Using economic theory to understand children's risky visuomotor decisions

Lead Research Organisation: University College London
Department Name: Clinical Health and Educational Psych


In playgrounds, traffic and around the house, we are at continuous risk of bodily injury. Children are particularly accident-prone, as reflected in the disproportionally high accident-rates of pedestrians aged 15 year and younger. In recent years many researchers, including myself, have made considerable strides in understanding how visuomotor abilities improve across development. Despite these advances in understanding, current approaches do not consider how children adjust for their changing abilities to avoid unnecessary bodily risk during everyday visuomotor decisions. For example, children are less efficient than adults at avoiding incoming traffic when crossing busy roads. Do they account for this correctly by waiting for larger gaps between cars before crossing?

Economic decision-making theories will be employed to model children's visuomotor choices. Economists identify the best financial investments by trading-off probabilities of positive and negative monetary outcomes. Likewise, such tactics can identify the best movement strategy (e.g., when to cross) that maximises safety and efficiency (e.g., avoids accidents but utilises safe gaps in traffic). This has proven very effective for modelling mature visuomotor behaviour, showing that adults often choose movements that optimise performance. Recently I pioneered this approach with children, showing that children aged 6 to 11 years make riskier visuomotor choices than adults during manual reaching. To understand and reduce the effects of risky action selection on childhood injury, we must characterise more broadly how visuomotor decision-making develops, and understand which neurocognitive processes drive this change. A combination of precise behavioural tests, mathematical modelling and neuroimaging will be used to address these fundamental questions.

This proposal consists of 3 main objectives that each form a necessary step towards understanding children's movements under real risk in real world situations; These are to (1) characterise children's risky visuomotor decisions in realistic circumstances, including whole-body movements and poor eye-sight, (2) identify which basic mental processes underlie children's immature visuomotor choices, and (3) investigate how these might be improved through training. By characterising changes in visuomotor decision-making in detail at the behavioural and neural level, these objectives will significantly advance our understanding of the developing visuomotor system in action and the mechanisms of visuomotor decision-making. Moreover, this project has great translational potential for improving childhood safety and well being in everyday life, by informing educational programs and generating new ideas for interventions to improve safety.

Planned Impact

This project aims to determine how decisions about how and when to move the body (i.e., to reach goals and avoid accidents) become optimised during childhood. There are several non-scientific beneficiaries of this work:

1) Traffic Safety Policy Officers: This work is of great interest to policy-makers concerned with child safety and risk-prevention. In the "Road Safety Policy" published by the UK's Department of Transport as well as in the Dutch government's "strategic traffic safety plan 2008-2020", children are identified as a focus point because this age category shows disproportionally high accident-rates in both countries. Developing age-appropriate training programs and improving understanding of the causes of accidents, are identified as specific action points. The objectives of this project are therefore directly relevant to societal needs prioritised by governmental policymakers both in- and outside the UK.

2) Traffic Safety Organisations: The gained knowledge will also be of great interest to traffic safety organisations and initiatives such as "THINK" and "Road Safety GB". "THINK" is the main developer of traffic education materials for primary school children in the UK, and Road Safety GB takes charge of regional traffic education and is involved in the assessment and improvement of child safety in public areas. In pursuit of these goals, both organisations are continuously looking for new didactic insights and tools that assess safety effectively (; The current project is highly relevant to these activities, as it focuses on almost unexplored aspects of visuomotor behaviour in childhood, and thus may open up new avenues for the development of education and risk-assessment tools.

3) Children, Families and Schools: The proposed research takes steps towards understanding the unnecessary risks children take in their everyday visuomotor behaviour, and how this might be improved through training. Families with children, and the schools these children attend are therefore a third group that stands to benefit from this work.

4) Athletes and Circus Performers: For all athletes, it is important to maximise the chance of successful action outcomes (e.g., scoring a goal) by choosing optimal movements. This is particularly true for circus artists, who often engage in extremely dangerous visuomotor activities. For these individuals, reducing the chance of failure can be vital, and forms a major part of their training. The work described in this proposal is therefore of interest to this group, in offering a new scientific perspective on their day-to-day activities.

