Adolescent road safety: pedestrian behavior in ADHD and typically developing groups

Doerr, Elizabeth; Baldassa, Andrea; Capodieci, Agnese; Gastaldi, Massimiliano; Meneghetti, Chiara; Muffato, Veronica; Orsini, Federico; Rossi, Riccardo; Tagliabue, Mariaelena; Carretti, Barbara · 2025 · BMC Psychology

DOI: 10.1186/s40359-025-03704-x

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Summary

This study investigates pedestrian safety behaviors in adolescents with Attention Deficit Hyperactivity Disorder (ADHD) compared to typically developing peers, addressing the gap in literature regarding sidewalk walking versus road crossing. While pedestrians are vulnerable road users, those with ADHD face elevated crash risks due to attention deficits and impulsivity. Previous research focused primarily on younger children and road-crossing scenarios, leaving routine walking behaviors and adolescent-specific risks underexplored. The study aimed to compare unintentional risky behaviors in both contexts and examine how parent-reported inattention and hyperactivity/impulsivity symptoms correlate with these behaviors. The researchers employed a virtual reality simulator to assess 42 participants aged 11 to 16: 21 with a clinical diagnosis of ADHD and 21 typically developing controls, matched for age, gender, and intelligence. Participants completed eight road-crossing scenarios and five sidewalk-walking scenarios, which included obstacles like opening car doors. Behavioral metrics included walking speed, movement wandering (trajectory deviation), head wandering (looking away from the path), reaction delays to obstacles, and safety checks (looking both ways). Parent-reported symptom scores for inattention and hyperactivity/impulsivity were collected to analyze correlations with performance. Results indicated that adolescents with ADHD exhibited significantly more unintentional risky behaviors than controls. In crossing scenarios, the ADHD group showed greater movement wandering and, counterintuitively, checked both sides of the road more frequently. In walking scenarios, the ADHD group demonstrated significantly higher horizontal and vertical head wandering, greater movement wandering, and longer delays in reacting to sudden obstacles, such as opening car doors. No significant differences were found between groups in walking speed or safe gap selection during crossing. Crucially, parent-reported inattention and hyperactivity/impulsivity symptoms positively correlated with movement wandering, head wandering, and reaction delays across both scenarios, suggesting that these traits drive risky behavior regardless of diagnosis. The findings highlight that ADHD increases pedestrian risk through unintentional errors, such as erratic movement and delayed reactions, rather than deliberate rule violations. The study extends previous work by demonstrating that these risks persist in routine walking contexts, not just during complex crossing tasks. The association between symptom severity and risky behavior implies that interventions should target core attentional and executive function deficits. These results underscore the need for tailored road safety strategies for adolescents with ADHD, focusing on reducing distractibility and improving environmental monitoring during independent mobility.

Key finding

Adolescents with ADHD display more unintentional risky pedestrian behaviors, such as movement wandering and delayed obstacle avoidance, which are associated with parent-reported inattention symptoms, despite also exhibiting adequate pre-crossing safety checks.

Methodology

simulator

Sample size: 42

Provenance

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