A new large-scale study finds that teen drivers with attention-deficit hyperactivity disorder (ADHD) are significantly more likely to get into car accidents, be issued traffic and moving violations, and engage in risky driving behaviors, compared to their non-ADHD peers.
An estimated 6.1 million children ages 2 to 17 living in the U.S. have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention (CDC). Many of these young people with ADHD are potential drivers, and safe transportation is a growing concern.
Evidence-based guidance to clinicians and families is urgently needed to protect these drivers, as well as others on the road.
“What this study suggests is that we have to go beyond current recommendations of medication and delaying the age of getting licensed to decrease crash risk for teens with ADHD,” said Allison E. Curry, PhD, MPH, lead author of the study and a Senior Scientist and Director of Epidemiology and Biostatistics at the Center for Injury Research and Prevention at the Children’s Hospital of Philadelphia’s (CHOP).
“Their higher rate of citations suggest that risky driving behaviors may account for why they crash more. More research is needed to objectively measure if and how these behaviors specifically contribute to crash risk.”
For the study, a multidisciplinary team of researchers from CHOP’s Center for Injury Research and Prevention and the Center for Management of ADHD analyzed detailed crash and traffic violation records for newly licensed drivers. This included 14,936 adolescents who were patients at six CHOP primary care practices in New Jersey and had obtained an intermediate driver’s license between January 2004 and December 2014.
The researchers linked the teens’ electronic health data with New Jersey driver licensing records, traffic violations, and police-reported crash data. Within this group, they identified 1,769 adolescents with childhood-diagnosed ADHD who had received an intermediate driver’s license during the study period, and compared their crash outcomes with those of the drivers without ADHD.
Although crash risk is higher for all newly licensed drivers, the team found it is 62 percent higher for those with ADHD the first month after getting licensed, and 37 percent higher during the first four years after licensure, regardless of their age when licensed.
Drivers with ADHD also experienced higher rates of specific crash types, including driving with passengers, at-fault-, single vehicle-, injury- and alcohol-related crashes, the last risk being 109 percent higher than those without ADHD.
The rates of traffic and moving violations were also significantly higher among young drivers with ADHD: Nearly 37 percent were issued a traffic violation and almost 27 percent a moving violation within their first year of driving, compared to 25 percent and 18 percent respectively among their peers without ADHD.
Drivers with ADHD also had higher rates of alcohol or drug violations and moving violations (including speeding, nonuse of seat belts, and electronic equipment use). Their rate was 3.5 times that of young drivers without ADHD in the first year of driving and 1.5 times that of young drivers without ADHD in the first four years of driving.
Because these behaviors can be changed, the findings suggest that clinicians and families can work with this at-risk group of teens to practice safe driving behaviors and potentially reduce their crash risk.
“We need additional research to understand the specific mechanisms by which ADHD symptoms influence crash risk so that we can develop skills training and behavioral interventions to reduce the risk for newly licensed drivers with ADHD,” said Thomas J. Power, Ph.D., ABPP, study co-author and director of the Center for Management of ADHD at CHOP.
“There’s not enough research currently being conducted on older adolescents and young adults with ADHD, particularly studies focused on promoting safe driving behavior.”
The findings are published in the journal Pediatrics.