Mediating Factors Associated With Pedestrian Injury in Children With Attention-Deficit/Hyperactivity Disorder
ABSTRACT Unintentional injury is the leading cause of pediatric mortality. One leading cause of unintentional injury is pedestrian injury. Children with developmental disabilities, particularly those with attention-deficit/hyperactivity disorder-combined type (ADHD-C) seem to have increased pedestrian injury risk. This study examined (1) the differences in pedestrian behavior between children with ADHD-C and normally developing comparison children and (2) the mediating factors that might link ADHD-C with pedestrian injury risk.
A total of 78 children aged 7 to 10 years (39 children with ADHD-C diagnoses and 39 age- and gender-matched typically developing children) participated. The main outcome measure was pedestrian behavior, as measured in a semi-immersive, interactive, virtual pedestrian environment. Key pedestrian variables related to different aspects of the crossing process were identified: (1) before the cross (ie, evaluating aspects of the crossing environment); (2) making the cross (ie, deciding to cross and initiating movement); and (3) safety of the cross (ie, safety within the pedestrian environment after the decision to cross was made).
Children with ADHD-C chose riskier pedestrian environments to cross within (F(1,72) = 4.83; P < .05). No significant differences emerged in other aspects of the crossing process. Executive function played a mediating role in the relationship between ADHD-C and the safety of the cross.
Children with ADHD-C seem to display appropriate curbside pedestrian behavior but fail to process perceived information adequately to permit crossing safely.
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ABSTRACT: Sudden cardiac death (SCD) in otherwise healthy children is tragic. Increasing attention has been paid to preventing these untimely events, particularly with regard to cardiac causes, as these are the most common, though not the exclusive causes. Interest has centered around sports participation, as about 25% of such events occur at this time(1), and the use of ADHD medication which may or may not precipitate SCD in susceptible individuals. A recent NHLBI panel evaluated the evidence base for addressing the prevention of SCD, and found too many gaps in evidence to formulate general recommendations for SCD prevention in the young(2). Particular concerns surround lack of knowledge of the true incidence of SCD, absence of a pilot ECG screening program to test the effectiveness of various screening methodologies, identification of the most effective screening strategy (the most useful screening method, and selective screening in high risk individuals vs. universal screening at a specific age), and limited knowledge of the impact of a screening program on the both the quality of life and clinical outcomes of the asymptomatic individuals and families screened. The report states "before a significant public health investment is made in large scale ECG screening, it would be ideal to empirically demonstrate a link between screening and improved health outcomes." (SELECT FULL TEXT TO CONTINUE).Circulation 05/2012; 125(21):2560-2. DOI:10.1161/CIRCULATIONAHA.112.103994 · 14.43 Impact Factor
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ABSTRACT: Limited literature documents injury-proneness of attention-deficit hyperactivity disorder in western population. However, only a few studies prospectively investigated the prediction of ADHD to injuries without considering other psychiatric and physical conditions and there is lack of such data in Asian population. To prospectively examine the prediction of ADHD to the risk of injury in a national sample of Taiwan, we conducted this study with samples including 1965 6-18-year-old youths with newly diagnosis of ADHD from 1999 to 2003, and 7860 sex-, age- and index day-matched non-ADHD controls from Taiwan's National Health Insurance Research Database (1997-2008). Relevant psychiatric and physical disorders, demographics, and medications were also included in the Cox proportional hazard models with injury as the outcome. Our results showed that ADHD cases had a roughly 2-fold and 5-fold higher risk of each injury, and overall injury than controls after considering all confounding factors, respectively. In addition to ADHD, use of anxiolytics, antidepressants, and antipsychotics, and comorbid physical illnesses also predicted the injury prospectively. Our findings strongly support that ADHD predicted injury risks and imply that physicians should take the risk of injury into consideration while prescribing medications other than stimulants to patients with ADHD, especially anxiolytics.Research in developmental disabilities 01/2013; 34(3):1100-1108. DOI:10.1016/j.ridd.2012.11.027 · 4.41 Impact Factor
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ABSTRACT: Objective: Recent studies showed that attention deficit hyperactivity disorder (ADHD) is a lifelong disorder which may be seen in adults as well as children. However, information about the relationship between ADHD and general medical conditions in adulthood is limited. This case-control study aims to determine whether ADHD symptoms are associated with extremity fractures and their clinical characteristics. Methods: Forty patients (25 male and 15 female; aged 18-50 years) who were seen due to extremity fractures and 40 control subjects were enrolled. Childhood and present ADHD symptoms of the participants were assessed using Wender Utah Rating Scale (WURS) and Adult ADHD Self-Report Scale (ASRS), respectively. Trauma type, reason of the trauma, fracture localization, hospitalization requirement, treatment type, and history of previous fracture(s) of the patients were recorded. Results: Total score and all subscale scores of WURS were higher in the fracture groups compared with controls. Patients also had higher ASRS total score and ASRS hyperactivity-impulsivity subscore than the controls did. WURS irritability, inattentiveness, and behavioral problems/impulsiveness subscore and total score were positively correlated with the history of previous fracture. The patients in whom the reason for the fracture was fighting were also showed higher WURS irritability subscore. Conclusions: Our results suggest that extremity fractures are associated with ADHD symptoms in adults. These findings may provide an insight into better understanding the lifelong negative impact of ADHD on the physical health of its sufferer.The International Journal of Psychiatry in Medicine 06/2014; 47(1):55-63. DOI:10.2190/PM.47.1.e · 0.89 Impact Factor