Beyond The Green Cross Code: Cognitive and Social influences On Child And Adolescent Road Safety
Submitting InstitutionUniversity of Lincoln
Unit of AssessmentPsychology, Psychiatry and Neuroscience
Summary Impact TypePolitical
Research Subject Area(s)
Medical and Health Sciences: Public Health and Health Services
Psychology and Cognitive Sciences: Psychology
Summary of the impact
Road traffic collisions are a major cause of mortality and morbidity in
children and young people globally (World Health Organisation report on
child injury prevention, 2008). Research into child and adolescent road
crossing behaviour, led by Dr Karen Pfeffer of the Evolution and
Development Research Group at the University of Lincoln, has influenced
road safety intervention practice via its inclusion in a series of safety
initiatives, programmes and guides for parents, health-care providers,
educators and road safety officers, produced by independent organisations
internationally since 2008. Dr Pfeffer's research has also had
international impact and influence via her appointment as a mentor for the
World Health Organization (WHO) Mentors for Violence and Injury Prevention
The research underpinning the impact investigated the role of attention
and cognitive processes in children's road crossing decisions, and the
role of social context in road crossing behaviour. Computer based tests of
the influence of selective attention during viewing of road traffic
scenes, combined with standardized neuropsychological tests, assessed the
relationship between the development of cognitive processes and the
ability to identify safe crossing points1,2. Naturalistic
observation of adults' and childrens' road crossing behaviour was used to
investigate the influence of social context3. Video simulations
of road traffic scenes presented to adolescents and their friends were
used to investigate peer influence on decision making5. The
research was carried out between 2003 and 2013. The principal investigator
was Dr Karen Pfeffer, and a key co-investigator in the research was Dr
Zahra Tabibi, who was a PhD student at the University of Lincoln.
Key insights of the research were:
- selective attention, divided attention, and the ability to inhibit
distracting information are required for identifying safe crossing sites
quickly and accurately. Young childrens' attention is especially
affected by distracting information when choosing a safe place to cross1,2;
- development of cognitive processes, particularly information
processing speed, is an important predictor of a child's ability to
identify safe road crossing sites4;
- adults provide implicit rather than explicit road safety guidance for
children when crossing roads. They act as good role models for children,
but only infrequently take the opportunity to explicitly teach road
safety in situ3;
- adults behave differently towards girls and boys in road crossing
contexts; specifically they behave more safely when with girls than boys3;
- adolescents' road safety behaviour can be modulated positively and
negatively by peer influences5.
Conclusions and recommendations arising from the research program to date
- road safety training programs for children should take into account
the development of children's attention capabilities;
- interventions aimed at reducing child road casualties should encourage
parents to teach road-crossing skills directly, and should take into
consideration differences in adult supervision of girls and boys.
References to the research
1. Tabibi, Z., & Pfeffer, K. (2003) `Choosing a safe place to cross
the road: the relationship between attention and identification of safe
and dangerous road crossing sites', Child Care Health and Development,
2. Tabibi, Z., & Pfeffer, K. (2007) `Finding a safe place to cross
the road: the effect of distractors and the role of attention in
children's identification of safe and dangerous road-crossing sites', Infant
and Child Development, 16(2): 193-206.
3. Pfeffer, K., Fagbemi, H.P., & Stennet, S. (2010) `Adult pedestrian
behavior when accompanying children on the route to school', Traffic
Injury Prevention, 11: 188-193.
4. Tabibi, Z., Pfeffer, K. & Sharif, J.T. (2012) `The influence of
demographic factors, processing speed and short-term memory on Iranian
children's pedestrian skills', Accident Analysis & Prevention,
5. Pfeffer, K & Hunter E (2013) `The effects of peer influence on
adolescent pedestrian road-crossing decisions', Traffic Injury
Prevention, 14: 434-440.
Details of the impact
The research findings and conclusions have been included in a series of
child pedestrian road safety guidance documents aimed at members of the
public and professionals, and have influenced the implementation of
pedestrian safety programs internationally. The efficacy of one US-wide
accident prevention initiative, which drew on the research programme, has
recently been positively evaluated as reducing childhood road accident
injuries by an independent peer reviewed cluster control research studya,b.
The research has also led to the principal investigator being invited to
act as advisor for international (Ghana) and local (UK, Lincolnshire Road
Safety Partnership) road safety programs.
The US Safe Routes to School (SRTS) programme's guide for parents and
caregivers, Teaching Children to Walk Safely as they Grow and Develop,
highlights Tabibi and Pfeffer's findings regarding the limitations of
children's attentional skills when finding a safe place to cross. The Safe
Routes to Schools Program is a Federal-Aid programme of the US Department
of Transportation's Federal Highway Administration (FHWA). The Teaching
Children to Walk Safely guide is made available via the US National
Center for Safe Routes to Schoola at the University of North
Carolina's Highway Safety Research Center. A recent independent evaluation
of the effectiveness of the US Safe Routes to School programme in New York
City found that implementation of the program resulted in a 33% reduction
in school-aged children's pedestrian injuries. The rate of school-aged
pedestrian injury during school-travel hours decreased by 44% in the
post-intervention period (2009-2010) relative to the pre-intervention
period (2001-2008) in the districts where the programme had been
implemented. In districts where the programme had not been implemented the
injury rates were unchangedb.
