Saturday, August 13, 2011

Safety in Developmental Disabilities

As I have talked about just a few times before, safety is real concern for parents whose children have autism.  Many of these children lack a basic awareness of their environment and will unknowingly put themselves in situations where there is a very real chance of harm or death.

So parents like me worry and take extra precautions to keep their children safe.  We talk about these concerns openly so that other parents - perhaps parents new to autism - will know enough to take appropriate precautions and keep their children safe.  The penalty for a lack of awareness in this area can be very severe.

But since this is autism we are talking about, there are always the "don't speak ill of autism" crowd how want to deny that these concerns are valid.  One of their complaints against this idea is that there is no "evidence" that safety is a systemic issue in autism.

Well, here is a recent study that takes a look at a relatively simple task that involves safety - crossing the street.  The developmental disability here is one of the forms of ADHD, but I have no doubt that the findings would apply to autism.  There are many children with autism who would also lack the ability "to process perceived information adequately to permit crossing safely."

Mediating factors associated with pedestrian injury in children with attention-deficit/hyperactivity disorder.

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.

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).

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.

Children with ADHD-C seem to display appropriate curbside pedestrian behavior but fail to process perceived information adequately to permit crossing safely.


Stavrinos D, Biasini FJ, Fine PR, Hodgens JB, Khatri S, Mrug S, Schwebel DC. Mediating factors associated with pedestrian injury in children with attention-deficit/hyperactivity disorder. Pediatrics. 2011 Aug;128(2):296-302. Epub 2011 Jul 25.
PMID: 21788213
DOI: 10.1542/peds.2010-3829

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