In this study Despina Stavrinos, assistant professor at the University of Alabama Birmingham's Injury Control Center and the study's lead author, points out that children with attention deficit hyperactivity disorder(ADHD or ADD)are shown to be at greater risk for, for instance, being hit by a car when crossing the street. The new study suggests that because of differences in their ability to perceive risk, children with ADHD may choose to cross the street when it is less safe, even if they follow safety protocol like checking both ways. They know what to do, know the rules, try to use them, but still place themselves at risk.
"They are looking," explained Stavrinos. "But they are failing to see. Just like distracted drivers, they are going through the motions, but they are not actually processing the risk."
Here are the details of this ADHD study: "To better understand the potential dangers of street crossing, researchers from the University of Alabama at Birmingham looked at 78 children, 39 of whom had ADHD-C -- a subtype that includes both inattention as well as hyperactivity and impulsivity issues -- and 39 of whom did not. The children were between 7 and 10, the age at which The American Academy of Pediatrics states it may be okay for children to be unsupervised pedestrians."
"Using a simulator that mimicked a typical street scene, the children were given 10 different street crossing scenarios. Researchers found that those with ADHD performed as well as non-ADHD participants in terms of looking both ways before crossing. However, when it came time to actually cross, those with ADHD picked smaller gaps in oncoming traffic, had more "close calls" and gave themselves less time to reach the other end of the crosswalk before traffic approached."
In 2009, a Canadian study gave several possibilities for why children with ADHD might have such difficulties, suggesting that they might overestimate their physical abilities when it comes time to weigh risks. That same study also found that children with ADHD might not have actually perceived any consequences for engaging in a risky behaviour. "These studies -- and there need to be more -- suggest that there is a different way of processing," she continued, adding that these issues are not necessarily unique to ADHD.
The potential implications of such risk-taking behavior are serious: According to the Centers for Disease Control, unintentional injury is the leading cause of death in children. And a growing body of scientific literature suggests that children with behavioral disorders, including ADHD, are more likely to suffer injury than those without the disorder.
So what can be done?
Parents of children with ADHD should increase supervision, said Dr. Steven Meyers, a professor of psychology at Roosevelt University and a Chicago-based clinical psychologist. He said that "over-practicing" of certain safety behaviors is essential, so that they become second-nature in children.
"Over practice," and taking medication ALL THE TIME is essential to providing children with ADHD both the skills and the ability to avoid risk taking behaviours. Dr. Russell Barkley has been addressing this issue for years. In his papery The ADHD Report (May 2002, page 2-5) he addresses the issue of parents taking their children off ADHD medication for the summer, on weekend or for a "drug break." His studies have shown that children on stimulant medications are shown to have fewer, and less dangerous, accidents. " Children with ADHD have approximately a three-fold increase in the likelihood of accidental poisoning...15% of hyperactive children have had at least four serious accidents...68% of children with ADHD have experienced physical trauma sufficient to warrant sutures or hospitalization...and only while only 39% of the general public has....40% of teens with ADHD have experienced two or more driving accidents while only 5.6% of the general public has."
The list goes on. The point? Children with ADHD have a significant increased risk of injury due to poor cognitive processing. They know the rules, can demonstrate them, and know when they aren't following them. In spite of that they have a high level of engagement in risk taking behaviour. If your child is requires medication (and not all children with ADHD do) remember, as Russell Barkley says, the ADHD medication is LIFE medication, something to take every day to stay safe. It's not just for taking math exams. And about behaviours? Rules? Procedures like Stop-Look-Walk? Those may be known, maybe your child can explain them...but they need to be over learned. Over taught. Habits.