Tabibi and Pfeffer's research is cited as an influence on the development
of another empirically validated road safety training package developed by
the Monash University Accident Research Centre, Australia. This programme
emphasises limitations in childrens' cognitive capacities as a risk factor
for child pedestrian collisions. A case-control group evaluation of this
computer simulation based training programme in 71 children found it to be
effective in reducing critically incorrect road crossing decisions, with
no accompanying reduction in missed opportunities for safe crossing in the
treatment groupc. Cognitive performance measures (e.g. colour
trails task) were also found to modulate the effect of the training
intervention with children who scored lower on cognitive assessments
benefiting more from training.
Tabibi and Pfeffer's research has also formed the basis of another widely
available online road safety guide for parents called Teach Your
Children to be Safe Pedestrians. The guide is distributed via the
EBSCO health library (an evidence based information website designed to
deliver the best-available evidence based information directly to
clinicians and health professionals). It is also available in both English
and Spanish versions via over 100 hospital websites, including, for
example, the Aspen Medical Centre Denver, Tufts Medical Centre, Boston,
and the New York University Medical School Langone Medical Centred.
The research findings regarding adult behaviour when accompanying
children to school are cited by the US National Highway Traffic Safety
Administration guide for State Highway Safety Officers, Countermeasures
that worke. This effective countermeasures guide for
policy makers emphasises the importance of cultural and social norms for
roadside behaviour in its recommendations for evidence-based adult
Tabibi and Pfeffer's research on children's attention has been widely
cited in many other road safety planning reports, research reviews and
educational materials, including the UK Department for Transport Research
Reports,f and is also cited in a number of best-selling
developmental psychology textbooksg. The research has also been
cited by the Children in Wales Child Accident Prevention Practice
and Information Exchange scheme, and Le Programme intercantonal de
prévention des accidents d'énfants, Switzerlandh.
Further evidence of the impact and influence of Dr Pfeffer's research on
pedestrian safety are her advisory duties for international and local
non-academic organisations. As a result of her research on childhood road
safety, she was selected and appointed to serve as an international mentor
for the World Health Organisation Mentors for Violence and Injury
Prevention program (WHO MENTOR-VIP) from 2007-2008i. The role
of the international mentor was to provide guidance and support to a
professional working in a low-income country on a specific project.
Following on from this work, Dr Pfeffer was invited by the coordinator of
the WHO MENTOR-VIP programme to contribute to a symposium at the Safety
2010 World Conference in London about the mentoring experience, to
showcase successful mentoring relationships and to encourage the
development of future mentoring partnerships among professionals and
researchers in the field of violence and injury preventionj.
Locally, she was also commissioned to evaluate the `2 fast 2soon' road
safety education programme for young drivers (17-24 year-olds) by the
Lincolnshire Road Safety Partnership. The Lincolnshire Road Safety
Partnership's `2fast2soon' programme won the Prince Michael of Kent
International Road Safety Award in 2010, and continues to be offered to
young drivers in Lincolnshire.
Sources to corroborate the impact
a. The Safe Routes to School parent guide: `Teaching Children
to Walk Safely as they Grow and Develop' National Center for Safe
Routes to School, University of North Carolina, 2009.
b. Evaluation of Safe Routes to School programme: DiMaggio, C.
and Guohua, L. (2013). Effectiveness of a Safe Routes to School program in
preventing school-aged pedestrian injury. Pediatrics, 131(2):
c. Monash University pedestrian safety training package for children:
Congui, M., Whelan, M, Oxley, J., Charlton, J., D'Elia, A. and Muir, C.
(2008) `Child Pedestrians: Factors associated with ability to cross roads
safely and development of a training package', Monash University Accident
Research Centre, Report no. 283.
d. The `Teach Your Children to be Safe Pedestrians' guide available
Ebsco Health Library:
Aspen Medical Centre: aspenmedgroup.org/your-health/?/28022///sp.
Tufts Medical Centre: www.tufts-
New York University Medical School: www.med.nyu.edu/content?ChunkIID=125753.
e. The US National Highway Traffic Safety Administration 2012 guide
for State Highway Safety Officers: `Countermeasures that work': www.nhtsa.gov/staticfiles/nti/pdf/811727.pdf.
f. UK Department of Transport Research Report: Cattan, M., Green,
J., Newell, C., Ayrton, R., and Walker, J. (2008), `Child Parent
interaction in relation to Road Safety Education Part 1: Critical
Literature Review', Road Safety Research Report 101, Department for
g. Significant text book citations:
Berk, L. (2009) Child Development: international edition, Boston:
MA, Pearson Education (8th edition).
Berk, L. (2010) Exploring lifespan development, international edition,
Boston: MA, Pearson Education (2nd edition).
Berk, L. (2012) Infants and children: prenatal through middle
childhood, international edition, Boston: MA, Pearson Education (7th
h. The `Children in Wales' e-briefing (April, 2010) for the CHAPPIE
network (Child Accident Prevention Practice and Information Exchange):
Swiss local government information website aimed at parents of young
children: Le Programme inter-cantonal de prévention des accidents
d'énfants (PIPAD'ES), Switzerland:
i. Description and contact details for WHO MENTOR VIP programme:
j. Pfeffer, K. (2010) `Maintaining mentorship across disciplines and
across cultures', WHO MENTOR-VIP: Perspectives on Distance Mentoring for
Injury and Violence Prevention, invited panel presentation at the Safety
2010 World Conference, London.