All ETDs from UAB

Advisory Committee Chair

Fred Biasini

Advisory Committee Members

David C Schwebel

Bart Hodgens

Snehal Khatri

Sylvie Mrug

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences


Unintentional injury is the leading cause of pediatric mortality, killing more children than the next 20 causes of death combined. In middle childhood, the second leading cause of unintentional injury is pedestrian injury. One group at particular risk of pedestrian injury is children with ADHD-Combined Type (ADHD-C). It is unknown why children with ADHD-C may be at elevated risk for pedestrian injury. The objective of the proposed research was to explore the underlying mechanisms for pedestrian injury risk in children with ADHD-C. We employed the ethically viable tool of virtual reality (VR) to measure the pedestrian behavior of 78 children ages 7 to 10. Half had a diagnosis of ADHD-C and half were age- and gender-matched typically developing controls having no previous diagnoses. We predicted children with ADHD-C would display riskier pedestrian behaviors than matched controls, as indexed by key pedestrian variables such as gap between cars when the child chooses to cross and the number of times the child is hit by a virtual vehicle. We also examined the following as mechanisms to explain increased risk of pedestrian injury in children with ADHD-C: executive dysfunction, inattention, oppositionality. Results largely confirmed iii expectations. Children with ADHD chose riskier environments to cross within, as measured by the smaller gaps between vehicles they chose to cross within, the shorter amount of time left to spare upon reaching the other end of the cross walk, and the increased frequency of hits/close calls they experienced. Mediation analyses revealed that executive function mediated the relationship between ADHD and pedestrian injury risk. Implications and future research directions are discussed.



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