New research shows that teens with ADHD are at an increased risk of traffic accidents, moving violations, and driving while intoxicated.
Parents of teens with attention deficit hyperactivity disorder (ADHD) may need to approach the topic of teen driving with some extra care, according to a new study.
The Children’s Hospital of Philadelphia (CHOP) study, published in Pediatrics, found that new drivers with ADHD are more likely to drive while intoxicated, neglect using seatbelts, and speed.
The research found a 62 percent higher crash risk for teen drivers with ADHD in the first month after getting licensed, and a 37 percent higher risk in the first four years after receiving their license — regardless of their age when getting their license.
“Their higher rate of citations suggest that risky driving behaviors may account for why they crash more,” said Allison E. Curry, PhD, MPH, the lead author.
Curry’s team evaluated information from 1,769 adolescents with ADHD who got their driver’s licenses between 2004 and 2014. They were all patients at six CHOP practices in New Jersey.
Crash risk is elevated for all newly licensed drivers.
Drivers with ADHD experienced higher rates of crashes that involved passengers, being at fault, injuries, and alcohol. Drivers with ADHD had a 109 percent higher risk of driving drunk compared to those without ADHD.
“It is not the [ADHD] diagnosis that causes risky driving — it is the behaviors that make up the diagnosis. So anyone impaired by these behaviors could be at risk,” said Gregory Fabiano, PhD, a professor at the University of Buffalo and ADHD specialist, who wasn’t affiliated with the study.
The rates of traffic and moving violations were higher among drivers with ADHD compared to those without the condition.
Almost 37 percent got a traffic violation and nearly 27 percent got a moving violation within their first year driving — compared to 25 percent and 18 percent without ADHD, respectively.
Drivers with ADHD had higher rates of alcohol or drug and moving violations (including speeding, not using 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 drivers without ADHD in the first four years of driving.
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An American Academy of Pediatrics (AAP) statement acknowledges that adolescents with ADHD are at a higher risk for car-related injuries and death. They cite Curry’s former research that found drivers with ADHD had a
The authors said the risk, though elevated, was lower than previously reported.
The AAP contends that the benefits of giving drivers with ADHD medications are uncertain, but note that adults with ADHD on medication saw a
Medication effectiveness varies throughout the day, and even if treated, adolescents may be functionally unmedicated in the late afternoon or night, which are times of the highest risk of crash, the report stated.
AAP also acknowledges that medication adherence can be challenging, and not all teens with ADHD take medication.
Curry’s 2017 study found that 12 percent of adolescents with ADHD were prescribed medication within 30 days of getting their licenses.
AAP calls on pediatricians to meet with patients prior to getting their licenses to discuss driving challenges and pinpoint children at risk for driving dangerously.
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As it stands, all teens can get their licenses at the age set by the state in which they live — regardless of whether or not they have ADHD.
A common recommendation is to delay licensure for teens with ADHD. But most states don’t let drivers participate in Graduated Driver Licensing (GDL) if they get their license after turning 18.
Without using GDL, which allows drivers to use a learner’s permit with some driving restrictions, drivers won’t have an extended learning period. Many experts believe teens with ADHD should utilize GDL.
Mandating that teens with ADHD wait to get their licenses would violate the American’s with Disabilities Act, Wes Crenshaw, PhD, a psychologist from Kansas, told Healthline.
He delayed teaching his daughter how to drive, but said doing so reduced her opportunity to practice while supervised.
Instead of that path, he recommends letting teens with ADHD drive as soon as they’re legally able, but giving them 5 to 10 times the number of hours their peers are required to have.
“ADD kids do not need less driving,” Crenshaw said. “They need more driving.”
“Too many parents get lazy about this and don’t want to put in the work,” he added. “By the time an ADD kid has ‘driver’s ed’ he or she should have had hundreds of practice hours with a parent. Never ever ever let driver’s ed be the primary teacher of your child.”
Fabiano suggests that teens with ADHD first obtain their learner’s permit and plan on a longer training period.
Parents or children may want to avoid learning to drive because of the mental effort it takes, but learning can be beneficial in the long run. That’s why parents need a clear plan to ensure enough practice.
“Even if a teen has aged out of graduated driver’s licensing laws at 17 or 18, parents might negotiate with the teen… to enact these driving restrictions until the teen has obtained sufficient experience in independent driving,” Fabiano added.
A recent study showed that teens with ADHD were at an increased risk of traffic accidents, moving violations, and driving while intoxicated.
Experts recommend that parents spend extra time supervising teens with ADHD as they learn to drive in order to better educate young drivers about safe driving practices.