Examining how different measurement approaches impact safety outcomes in child pedestrian research: Implications for research and prevention

Cyborg Children: A Systematic Literature Review on the Experience of Children Using Extended Reality

This literature review presents a comprehensive and systematic account of research on the experiences of children with extended reality (XR), including VR, AR, and other types of immersive technologies that enhance and augment children's activities. The search on Scopus and Web of Science produced 531 outputs. Content analysis with inter-rater reliability (Krippendorff's α) and Leximancer, a software for text mining, were used for analyzing the material. Four research strands were identified: (1) interventions, treatments, and medical procedures in clinical contexts; (2) teaching and learning enhanced by XR; (3) children's adoption and user experiences; (4) design and prototyping of XR hardware and software for children. The results showed the following findings: (a) studies on children's clinical interventions and treatments using HMD-supported immersive virtual reality comprise the most substantial strand of studies; (b) research in this area, and in teaching and learning studies, has grown dramatically since 2017, while the other areas have been stagnant over the years; (c) AR research is still limited and is mainly applied in educational contexts for design and prototyping; (d) few studies have considered children's perspectives on XR safety issues; (e) research on the use of XR for enhancing social and emotional skills development is underrepresented. Future research should focus on the potential of XR technologies for interventions to enhance children's psychosocial wellbeing and health more broadly. The further implications and study limitations for the fast-developing nature of this transdisciplinary research field are also discussed.

A Feasibility Randomized Trial Evaluating Safe Peds: A Virtual Reality Training Program to Teach Children When to Cross Streets Safely

OBJECTIVE

Injury as pedestrians is a leading contributor to childhood deaths. This study evaluated the effectiveness of Safe Peds, a fully immersive virtual reality training program to teach children when to cross street safely, with the focus on a number of foundational skills and practicing these in traffic situations of varying complexity.

METHODS

Children 7-10 years old were randomly assigned to a control (N = 31) or intervention (N = 26) group. Eligibility criteria included English speaking and typically developing. Testing took place on campus. All children completed pre- and post-testing measures, with those in the intervention group receiving training in between. Training comprised 1 session with 3 phases for a total of up to 1.5 hr and was tailored to each child's performance over trials. On each trial, children decided when to cross and fully executed this crossing, with measures automatically taken by the system as they did so.

RESULTS

Negative binomial regression and analysis of covariance tests were applied, predicting post-test scores while controlling for pre-test scores, age, and sex. The intervention was effective in improving children's street crossing skills, including stopping and checking skills (stop at the curb, look left/right/left, check for traffic before crossing the yellow line), and choosing safe inter-vehicle gaps. Children in the control group did not show significant improvements in any crossing skills.

CONCLUSIONS

The Safe Peds program effectively teaches children skills to support their deciding when to safely cross in a variety of traffic situations. Implications for pedestrian injury are discussed.

The effect of a heavy backpack on children's street-crossing performance

PURPOSE

The current study examined how wearing a heavy backpack influences children's street crossing behaviors.

METHOD

Using a fully-immersive virtual reality system, numerous indices of children's street crossing behaviors (7-13 years) were measured both when wearing a heavy backpack (12% of bodyweight) and when not doing so.

RESULTS

A heavy backpack slowed walking speed. However, any potential increase in risk from this was counteracted by compensatory actions that included: the selection of larger inter-vehicle gaps to cross into; greater efficiency in initiating the crossing (reduced start delay); and increased walking speed when in the path of the approaching vehicle. Ultimately, there was no greater risk outcome (time left to spare) compared to children's performance when not wearing a backpack. There were no age or sex differences.

CONCLUSION

When tested in ways that preserve perceptual-motor coupling in traffic situations, children strategically responded to maintain their safety despite wearing a heavy backpack that slowed their walking speed. Previous conclusions that a backpack increases pedestrian injury risk is likely an artifact of the testing method used.

Risks to pedestrians in traffic systems with unfamiliar driving rules: a virtual reality approach

In this study, a virtual-reality (VR) pedestrian simulation method was used to evaluate the risks to pedestrians crossing streets in a traffic system with driving rules that were unfamiliar to them. Pedestrians from mainland China (which has a right-side driving (RD) system) and Hong Kong (which has a left-side driving (LD) system) were studied. Significant differences were observed between pedestrians from the different locations in terms of the direction in which the pedestrians habitually first looked before crossing. When exposed to an unfamiliar driving rule (i.e., traffic coming from an inconsistent direction in terms of participants' habitual driving system), the odds of participants from mainland China making an error in their looking behavior were 2.93 times those when exposed to a familiar driving rule. Road markings and traffic sound did not improve these participants' looking behavior. The results also show a negative correlation between inattentive looking behavior and time to collision (significant at the 1% level), as these errors lead to a shorter time to collision and increased the risk to pedestrians. The results of this study confirmed the risks for pedestrians traveling to places with unfamiliar driving rules and confirmed the existence of habitual looking behavior, and therefore provide evidence of the need for future studies to improve this problem. These may help decision makers take the risks of pedestrians from different driving rules into consideration in future traffic policymaking or traffic-facility improvements. The use of a VR simulation-based approach in this study provided a safe and controllable way to trial interventions and potential improvements without risking injury to participants, and thus may also be used for similar future studies.

Roles of individual differences and traffic environment factors on children's street-crossing behaviour in a VR environment

OBJECTIVE

Pedestrian injuries are among the most common cause of death and serious injury to children. A range of risk factors, including individual differences and traffic environment factors, has been investigated as predictors of children's pedestrian behaviours. There is little evidence examining how risk factors might interact with each other to influence children's risk, however. The present study examined the independent and joint influences of individual differences (sex and sensation seeking) and traffic environment factors (vehicle speeds and inter-vehicle distances) on children's pedestrian safety.

METHODS

A total of 300 children aged 10-13 years were recruited to complete a sensation-seeking scale, and 120 of those were selected for further evaluation based on having high or low sensation-seeking scores in each gender, with 30 children in each group. Children's pedestrian crossing behaviours were evaluated in a virtual reality traffic environment.

RESULTS

Children low in sensation seeking missed more opportunities to cross and had longer start gaps to enter the roadway compared with those high in sensation seeking, and these effects were more substantial when vehicles were spread further apart but travelling slowly. Interaction effects between inter-vehicle distance and vehicle speed were also detected, with children engaging in riskier crossings when the car was moving more quickly and the vehicles were spread further than when the vehicles were moving quickly but were closer together. No sex differences or interactions emerged.

CONCLUSION

Both sensation seeking and traffic environment factors impact children's behaviour in traffic, and there are interactions between traffic speeds and inter-vehicle distances that impact crossing behaviour.