Children and motorbikes: Toward an answer for how young is too young. Bianca Albanese
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1 Children and motorbikes: Toward an answer for how young is too young Bianca Albanese
2 Background Transport injuries are the leading cause of death/injury to Australian children Motorcycles are second most common vehicle type Other vehicles Animals Vehicles involved in child hospitalised transport injuries Pedestrian Two children killed every year using off-road vehicles in NSW NSW Child Death Review Team (2014) Car Motorcycles Bicycle Australian Institute of Health and Welfare (2014)
3 Background Similar high injury rates in US On-road motorcycle crashes leading cause of child injury in Asia
4 Background No legislative controls restricting minimum age Motorcycles or minibikes available for children as young as 3 years
5 Background Most crashes involved loss or control or impact with stationary object (Mulligan 2014) Match physical, cognitive and sensory maturity with the vehicle and riding task
6 Background Ban based on age?
7 Background Match age with bike and riding type?
8 Aim To develop a tool to study the association between child development and safe operation of motorcycles
9 Methods 1 Task 2 Collated 3 Expert 4 Assessment Analysis Materials Panel Tools
10 Methods 1 Task 2 Collated 3 Expert 4 Assessment Analysis Materials Panel Tools Task analysis Observed 5 children 8-12 years perform off-road motorcycle activities 1. Identify subtasks involved in motorbike riding 2. Analyse attributes needed for safe and successful riding in each subtask 3. Review existing assessment tools
11 Method Task Riding PTW Subtask Skill 1 (cornering) Skill 2 (braking) Skill 3 (inclines) Domain Physical Cognitive Sensory Physical Cognitive Sensory Physical Cognitive Sensory Attribute Balance Information processing Depth perception Strength Decision making Judge distances Weight distribution Information processing Judging gradients Tool Movement Assessment Battery for Children
12 Methods 1 Task 2 Collated 3 Expert 4 Assessment Analysis Materials Panel Tools
13 Method Delphi Consensus List of attributes Experience with tools Qualitative feedback Round 1 Round 2 Rate utility of assessment items Qualitative feedback Review aggregate ratings Re-rate utility of tools Round 3
14 Results Task Analysis 10 component tasks 1. Mounting & starting 2. Initiating movement 3. Accelerating 4. Braking 5. Cornering 6. Negotiating uneven terrain 7. Negotiating incline or decline 8. Negotiating obstacles 9. Jumping 10. Stopping Key attributes across sensory, cognitive and motor domains
15 Results Task Analysis 10 component tasks 1. Mounting & starting 2. Initiating movement 3. Accelerating 4. Braking 5. Cornering 6. Negotiating uneven terrain 7. Negotiating incline or decline 8. Negotiating obstacles 9. Jumping 10. Stopping Key attributes across sensory, cognitive and motor domains
16 Results SUB-TASK 7: Negotiating incline or decline STEP DESCRIPTION SENSORY, COGNITIVE AND PHYSICAL ASPECTS INVOLVED 1 Look at the terrain ahead and assess the correct speed, body position and throttle to negotiate the incline or decline. Auditory and visual acuity and processing. Cognitive processing, planning, judgement and decision making.. Hazard perception. 2 Adjust body position, throttle and, if geared, select the correct gear, to negotiate the incline or decline effectively. 3 As the bike enters the incline or decline, adjust body position and throttle or apply brakes as needed. 4 Continue to assess the incline or decline and terrain as the bike passes over it. Adjust body position, throttle or brake as needed. 5 Assess the exit of the incline or decline and adjust body position and speed as the bike passes out of the incline or decline and into the next section. Balance and core strength. Upper and lower limb strength and gross motor control, fine motor control in hands/wrists. Visual acuity and processing. Cognitive planning, assessment and feedback. Motivation and commitment to task. As above. Cognitive assessment, review, planning and implementation of task sequencing. Gross motor control, upper and lower limb strength, core strength. Balance, visual and auditory acuity. As above.
