PhotoThere has long been a correlation between children affected by ADHD and higher numbers of bicycle accidents at intersections, and a new University of Iowa study has discovered why.

According to the study, it’s because kids with ADHD are impulsive and struggle to pay attention: two traits that work against them when it comes to accurately judging how much time is available to cross the street.

"Crossing roads on a bicycle requires decision and action," says Molly Nikolas, an assistant professor in the UI Department of Psychological & Brain Sciences and corresponding author of the study. "What we found is children with ADHD have deficits in both areas."

ADHD — a behavioral disorder marked by impulsiveness, hyperactivity, and inattention — affects almost six million kids in the U.S., according to the Centers for Disease Control and Prevention. With so many affected, it’s important to understand the ‘why’ behind these accidents in order to address the ‘how’ in preventing them.

Less precise timing

Using a real-time bicycle simulator, UI researchers studied how 63 children — 27 with ADHD — crossed 12 intersections with continuous cross traffic. The children, all between the ages of 10 and 14, rode stationary bikes surrounded by three screens that projected images of a typical Midwest town.

They discovered that overall, the children with ADHD selected about the same size gaps between cars as the others in the study, but their timing entering the roadway was less precise. As a result, the children with ADHD had less time to spare than the children not affected by the disorder.

"What we found is the timing issues were more related to symptoms of inattention while the decisions about which gaps to cross were related to hyperactivity and impulsivity—all core symptoms of ADHD," Nikolas says.

So what steps can parents and caregivers take to help prevent accidents?

Longer gaps

Researchers say teaching kids to look for longer gaps between cars may be the best way to help kids with ADHD cross busy intersections.

“Even if their timing remains off, if they have a big enough gap, they will be okay,” said Nikolas. “If we can have some intervention or prevention strategies that focus on the decision making, that may help compensate for the timing deficit.”

Russell Barkley, a clinical psychologist at the Medical University of South Carolina and author of several books about ADHD, recommends parents gradually expose their children with ADHD to different scenarios while bicycling. He also says ADHD medications can help some children.

"It has shown to decrease general accidental injury risks in ADHD youth by 31 percent to 43 percent over untreated ADHD populations by age 10 to 12," he says. "It has also improved the driving performance of ADHD teens and young adults."

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