Learning to drive poses extra risks for teens with attention problems

Teenagers with attention-deficit/hyperactivity disorder (ADHD) or parent-reported “trouble staying focused” are poorer drivers and make more driving errors than their peers during the teenagers’ learning permit period.­ These findings are based on an analysis of survey data from a prior randomized study in which 512 parent-teenager pairs were randomized to a web-based parent-teenager driving plan intervention or a usual practice control condition for 24 weeks during the learner’s permit period and were surveyed several times, including at the end of the study period.

Of the 134 adolescents who also underwent on-road driving assessments at 24 weeks and had complete survey data, 113 (84.3%) were typically developing (TD) adolescents, 12 (9.0%) had ADHD, and 9 (6.7%) had trouble staying focused. Sociodemographic variables were similar for all 3 groups. Overall, TD teenagers did better behind the wheel than did adolescents with ADHD or those who had difficulty staying focused.

Specifically, teenagers who had difficulty staying focused were more likely than those with ADHD or TD to have their on-road driving assessment (administered by a certified driver rehabilitation specialist) terminated because the specialist had to intervene to prevent a collision, the driver violated a traffic law, or because of another serious driver action or inaction. In addition, teenagers who had difficulty staying focused received marginally lower overall driving scores compared with TD teenagers, whereas those with ADHD made significantly more total errors than TD teenagers. As for specific tasks, teenagers with ADHD made more errors during high-demand tasks and right-turn tasks compared with TD teenagers, whereas teenagers with trouble staying focused made more errors during “straight at intersection tasks.”

Teenagers with trouble staying focused and those with ADHD also committed the most so-called critical errors, most often dangerous maneuvers, followed by disobeying traffic signs, lane violations, speeding, or striking an object or curb (Bishop HJ, et al. J Dev Behav Pediatr. 2019;40(8):581-588).

Thoughts from Dr Farber

The authors also comment that no specific programs are available to help drivers with ADHD improve. Teenaged drivers, with or without ADHD, remain a concern. Just remember that a license says the state feels a child can drive, but the parents still need to decide if a child should drive. You’ll find that cdc.gov/parentsarethekey is a useful site.