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Information
Section: Conditions
Condition:
ADHD
Article: ADHD: Safety
Source: Leslie E. Packer,
PhD
This File Last
Updated: January 26, 2009
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Article
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2
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THE 2/3 RULE
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A number of years ago, psychologist Russell Barkley described a 2/3 rule. If you calculate 2/3 of your child's chronological age, that is their maturational level and social level. So if a child is 15, the 2/3 rule suggests that they will have the maturity of a 10 year-old.
So if your teenager is 17 and wants the car keys, ask yourself this: would you give a 12 year old the car keys?
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Being a
pedestrian was the single biggest source
of accidents in children with ADHD. Bicycle accidents were also frequent. And now they want to drive?! .
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DAD, CAN
I HAVE THE CAR KEYS?
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Early studies by Barkley (1993, 1996) found that while
knowledge of driving was not affected by ADHD,
teens and young adults with ADHD were more likely
to have had automobile accidents, to have had more
crashes than their non-ADHD peers, to be at fault
for more crashes than control subjects, and to have
had more physical injuries associated with the
accidents. They are also more likely to have
received traffic citations and more of them than
control subjects (particularly for speeding). In a simulated driving task, young adults with ADHD had more
crashes, scrapes, and erratic steering than their non-ADHD peers. As with younger children with ADHD, young adults who had comorbid conduct issues were at highest risk for problems. Subsequent research by Barkley as well as other investigators has supported the relationship between ADHD and driving problems.. task.
Of especial note, Barkley and his colleagues (2002) compared 105 young adults with
ADHD (age 17-28) to 64 community control adults on five domains of driving ability and a
battery of executive function tasks. As expected, the ADHD subjects reported more driving problems (e.g., speeding tickets), license suspensions, and crashes. On cognitive measures, the ADHD group was less attentive than the controls, but there was no significant relationship between scores and driving skills in a simulated driving task or either measure and actual driving records. Other research, however, led Barkley (2004) to conclude that ADHD interferes with safe driving by its impact on attention and deficits in resisting distraction, deficits in response inhibition, slower and more variable reaction time, and deficits in self-monitoring or self-awareness that lead teens and adults with ADHD to overestimate their skills.
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WOULD
MEDICATION HELP?
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Would taking a
stimulant medication reduce any of the safety risks
while driving? Studies and reviews published in the last few years [cf, Jerome et al. (2006); Barkley and Cox (2007)] all conclude that there is evidence that the use of stimulant medications may improve driving safety.
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NOW
WHAT?
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Safety first. Many
high schools or secondary schools offer drivers'
education training programs to students. I have
never seen a school district factor in ADHD to the
training protocols or even inform their driving
instructor that a particular student has ADHD and
may require additional training and experience as
part of the program. In general, driver's education
programs seem to be a "one size fits all" approach.
The teenager who has completed the course -- and
the worried parents -- may have a false sense of
security because the course was taken and
completed. To complicate matters, many high school students' medications wear off in the afternoon, but the student may want to drive at night or on weekends when they may not be taking medication.
Educators who are aware of the safety
risks might wish to share some of this information
with parents and encourage them to arrange for
additional supervised training or restriction to
daytime driving until the teen gets more experience under their (seat)belt.
Safety
first!
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POSTSCRIPT
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This article was originally
written in 1998. At that time, there were no web sites or pages on ADHD and safety, and this was the only site really trying to increase awareness of this issue. By now, there are many sites and public awareness is growing, although it is not clear to me that it has reached enough parents and educators. The December 2007 issue of Attention, ChADD's publication, describes a 3-stage driving program that parents may wish to consider using with their teens.
As for me, well, my kids are both young adults now. The kid with ADHD and the string of accidents as a child decided to delay learning to drive as he had enough anxiety and awareness to realize what a significant responsibility it is to be behind the wheel. He has now been driving for over 7 years, and other than one minor misjudgement that de-mirrored someone's car and getting caught in the middle of a chair car accident, he has not displayed the pattern described in a lot of the research. Perhaps his anxiety leads to more caution than someone with ADHD without anxiety might display. To date, no one has looked at comorbid conditions and their impact on driving safety for teens and adults with ADHD. Nor has anyone yet looked at different subtypes of ADHD to see if the primarily inattentive subtype has the same issues in driving or different issues.
I would like to leave parents with one other suggestion. When my younger child -- who is not diagnosed with ADHD -- had a number of accidents and moving violations as a new driver, I hired a driving expert to evaluate her under a variety of driving conditions to find out if there were any issues that needed to be addressed. The evaluator took her out under different kinds of road and driving conditions -- suburban, urban, day, night, parkway, local, etc. His evaluation and his feedback to her were extremely helpful.
If you have any doubts and can afford to arrange for an evaluation, contact a disability rehabilitation center to inquire as to whether they have driving re-trainers or evaluators who can take your child out for a day (and evening) of driving in a variety of traffic situations. The information you get is very helpful, and you can even include testing while on medication and while off it. The evaluation can help you decide whether to give your child the car keys, and if so, with what restrictions.
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Information
Section: Conditions
Condition:
ADHD
Article: ADHD: Safety
Source: Leslie E. Packer,
PhD
This File Last
Updated: January 26, 2009
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Article
Page 1
2
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Tourette
Syndrome "Plus" © Copyright 1998 - 2009 Leslie
E. Packer, PhD. except as noted.
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This page last updated January 26, 2009.
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