Appropriateness of different pedagogical approaches to road safety education for children with Developmental Coordination Disorder (DCD)

The self-reported driving and pedestrian behaviour of adults with developmental coordination disorder

BACKGROUND

Developmental coordination disorder (DCD) affects movement coordination, but little is known about how the condition impacts the behaviours of car drivers and pedestrians.

AIMS

This study examined the self-reported driving and pedestrian behaviours of adults with Developmental Coordination Disorder (DCD).

METHODS AND PROCEDURES

One hundred and twenty-eight participants (62 adults with DCD vs. 66 TD adults) responded to an online survey asking them about their perceptions of confidence and self-reported driving and pedestrian behaviours in the real-world.

OUTCOMES AND RESULTS

Results suggested that adults with DCD felt less confident and reported more lapses in attention (e.g., forgetting where their car was parked) and errors (e.g., failing to check their mirrors prior to a manoeuvre) when driving compared to typically developed (TD) adults. Adults with DCD also reported feeling less confident and reported less adherence to road traffic laws (e.g., not waiting for a green crossing signal before crossing the road) when walking as pedestrians.

CONCLUSIONS AND IMPLICATIONS

These results offer some much-needed insight into the behaviours of those with DCD outside of the laboratory environment and underline the need for research investigating the driving and pedestrian behaviours of individuals with DCD in 'real-world' contexts.

Roadside experiences of parents of children with developmental coordination disorder and/or attention deficit hyperactivity disorder

Introduction

Pedestrians are a vulnerable group at the roadside and previous research has identified that children with DCD and ADHD are at a heightened risk of pedestrian injuries. Despite this, limited research has explored parental perspectives of the pedestrian risks faced by children with DCD and/or ADHD. Understanding parents' perspectives provides a unique insight into the challenges children face every day and the concerns that parents perceive regarding their children's safety as pedestrians. Therefore, the aim of this study was to explore parents' perspectives of the pedestrian risks faced by their children with DCD and/or ADHD.

Methods

Semi-structured interviews were conducted with 14 parents of primary school and early secondary school aged children with age range 7-17. The participants were divided into three groups based on their children's conditions: DCD group (10-17 years, n = 3), ADHD group (7-13 years, n = 5), and co-occurring group (7-16 years, n = 6). All parents confirmed an existing diagnosis and completed the SNAP-IV and DCDQ as screening tools. The interviews explored parents' perspectives regarding their children's pedestrian behaviors, parents' concerns and preventative measures taken to improve the pedestrian safety of their children with DCD and/or ADHD. Reflexive thematic analysis was undertaken to analyze the interviews, from which three themes were developed.

Results

The first theme related to the challenges experienced by children at the roadside; parents emphasized the significance of structured and controlled pedestrian crossing sites, underlining their preference for designated crossings as safer options due to their heightened perceptions of risk associated with other road-crossing locations. The second theme: parental concerns and influences on children's road safety referred to their children's performance and safety at the roadside, leading to increased monitoring and a more protective approach to road crossing. The third theme: road safety education related to various strategies parents implemented to mitigate risks, while balancing independence and prioritizing their safety.

Discussion

While there were commonalities in the challenges faced by children with DCD and/or ADHD at the roadside, there were also notable differences. Parents of children with DCD discussed challenges with spatial awareness and motor skills, whereas parents of children with ADHD discussed challenges with impulsivity and inattention. Parents of children with co-occurring DCD and ADHD described a complex interplay of these challenges. It is evident from the interviews that children with DCD and/or ADHD require a distinct approach to develop their pedestrian skills effectively and parents reported specific strategies they used to address the risks associated with their children's roadside behavior. Promoting pedestrian safety for children with DCD and/or ADHD necessitates collaboration among parents, schools and local authorities to implement comprehensive measures ensuring their safety. These findings contribute to understanding parental experiences and needs, providing valuable guidance for targeted interventions and policies to enhance the road safety of children with DCD and/or ADHD.

Navigation abilities and spatial anxiety in individuals with and without Developmental Coordination Disorder (DCD/Dyspraxia)

BACKGROUND

Navigation skills are essential for independent living as they allow us to explore our environment; find our way to new locations, refine pathways to familiar locations and retrace our route home. Alongside motor coordination difficulties, there is evidence that individuals with Developmental Coordination Disorder (DCD/Dyspraxia) experience spatial processing difficulties, which are known to negatively affect navigation abilities. However, although self-reports indicate that adults with DCD have difficulties with sense of direction and navigation, no known studies have measured navigation abilities and strategies in adults with DCD. Furthermore, given evidence that individuals with DCD report higher levels of anxiety, we will additionally investigate associations between anxiety and navigation in this group.

AIMS

This study compares navigation abilities, navigation strategies and spatial anxiety in adults with and without DCD.

METHODS

Participants include 226 Adults aged 18-55 years, across two groups 1) DCD (N = 138, 111 F:25 M; 2:Other) 2); Typically Developing (N = 88, 77 F: 11 M). In this cross-sectional study, participants completed a series of tasks on the online Qualtrics platform. This included the Adult Developmental Coordination Disorder Checklist, the State-Trait Anxiety Inventory, the Wayfinding Anxiety Measure, the Wayfinding Questionnaire, the Wayfinding Strategy Questionnaire, and a navigation task.

