Pedestrian trauma represents a significant proportion of all road trauma. In particular, the safety of child pedestrians is of concern, given that a sizeable proportion of pedestrians killed and seriously injured involve children and the special value society places on its youth. At ages 6-10 years, children are at highest risk of pedestrian collision, most likely due to the beginning of independent unsupervised travel at a time when their road strategies, skills and understanding are not yet fully developed. Road safety education is considered an essential component of teaching children the skills to interact with traffic safely. While many programs are available in Australia and internationally, many do not consider the separate component skills of the road-crossing task and the functional and behavioural factors that may put some children at increased risk. Moreover, some concern has been raised regarding the ability of some education programs to foster the transfer of knowledge to improved behaviour in real-world environments. This report presents the findings of a two-phased study: i) an experimental study addressing the impacts of functional performance, behaviour, traffic patterns and exposure to traffic on road-crossing skill amongst primary school children using a simulated road-crossing environment and parent survey; and ii) a training study aimed to firstly use this information to develop a targeted and practical training program aimed to teach good road-crossing skills, particularly amongst those who are at highest risk of crash involvement, and secondly, to evaluate the effectiveness of the training program in developing the appropriate functional and behavioural skills required to make safe road-crossing decisions. In the experimental phase, children viewed video scenes of traffic and made choices about crossing the road by responding ‘yes' when they thought it was safe to cross and rated the safety of that crossing. The results of the first phase of the study suggest that children predominantly made decisions based on the distance gap of vehicles and that younger children (6-7 year olds) were 12 times more likely than older children (8-10 year olds) to make critically incorrect crossing decisions (where a ‘yes' response was made but walking time was less than the time gap and may have resulted in a collision in a real life scenario). In addition, poor performance on all tests of functional skills was associated with a higher likelihood of critically incorrect crossing decisions. Some differences in travel patterns and traffic exposure were noted, however, no gender differences were found. Based on logistic regression modelling, ‘at-risk' children were identified as younger children, those with poorer perceptual, attentional and cognitive/executive skills and those with lower traffic exposure. Using this information, a targeted and practical training program was developed using a simulated road-crossing environment. Group-based feedback was provided on road-crossing responses. Responses were compared at p r e-training, one-week post-training and one-month post-training. Significant overall reductions in proportion of critically incorrect responses were found immediately after training (56%) and one-month post-training (47%) by the case group compared with pre-training responses, and relative to any changes in the control group. The beneficial effects were greater for younger children, females, children with less well developed perceptual, attentional and cognitive skills, and those with little traffic exposure. The effects of the training program on other outcome measures (e.g., proportion of missed opportunity responses, decision time and safety rating responses) were less clear but showed some beneficial effects. This study has identified ‘at-risk' groups of child pedestrians and highlighted key functional and behavioural factors associated with poor road-crossing skill. The evaluation of the training program clearly shows a beneficial effect in improving road-crossing skills amongst 'at-risk' children. This training effect was sustained over a one-month period. The use of a simulated training program that targets the component skills of road-crossing decisions is a novel and safe way to improve essential skills and strategies to cross roads safely and has major implications for improvements to education and training programs for child pedestrian safety. (Author/publisher)
Abstract