations age. Using N-back and memory strategy enhancement, the present study aimed to explore the feasibility of using, and outcomes of a working memory (WM) training program on visuospatial and verbal WM in older female adults. Older women from two comparable local health centers who scored 26 and higher on Mini-Mental State Examination were invited to participate. Women at one center (experimental group) received three sessions on memory enhancement techniques and a computerized training program with N-back. Women at the other center (control group) received three sessions on memory and aging and training on using various features of cellphones. All participants completed the Corsi Block Task and Digit Span Task at pre- and post-training. The experimental group showed significant improvements in their visuospatial and verbal WM compared to the control group. These findings support the brain's plasticity in the elderly. WM training for improving cognitive performance in older adults has potential and should be further investigated.

Aberrant Driving Behaviour, Risk Involvement, and Their Related Factors Among Taxi Drivers.

The current study aims to investigate the aberrant driving behaviour and risk involvement of Iranian taxi drivers. The sample comprised 405 Iranian taxi drivers, who were recruited with a cross-sectional design, using a self-completion questionnaire survey during October and November 2016. We contribute to the literature by understanding how and to what extent the socioeconomic, demographic, driving, and aberrant driving behaviours influence risk involvement (accident involvement and traffic tickets). The validated 27-item Driver Behaviour Questionnaire (DBQ) was applied to measure aberrant driving behaviour. The results from valid observations (n = 381) explored a four-factor solution (including errors, ordinary violations, lapses, and aggressive violations) of the DBQ. The results also showed that being a single driver, having a high annual driving mileage, and a high number of daily taxi trips were positively associated with accident involvement. Furthermore, there was a positive correlation between the more ordinary violations and aggressive violations and accident involvement. Establishing better training and qualification mechanisms for taxi drivers could be considered by traffic safety experts in order to reduce ordinary and aggressive violations.

Aggression, emotional self-regulation, attentional bias, and cognitive inhibition predict risky driving behavior.

The present study explored whether aggression, emotional regulation, cognitive inhibition, and attentional bias towards emotional stimuli were related to risky driving behavior (driving errors, and driving violations). A total of 117 applicants for taxi driver positions (89% male, M age=36.59years, SD=9.39, age range 24-62years) participated in the study. Measures included the Ahwaz Aggression Inventory, the Difficulties in emotion regulation Questionnaire, the emotional Stroop task, the Go/No-go task, and the Driving Behavior Questionnaire. Correlation and regression analyses showed that aggression and emotional regulation predicted risky driving behavior. Difficulties in emotion regulation, the obstinacy and revengeful component of aggression, attentional bias toward emotional stimuli, and cognitive inhibition predicted driving errors. Aggression was the only significant predictive factor for driving violations. In conclusion, aggression and difficulties in regulating emotions may exacerbate risky driving behaviors. Deficits in cognitive inhibition and attentional bias toward negative emotional stimuli can increase driving errors. Predisposition to aggression has strong effect on making one vulnerable to violation of traffic rules and crashes.

The influence of demographic factors, processing speed and short-term memory on Iranian children's pedestrian skills.

OBJECTIVES: Young children, children from lower socioeconomic status and boys have the highest risk of pedestrian injury. This study examined the relationship between cognition and specific pedestrian skills of these groups of children in Iran. METHODS: 180 Iranian children aged 7 and 11 years from lower- and higher-socioeconomic status backgrounds participated in the study. A task to identify safe and dangerous road crossing sites and to plan a safe route to cross a road was administered to measure pedestrian skills. Coding and Digit Span subscales of WISC-R were administered to assess processing speed and short-term memory. RESULTS: Identifying safe/dangerous road crossing-sites and safe route-construction abilities increased with age. Boys scored higher than girls when identifying road crossing sites but did not differ to girls in route-construction. Lower socioeconomic status children scored higher than higher socioeconomic status children on the route-construction task. Girls from lower socioeconomic status backgrounds scored lowest on the identifying safe/dangerous sites task and girls from higher socioeconomic status backgrounds scored lowest on the route construction task. Speed of processing was a significant predictor for identifying crossing sites and socioeconomic status was a significant predictor for route-construction. CONCLUSIONS: Pedestrian skills are complex and influenced by age, gender, socioeconomic status and cognitive development. Results are discussed in relation to child pedestrian safety research in Iran and road safety education for children.