5) Patients Groups at Potential Risk of Poor Visuomotor Decision-Making: The experiments described in this proposal can in the future be used to investigate which clinical groups are at risk of making inefficient movement choices. Identifying such groups can help identify individuals who may benefit most from training to improve this ability. While clinical testing is not the aim of this project, the experiments already set the stage for follow-up research with two clinical target groups (i.e., individuals with ADHD and with recent clinical vision loss). My strong connections with Moorfields Eye Hospital will help me recruit vision patients. My collaborations with UCL colleagues investigating developmental disorders (i.e., Prof. Annette Karmiloff-Smith, Prof. Janette Atkinson, Dr. Liz Pellicano and Prof. Essi Viding, mentor on this project) will help me reach individuals with ADHD.


10 25 50
Title Delicate 
Description Extraordinary Bodies is an inclusive circus company for disabled and non-disabled artists, and I have provided a neuroscience perspective on their integrative art/science project "Delicate", which explores the effects of changing visuomotor abilities on confidence, identity, and society. This project is in part funded by a the Arts Council, the Wellcome Collection, and a charity set up around the time of the Paralympics. 
Type Of Art Performance (Music, Dance, Drama, etc) 
Year Produced 2020 
Impact This work is currently under development and the performance is yet to be given. However, attending various research workshops and meetings with these talented artists has been highly inspirational and provided me with a new perspective on which scientific questions around risk, confidence, identity and vulnerability have the greatest real-life impact. 
Description We investigated the economics of movement during childhood. Major innovations were that we compared participants' visuomotor efficiency against quantitative economic decision-making models, used virtual reality (VR) to understand development in realistic scenarios, and uncovered neural decision-mechanisms using functional MRI. Our findings provide new insights in when, how, and why children learn to solve visuomotor problems more efficiently, with important implications for childhood risk-reduction.

>> When and how does child visuomotor decision-making improve?
Children between 6-10 years of age, sampled insufficient visual information to maximise target interception performance, whilst teens and adults collected the optimal amount. This happened when sampling cost points (Jones, Landin, McLean, Juni, Maloney, Nardini & Dekker, 2019), and during online movements that mimic real-life target interception (Dekker, Milne, Large, Jones, Lisi, in prep). Learning when to stop looking and safely start moving may take many years.

We also tested visuomotor decision making in a whole-body tasks in which participants moved between two pipes in VR to "pop" balloons (Dekker & Large, 2017; Dekker, Large, Smeets, Brenner & Lisi, in prep). Adults knew with surprisingly accuracy where to stand to maximise their score given their interception strategy. Children and teenagers however, stayed far from their own optimal position, showing that late development of visuomotor decision-making translates to realistic tasks with many degrees of freedom.

To understand efficient visuomotor decision-making in vision loss, we used a VR visual search (phone-finding) task that applies gaze-contingent (glaucoma-like) visual impairments to normally seeing participants (Chow-Wing-Bom, Jones, Dekker, 2020). Counter to dominant impairment models, participants could not ignore "impairment" of their worse eye, and compensated with head and eye movements. Real-life measures of vision loss compensation, may be essential to understand patient requirements.

>> Why does child visuomotor decision-making improve?
Perceptual development is often explained as learning to perform the same tasks as adults do better. Using a visual averaging task we showed that children in fact used qualitatively different centre-finding strategies altogether (Jones & Dekker, 2017). Adults may use world-knowledge that children are still acquiring to infer better decision-strategies.

Using visuomotor gambling tasks optimised for modelling sub-components of visuomotor decision-making, we found that improved decisions in childhood may reflect increased joint consideration of outcome value and probability information, through more precise computations, or balanced weighting of these factors (Jarvstadt, Dekker, Large, Mareschal, Hahn, in prep). We found similar results for a closely-matched economic gambling task, suggesting common developmental mechanisms across decision-domains.

