Objective: Pedestrian injuries are a leading cause of child death and may be reduced by training children to cross streets more safely. Such training is most effective when children receive repeated practice at the complex cognitive-perceptual task of judging moving traffic and selecting safe crossing gaps, but there is limited data on how much practice is required for children to reach adult levels of functioning. Using existing data, we examined how children's pedestrian skills changed over the course of 6 pedestrian safety training sessions, each composed of 45 crossings within a virtual pedestrian environment.Methods: As part of a randomized controlled trial on pedestrian safety training, 59 children ages 7-8 crossed the street within a semi-immersive virtual pedestrian environment 270times over a 3-week period (6 sessions of 45 crossings each). Feedback was provided after each crossing, and traffic speed and density were advanced as children's skill improved. Postintervention pedestrian behavior was assessed a week later in the virtual environment and compared to adult behavior with identical traffic patterns.Results: Over the course of training, children entered traffic gaps more quickly and chose tighter gaps to cross within; their crossing efficiency appeared to increase. By the end of training, some aspects of children's pedestrian behavior was comparable to adult behavior but other aspects were not, indicating that the training was worthwhile but insufficient for most children to achieve adult levels of functioning.Conclusions: Repeated practice in a simulated pedestrian environment helps children learn aspects of safe and efficient pedestrian behavior. Six twice-weekly training sessions of 45 crossings each were insufficient for children to reach adult pedestrian functioning, however, and future research should continue to study the trajectory and quantity of child pedestrian safety training needed for children to become competent pedestrians.
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