ADHD and Teen Drivers: Behind the Wheel with ADHD, Part 1

ann shanahan

Of all possible risks, including illness, substance abuse, and even violence, none is more likely to cause serious injury or death than a motor vehicle accident…especially when young people are driving. In fact, motor vehicle crashes are the current leading cause of death for American teens, according to the Centers for Disease Control and Prevention.

The news gets worse when we look at teens who struggle with ADHD and other executive-functioning issues. And yet, nothing in the school-based or commercial “drivers ed” programs cover the special risks associated with the symptoms of ADHD.

In this article, we will spell out some problems for families with ADHD teens in more detail, and offer a couple of solutions for how you as a parent can address these problems.

Sobering Statistics

In 2013, per mile driven in the U.S., average teen drivers aged 16 to 19 were three times more likely than those aged 20 and older to be in a fatal crash.

Teenage drivers with ADHD, compared to other teens, were:

  • Seven times as likely to have been in two or more accidents
  • Two times as likely to have had a speeding ticket.
  • Five times as likely to have had a traffic citation.
  • Four times as likely to have been in an accident.
  • Four times as likely to have been at fault for the accident they were in.
  • Six to eight times more likely to have had their license suspended or revoked for poor-driving behavior.
  • More likely to have driven an automobile without adult supervision prior to becoming a licensed driver.

 

Common Mistakes of ADHD Teens

Two of the most common traffic violations for teens with ADHD are:

  • speeding
  • failure to yield

ADHD teens are often inattentive, impulsive, or distracted. As a result, they are more likely to exceed the speed limit, try risky maneuvers, or miss a stop sign. Many teens with ADHD lose track of time and are often late. They think they can make up time by driving faster, which can cause them to lose control of the vehicle. Coupled with their inexperience at driving in various (adverse) situations, these teens place themselves at serious risk of an accident, especially during the first year of driving.

WHY is it worse for ADHD Teens?

Executive functions are the brain functions that activate, organize, integrate, and manage other tasks. They enable individuals to account for the short- and long-term consequences of their actions, and plan for those results. An impairment of one or more areas of executive functioning, which is common in ADHD, adversely affects driving competency. Let’s look at what is really happening.

Driving competently requires the brain to focus simultaneously on many different situations:

  • what is happening inside the car
  • what is occurring just outside the car (on all sides)
  • where the car is going

These different tasks require executive functioning skills that may be directly impaired for a person who has ADHD. Here are 3 very common ADHD symptoms that magnify the risk of driving:

  • IMPULSIVITY à   speeding, risky maneuvers
  • DISTRACTIBILITY   à reading billboards; listening to conversations among passengers    
  • INATTENTION à delayed use of strategies to avoid dangerous outcomes; missing a turn or lane change opportunity; getting lost

Maturational Lag Common in Teens with ADHD

In addition to impulsivity, distractibility and inattention, the maturational lag common in teens with ADHD creates another risk factor for safe driving. Maturity of judgment is a critical factor that calls for the driver to be able to apply relevant driving rules and strategies at the right time, in the right place, and with appropriate response to the conditions presented.

In youth with ADHD, the brain matures in a normal pattern but is delayed by several years in some regions of the brain, compared to youth without the disorder. (National Institute of Mental Health NIMH, 2007). The delay in the ADHD brain is most prominent in regions at the front of the brain’s outer mantle (cortex), which is important for the ability to control thinking, attention, and planning.  

How Hard is it for an ADHD Teen to Get a Driver’s License?

The procedure for obtaining a driver’s license today remains minimal, depending on location. Some states do not even require a learner’s permit. Some allow a permit before age 16. Although some states have installed graduated licensing, the restrictions apply to only the youngest drivers. Granting a license is a state’s right, so there are variations in requirements from state to state. Three stages of progression from non-driver to fully licensed driver are common to all:

  • A learner’s stage
  • An intermediate stage
  • Unrestricted license

 

What can Parents Do to Help?

  1. Teach your child to drive a manual transmission. Researchers at University of Virginia conducted tests on teens ages 16-19 who suffer from ADHD. The researchers trained all of the teenagers to drive using both automatic transmission and manual transmission (stick shift). The results showed that teens drove twice as well in a car with manual transmission than with automatic transmission. Anything that brings the driver’s attention back to driving is a good thing.
  2. Make sure medications (when relevant) are taken. To date, stimulant medication is the only therapeutic intervention for ADHD that has demonstrated the clear ability to improve driving performance. If you make sure your child takes medication for ADHD to help with schoolwork, use the same vigilance with regard to driving. This is especially important on the weekends, when most teenage driving occurs.

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