Children diagnosed with attention-deficit/hyperactivity disorder (ADHD) may have particularly high pedestrian injury risk given their deficits in attention, inhibition, and concentration. The aim of this study was to assess the difference between children with ADHD and typically-developing children in pedestrian skills. A sample of 34 children ages 8-12 years (50% diagnosed with ADHD), completed IVA+PLUS to assess attentional skills and engaged in a Mobile Virtual Reality (MVR) pedestrian task to assess pedestrian skills. MANCOVA models controlling for age indicated significant differences between the two groups in all IVA+PLUS attentional measures. Similarly, using ANCOVA controlling for age, ADHD group had significantly higher unsafe crossings and lower frequency of looking at traffic in the MVR environment. Spearman correlations indicated that for children with ADHD, there were positive correlations between looking at traffic and missed opportunities and between missed opportunities and unsafe crossing. For typically-developing children, more frequent looking at traffic was significantly related to longer time to contact with oncoming traffic. None of the IVA+PLUS measures related to unsafe crossings in either group. In summary, ADHD children performed less safely in the MVR, confirming there may be increased risk of pedestrian injury among children with ADHD compared to typically-developing children. Unsafe crossing of children with ADHD might be the result of deficits in attention due to the fact that there was a trend for children with ADHD to look less at oncoming traffic. It may also be a result of deficits in their speed of processing. Notably, children with ADHD in this study were evaluated off medications. When children with ADHD are unmedicated and exposed to traffic, parents should be aware of their increased vulnerability and educated to supervise children with ADHD carefully. Future research should also evaluate whether medicating children with ADHD might improve their pedestrian safety.

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