17 Results Delphi Consensus 1 Task 2 Collated 3 Expert 4 Assessment Analysis Materials Panel Tools Eight content experts participated in Delphi consensus Round 1: 34 assessment items were compiled
18 Results Item Strong utility, Strong utility, Change (%) Round 2 (%) Round 3 (%) One leg standing 100% 100% 0% Drawing lines through paths 80% 100% 20% Stereognosis 60% 100% 40% Catching ball 80% 80% 0% Throwing ball 80% 80% 0% Bouncing ball 80% 80% 0% Threading lace 80% 80% 0% Standing on balance board 80% 80% 0% Walking heel-to-toe 80% 80% 0% Sit-to-stand 60% 80% 20% Finger identification 60% 80% 20% Zoo map test 100% 75% -25% Sky search test 75% 75% 0% Map mission test 67% 75% 8% Key search test 100% 67% -33% Hand strength 100% 60% -40% Lateral step-up 80% 60% -20% Catching bean bag 80% 60% -20% Tapping feet and fingers 60% 60% 0% Hopping 40% 60% 20% Standing on balance beam 80% 40% -40% Throwing bean bag 100% 40% -60% Push-ups 40% 40% 0% Standing long-jump 60% 40% -20% Playing cards test 67% 25% -42% Code transmission test 50% 25% -25% Opposite worlds test 25% 25% 0% Shuttle run 20% 20% 0% Reproduce drawings 60% 0% -60% Water test 33% 0% -33% Creature counting test 25% 0% -25% Score! 25% 0% -25% Six parts test 0% 0% 0% Jumping in place 0% 0% 0%
19 Results Strong Utility Item Strong utility, Strong utility, Change (%) Round 2 (%) Round 3 (%) One leg standing 100% 100% 0% Drawing lines through paths 80% 100% 20% Stereognosis 60% 100% 40% Catching ball 80% 80% 0% Throwing ball 80% 80% 0% Bouncing ball 80% 80% 0% Threading lace 80% 80% 0% Standing on balance board 80% 80% 0% Walking heel-to-toe 80% 80% 0% Sit-to-stand 60% 80% 20% Finger identification 60% 80% 20% Zoo map test 100% 75% -25% Sky search test 75% 75% 0% Map mission test 67% 75% 8% Key search test 100% 67% -33% Hand strength 100% 60% -40% Lateral step-up 80% 60% -20% Catching bean bag 80% 60% -20% Tapping feet and fingers 60% 60% 0% Hopping 40% 60% 20% Standing on balance beam 80% 40% -40% Throwing bean bag 100% 40% -60% Push-ups 40% 40% 0% Standing long-jump 60% 40% -20% Playing cards test 67% 25% -42% Code transmission test 50% 25% -25% Opposite worlds test 25% 25% 0% Shuttle run 20% 20% 0% Reproduce drawings 60% 0% -60% Water test 33% 0% -33% Creature counting test 25% 0% -25% Score! 25% 0% -25% Six parts test 0% 0% 0% Jumping in place 0% 0% 0%
20 Results Strong Utility Weak Utility Item Strong utility, Strong utility, Change (%) Round 2 (%) Round 3 (%) One leg standing 100% 100% 0% Drawing lines through paths 80% 100% 20% Stereognosis 60% 100% 40% Catching ball 80% 80% 0% Throwing ball 80% 80% 0% Bouncing ball 80% 80% 0% Threading lace 80% 80% 0% Standing on balance board 80% 80% 0% Walking heel-to-toe 80% 80% 0% Sit-to-stand 60% 80% 20% Finger identification 60% 80% 20% Zoo map test 100% 75% -25% Sky search test 75% 75% 0% Map mission test 67% 75% 8% Key search test 100% 67% -33% Hand strength 100% 60% -40% Lateral step-up 80% 60% -20% Catching bean bag 80% 60% -20% Tapping feet and fingers 60% 60% 0% Hopping 40% 60% 20% Standing on balance beam 80% 40% -40% Throwing bean bag 100% 40% -60% Push-ups 40% 40% 0% Standing long-jump 60% 40% -20% Playing cards test 67% 25% -42% Code transmission test 50% 25% -25% Opposite worlds test 25% 25% 0% Shuttle run 20% 20% 0% Reproduce drawings 60% 0% -60% Water test 33% 0% -33% Creature counting test 25% 0% -25% Score! 25% 0% -25% Six parts test 0% 0% 0% Jumping in place 0% 0% 0%