RESULTS

Our analysis shows that 1) compared to those with typical development, individuals with DCD have similar navigation performance but lower navigation and orientation scores, and distance estimation scores. 2) Movement co-ordination difficulties were only a significant predictor of landmark recognition and egocentric path route knowledge, and played no role for other aspects of navigation performance. 3) For wayfinding strategy use the DCD group used orientation strategies significantly less often than those with typical development, however there was no group difference in the use of route strategies. 4) The DCD group had significantly higher spatial anxiety scores across navigation, manipulation and imagery spatial sub-domains, even after controlling for general anxiety. 5) Spatial navigation anxiety was a significant predictor of navigational skill for all three wayfinding measures (navigation & orientation, distance estimation and spatial anxiety).

CONCLUSIONS

The findings establish benchmarks of navigational skills in DCD and highlight spatial anxiety and route strategies as factors that may inhibit navigation success and could help specify suitable intervention targets.

Disability and pedestrian road traffic injury: A scoping review

Disability and ableism remain a nascent area of inquiry in road traffic injury research. A scoping review of academic literature was conducted to understand the state of knowledge on disability and pedestrian-motor vehicle collisions. Sixty-two eligible articles were identified and included. A significantly higher risk of pedestrian collisions, injuries, and fatalities was consistently found among disabled people. Risk factors included individualized factors such as walking speed and crossing decisions of disabled people. The roles of social/political environments in injury risk were less commonly explored. More research is needed to assess how inaccessible or disabling environments may produce elevated risk of pedestrian injury among disabled populations.

The nature of the risk faced by pedestrians with neurodevelopmental disorders: A systematic review

Pedestrians represent one of the most vulnerable road user groups worldwide. Children and adult pedestrians with neurodevelopmental disorders may be at greater risk due to deficits in a range of domains, such as attention, social communication, motor control and executive function. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (American Psychological Association, 2013), neurodevelopmental disorders include individuals with a diagnosis of Autism Spectrum Disorders, Attention Deficit Hyperactivity Disorder, Specific Learning Disorder, Motor Difficulties, Communication Disorders and Intellectual Disabilities. The purpose of this systematic review and meta-analysis was to explore existing literature relating to determine the nature of the risk faced by pedestrians with neurodevelopmental disorders. Relevant databases including Web of Science, PhysInfo and CINAHL were searched up to July 2019. All peer reviewed journals that presented data focusing on neurodevelopmental disorders and some aspect of road crossing or roadside behaviour that included a control or comparison group were included. A total of 149 abstracts were assessed and 17 met the inclusion criteria. The identified papers could be grouped into four areas: (1) rate of injury; (2) assessment of risk; (3) eye gaze and understanding of road layout and (4) gap choice. No papers exploring the risk factors at the roadside for individuals with Specific Learning Disorders or Communication Disorders were identified. Overall, the review provide evidence for an elevated risk of injury for individuals with ADHD at the roadside, potentially as a consequence of poor temporal gap choice, although there was evidence that this risk could be mediated by executive dysfunction rather than ADHD symptomology. Furthermore, poor temporal gap choice was found in children with DCD but it remains unclear as to whether this risk translates to the roadside. Finally, both children and adults with ASD and children with ID were found to demonstrate differences in behaviour / understanding at the roadside. In general, co-occurrence between neurodevelopmental disorders has been largely ignored in the current literature relating to pedestrian risk and future research could consider this along with executive functioning.

The Lived Experience of Crossing the Road When You Have Developmental Coordination Disorder (DCD): The Perspectives of Parents of Children With DCD and Adults With DCD

Pedestrians are one of the most vulnerable groups at the roadside, furthermore, previous research has demonstrated perceptual-motor limitations in individuals with DCD which may put these individuals at even more at risk in the context of road crossing. However, it is unclear whether this is the lived experience of these individuals at the roadside. Furthermore, difficulties with road crossing and safety have been found in other neurodevelopmental disorders but the impact this might have on an individual with co-occurring difficulties is unknown. Therefore, we utilized a questionnaire to survey the lived experience of adults with DCD and parents of children with DCD with the specific objectives of describing behaviors exhibited by adults and children with DCD (the latter reported by parents) at the roadside and to determine the how these individuals perceive road crossing actions. For each of these we compared different co-occurrence groups. We also had one final objective which was not focused on road crossing but more on the general perception of accidents and unrealistic optimism. Individuals with co-occurrences which have previously been linked to unsafe crossing behaviors (i.e., ADHD, ASD, and LD) reported a greater regularity of dangerous looking behavior (forgetting to look, running without looking) and visibility (crossing between cars, crossing when you can't see), these adults and the parents of these children were seemingly aware of the risky nature of these behaviors. When asked "why" crossing ability might be different, perceptual and motor difficulties alongside heightened awareness of risk and lowered awareness of risk were all cited by participants. Unrealistic optimism was not an explanation for the risky behavior in adults with DCD and in fact, these adults demonstrated a clear understanding of the likelihood of accidents. The findings of this study suggest that road crossing is perceived to be more challenging for both children and adults with DCD and this needs to be taken into account when considering remediation for this group.