We found that the 7 to 8-year-old brain recruited frontostriatal areas more to ignore salient grasp responses during visual discrimination than older participants (Dekker, Chow-Wing-Bom, Mareschal, in prep), so improved visuomotor decision-making in childhood may also reflect better suppression of disadvantageous impulses.

>>How is visuomotor decision-making amenable to training?
Unlike adults, children showed little benefit of task-relevant feedback or pre-task training in any paradigm. Why? We speculate that since many factors co-determine expected outcome, finding the optimal strategy requires knowledge of how the body performs that translates readily to new task-contexts. This may require long-term training with incrementally complex tasks.
Exploitation Route This research has broad academic implications including in child development, perception, action, decision making and learning. We have communicated our first results in highly regarded scientific journals such as the Journal of Experimental Psychology General, and as peer-reviewed presentations and keynote talks at major international conferences. The next steps are further publication of the project's findings in international journals with a wide readership, and address new questions raised by the research in via new grant applications. Both aims will greatly benefit from high-profile academic collaborations developed as part of this project. This research topic has great potential for impact on reducing childhood risk in traffic and sensory loss. While our results make important steps towards translating controlled laboratory methods to realistic scenarios, providing recommendations to education, clinic, or policy requires further research with applied impact. To actively inspire such research, we have engaged with vision patient groups, artists, museums, and reported findings to the "Traffic Safety Netherlands" organisation, and the Dutch Institute for Road Safety Research. We will also seek to communicate with British traffic safety organisations such as the Royal Society for the Prevention of Accidents, the Child Safety Education Coalition and the Department for Transport.
Sectors Education,Leisure Activities, including Sports, Recreation and Tourism,Government, Democracy and Justice

Description Summer 2017, I attended a traffic conference where I presented data and discussed the practical use of my research on traffic safety research in children. Since, I have discussed future research directions with employees of the SWOV, a Dutch government-linked research institution that does policy-informing research, and consulted on how too incorporating my "ideal observer" modelling approach to visuomotor performance in childhood in their work. I have had a meeting with traffic specialists of the SWOV about a project on use of audiovisual information in cycling and the effects on child safety, building directly onto work in my ESRC grant. The proposed research has been incorporated in grant applications.
Sector Government, Democracy and Justice
Impact Types Policy & public services