21 Results Strong Utility No consensus Weak Utility Item Strong utility, Strong utility, Change (%) Round 2 (%) Round 3 (%) One leg standing 100% 100% 0% Drawing lines through paths 80% 100% 20% Stereognosis 60% 100% 40% Catching ball 80% 80% 0% Throwing ball 80% 80% 0% Bouncing ball 80% 80% 0% Threading lace 80% 80% 0% Standing on balance board 80% 80% 0% Walking heel-to-toe 80% 80% 0% Sit-to-stand 60% 80% 20% Finger identification 60% 80% 20% Zoo map test 100% 75% -25% Sky search test 75% 75% 0% Map mission test 67% 75% 8% Key search test 100% 67% -33% Hand strength 100% 60% -40% Lateral step-up 80% 60% -20% Catching bean bag 80% 60% -20% Tapping feet and fingers 60% 60% 0% Hopping 40% 60% 20% Standing on balance beam 80% 40% -40% Throwing bean bag 100% 40% -60% Push-ups 40% 40% 0% Standing long-jump 60% 40% -20% Playing cards test 67% 25% -42% Code transmission test 50% 25% -25% Opposite worlds test 25% 25% 0% Shuttle run 20% 20% 0% Reproduce drawings 60% 0% -60% Water test 33% 0% -33% Creature counting test 25% 0% -25% Score! 25% 0% -25% Six parts test 0% 0% 0% Jumping in place 0% 0% 0%
22 Results Strong Utility No consensus Item Strong utility, Strong utility, Change (%) Round 2 (%) Round 3 (%) One leg standing 100% 100% 0% Drawing lines through paths 80% 100% 20% Stereognosis 60% 100% 40% Catching ball 80% 80% 0% Throwing ball 80% 80% 0% Bouncing ball 80% 80% 0% Threading lace 80% 80% 0% Standing on balance board 80% 80% 0% Walking heel-to-toe 80% 80% 0% Sit-to-stand 60% 80% 20% Finger identification 60% 80% 20% Zoo map test 100% 75% -25% Sky search test 75% 75% 0% Map mission test 67% 75% 8% Key search test 100% 67% -33% Hand strength 100% 60% -40% Lateral step-up 80% 60% -20% Catching bean bag 80% 60% -20% Tapping feet and fingers 60% 60% 0% Hopping 40% 60% 20% Standing on balance beam 80% 40% -40% Throwing bean bag 100% 40% -60% Push-ups 40% 40% 0% Standing long-jump 60% 40% -20%
23 Results Strong Utility No consensus Item Strong utility, Strong utility, Change (%) Round 2 (%) Round 3 (%) One leg standing 100% 100% 0% Drawing lines through paths 80% 100% 20% Stereognosis 60% 100% 40% Catching ball 80% 80% 0% Throwing ball 80% 80% 0% Bouncing ball 80% 80% 0% Threading lace 80% 80% 0% Standing on balance board 80% 80% 0% Walking heel-to-toe 80% 80% 0% Sit-to-stand 60% 80% 20% Finger identification 60% 80% 20% Zoo map test 100% 75% -25% Sky search test 75% 75% 0% Map mission test 67% 75% 8% Key search test 100% 67% -33% Hand strength 100% 60% -40% Lateral step-up 80% 60% -20% Catching bean bag 80% 60% -20% Tapping feet and fingers 60% 60% 0% Hopping 40% 60% 20% Standing on balance beam 80% 40% -40% Throwing bean bag 100% 40% -60% Push-ups 40% 40% 0% Standing long-jump 60% 40% -20%
24 Where we re up to Obtained agreements to use items in modified tool Pilot study over summer riding season Feasibility of implementing assessments Reliability and external validity of the proposed tools
25 Where we re going Feasibility Longitudinal study >250 children aged 5-16 years Assess change in developmental maturity over 2 year period Guidance on controlling off-road riding risk
26 Acknowledgments Funding from NSW Kids and Families Julie Brown supported by a NHMRC Fellowship Other researchers: Julie Brown, Ryder Lystad, Michael Berryman, David Schwebel, Susan Adams, Chris Mulligan, Soundappan Soundappan, Rebecca Ivers, Lisa Keay, Kristy Coxon
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