Children with ADHD and traffic accidents

Children with ADHD may be more likely to get into traffic accidents due to impulsivity.

Children with attention-deficit hyperactivity disorder (ADHD) may be more likely to have accidents when crossing busy intersections on their bicycles because they're impulsive and have trouble paying attention, a new study suggests.

Researchers said it was known that these children were at increased risk, but the reasons were unclear.

"Crossing roads on a bicycle requires decision and action. What we found is children with ADHD have deficits in both areas," study corresponding author Molly Nikolas said in a University of Iowa news release. Nikolas is an assistant professor in the department of psychological and brain sciences.

Bicycle crashes are a leading cause of severe injuries in children. Each year, nearly 400,000 kids are treated in U.S. emergency departments for bicycle-related injuries, according to the study.

Using a lab-based stationary bicycle, researchers studied how 27 children with ADHD and 36 children without the disorder crossed busy intersections, shown by computer simulation. The children were between the ages of 10 and 14. None of those with ADHD was on medication at the time.

Overall, children crossed when there were similar-sized gaps between cars. But those with ADHD were less precise in timing when to enter the intersection and had less time to spare, according to the study in the December issue of Journal of Child Psychology and Psychiatry.

Moreover, after being exposed to heavy traffic with shorter gaps between cars, youngsters with ADHD had difficulty readjusting when traffic eased and gaps between cars widened. Rather than waiting for the wider gaps, the children with ADHD continued to choose shorter gaps, increasing their risk of an accident.

"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 said.

The best way to help children with ADHD cross busy intersections may be to teach them to look for longer gaps between cars, no matter how heavy the traffic, she said.

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

Almost 6 million American children between the ages of 3 and 17 have ADHD, according to the U.S. Centers for Disease Control and Prevention.

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Potential link between pesticides and ADHD

A study indicates a possible link between a pesticide and ADHD.

There's evidence -- but not proof -- of a link between a commonly used household pesticide and attention deficit hyperactivity disorder (ADHD) in children and young teens, according to a new study.

Specifically, researchers found an association between exposure to pyrethroid pesticides and ADHD, as well as ADHD symptoms such as hyperactivity and impulsivity.

The link between the pesticides and ADHD was stronger in boys than in girls, according to the findings published online in the journalEnvironmental Health.

However, researchers only found an association between pesticides and ADHD. The study did not prove a cause-and-effect relationship.

Pyrethroid pesticides -- considered safer than organophosphate pesticides -- are the most widely used pesticides for home and public health pest control, and their use in agriculture is increasing, according to the researchers.

"Given the growing use of pyrethroid pesticides and the perception that they may represent a safe alternative, our findings may be of considerable public health importance," study corresponding author Dr. Tanya Froehlich, a developmental pediatrician at Cincinnati Children's Hospital Medical Center, said in a hospital news release.

She and her colleagues analyzed data from nearly 700 children between the ages of 8 and 15. The children had taken part in the 2000-2001 National Health and Nutrition Examination Survey. The researchers looked at levels of 3-PBA -- a chemical indicator of exposure to pyrethroids -- in the children's urine.

Boys with detectable levels of 3-PBA in their urine were three times more likely to have ADHD than those without detectable 3-PBA. For every 10-fold increase in 3-PBA levels in boys, there was a 50 percent increased risk for hyperactivity and impulsivity -- both symptoms of ADHD.

In girls, levels of 3-PBA were not associated with increased risk of ADHD or symptoms of the disorder.

"Our study assessed pyrethroid exposure using 3-PBA concentrations in a single urine sample," Froehlich said. But because these chemicals don't stay in the body for long, she suggested that future studies need to take multiple measurements over time. Such studies would need to be done before "we can say definitively whether our results have public health ramifications," she said.

Previous studies have found that pyrethroid exposure increases hyperactivity, impulsivity and abnormalities in the dopamine system in male mice, according to the researchers. Dopamine is a brain chemical believed to play a role in many activities, including those that govern ADHD, the researchers said.

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Does your child have ADD, ADHD, or both?

This article presents many common symptoms of ADD and ADHD to help parents determine if their child should be further evaluated for these conditions.

Does your child have Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder or both?

People with ADHD show a persistent pattern of inattention or hyperactivity-impulsivity that interferes with functioning or development, according to the Center for Disease Control. If a child exhibits six or more of each of the following patterns of symptoms, they may require further evaluation by a professional, according to the CDC:

Inattention
■Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
■Often has trouble holding attention on tasks or play activities.
■Often does not seem to listen when spoken to directly.
■Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
■Often has trouble organizing tasks and activities.
■Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time, such as schoolwork or homework.
■Often loses things necessary for tasks and activities, such as pencils and books.
■Is often easily distracted.
■Is often forgetful in daily activities.

Hyperactivity and Impulsivity
■Often fidgets with or taps hands or feet, or squirms in seat.
■Often leaves seat in situations when remaining seated is expected.
■Often runs about or climbs in situations where it is not appropriate.
■Often unable to play or take part in leisure activities quietly.
■Is often "on the go" acting as if "driven by a motor".
■Often talks excessively.
■Often blurts out an answer before a question has been completed.
■Often has trouble waiting his/her turn.
■Often interrupts or intrudes on others.

Other indications of possible concerns include that several inattentive or hyperactive-impulsive symptoms were present before the child was 12, that symptoms are present in two or more settings, such as at home and school, that the symptoms interfere with socializing, school and work, and that the symptoms are not better explained by another mental disorder, according to the CDC.

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