Description Moorfields Eye Charity Career Development Award
Amount £88,113 (GBP)
Funding ID R190029A 
Organisation Moorfields Eye Charity 
Sector Charity/Non Profit
Country United Kingdom
Start 05/2019 
End 09/2020
Description Moorfields Eye Charity Springboard Award
Amount £48,900 (GBP)
Funding ID R190044A 
Organisation Moorfields Eye Charity 
Sector Charity/Non Profit
Country United Kingdom
Start 05/2019 
End 05/2021
Title Bayesian Adaptive Methods (Quest+) for Measuring Vision in Children 
Description Maximum Likelihood (ML) estimators such as QUEST+ allow complex psychophysical measurements to be made more quickly and precisely than traditional staircase techniques. They could therefore be useful for quantifying sensory function in populations with limited attention spans, such as children. To test this, the present study empirically evaluated the performance of an ML estimator (QUEST+) versus a traditional Up-Down Weighted Staircase in children and adults. Seventy-one children (4.7-14.7 years) and 43 adults (18.1-29.6 years) completed a typical psychophysical procedure: Contrast Sensitivity Function (CSF) determination. Some participants were tested twice with the same method (QUEST+ or Staircase), allowing test-retest repeatability to be quantified. Others were tested once each with either method (QUEST+ and Staircase), allowing accuracy to be quantified. The results showed that QUEST+ was more efficient: In both children and adults, approximately half the number of ML trials were required to attain comparable levels of accuracy and reliability as a traditional Staircase paradigm, and plausible CSF estimates could be made in even the youngest children. The ML procedure was also as robust as the Staircase to lapses in concentration, and its performance did not depend on prespecifying correct model priors. The results show that ML estimators could greatly improve our ability to study sensory processes and detect impairments in children, although important practical considerations for-and-against their use are discussed. 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2019 
Provided To Others? Yes  
Impact This method is laying the groundwork for various tablet-based child- and patient friendly vision tests currently under development in developing countries and selected UK Paediatric Hospitals 
Description Visuomotor versus Motor Risk Taking in Childhood 
Organisation City, University of London
Country United Kingdom 
Sector Academic/University 
PI Contribution We co-designed experiments and collected data
Collaborator Contribution The partner co-designed experiments, collected data, and shares knowledge on modelling of decision-making data
Impact None yet. A manuscript is in process for publication
Start Year 2018
Description development of cumulative allocation choices 
Organisation New York University
Country United States 
Sector Academic/University 
PI Contribution We have currently co-written a grant application and submitted it to the NSF, and contributed to a conference abstract. We have also replicated the original findings in London, and are currently collecting data in children.
Collaborator Contribution Prof. Maloney has designed the task, collected pilot data from adults, took lead on writing a grant application, and submission to the NSF.
Impact We have an abstract accepted for a poster presentation at an international conference on decision-making.
Start Year 2019
Description risk-taking during whole body movements in virtual reality 
Organisation Free University of Amsterdam
Department Faculty of Human Movement Sciences
Country Netherlands 
Sector Academic/University 
PI Contribution We have taken the lead on designing the study, developing the methods, running the experiment and collecting data. We are collaborating with a team in the Netherlands at the Vrije Universiteit Amsterdam.
Collaborator Contribution The experts in the Netherlands are advising us on data analysis and design choices, as they have experience with whole-body movement tasks and their challenges.
Impact Paper accepted for a talk at Vision Sciences Society, Florida, 2018.
Start Year 2017
Description Applied Science Workshop on Traffic Safety 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact This was a meeting for international traffic safety research experts from science, industry and government organisations. I presented the research on childhood visuomotor decision-making described in this grant in a 20-minute talk. This was followed by an interactive discussions of childhood risk and safety in traffic, the importance of using precise quantitative measures to determine what constitutes risky behaviour, and how applied research may incorporate these.
Year(s) Of Engagement Activity 2017
Description STEM workshop for teenage girls 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact I provided a STEM tutorial on science and neuroimaging for teenage girls from impoverished backgrounds with promise to pursue careers in science. I am now mentoring one of the girls in her further career development and she has requested a work experience placement in my lab
Year(s) Of Engagement Activity 2019
Description Show and Tell at Henry Wellcome Collection 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Research was presented in an interactive way using a virtual reality set-up at a Henry Wellcome Collection Late event. There was great interest from the general public, and many expressed to have learnt a new piece of information about development of visuomotor behaviour in children.
Year(s) Of Engagement Activity 2018
Description Workshops at London Primary Schools 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact We provide workshops at local London schools, in which children could take part in real experiments on visuomotor development and decision-making. We give age-appropriate talks in classes and during school assemblies and in classrooms on the scientific process, visuomotor development, and the brain. We provide content for school news letters to convey to parents the aims and importance of our research.
Year(s) Of Engagement Activity 2017,2018,2019,2020
Description workshop with Circus Company Extraordinary Bodies 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact I have recently set up a first step towards collaboration with Extraordinary Bodies, a circus company existing of performers with and without special needs. I am acting as scientific consultant for a new show on accounting for risk and uncertainty in the face of a changing body, whether with ageing or due to a disease or accident.
Year(s) Of Engagement Activity 2018
Description workshops with parents and children with vision impairment part of the Eye-Young Patient Advisory Group of Moorfields Eye Hospital 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Patients, carers and/or patient groups
Results and Impact In preparation of follow-up funding, my lab has attended and presented our work a meeting with children with visual impairments, and have done activities with them to investigate how their vision loss affects their performance in everyday tasks. These workshop are part of eye-ypag initiative at Moorfields Eye Hospital, via which children with visual impairments are asked to contribute to research development and process.
Year(s) Of Engagement Activity 2019,2020