Teens With ADHD Face a Higher Crash Risk
MONDAY, June 12, 2017 -- As if parents don't worry enough when their teens drive the family car, new research shows that adolescents with attention-deficit/hyperactivity disorder (ADHD) are even more likely than their peers to have an accident.
On a positive note, the higher risk was actually much lower than previously reported in earlier, small studies, the investigators added.
"We found that adolescents with ADHD are 35 percent less likely to get licensed six months after they become eligible for a license as compared with other adolescents. [But] after acquiring a driver's license, adolescents with ADHD have an estimated 36 percent higher crash risk than other newly licensed teens," said study author Allison Curry.
She is director of epidemiology and biostatistics at the Center for Injury Research and Prevention at Children's Hospital of Philadelphia (CHOP).
Curry noted that higher risk was seen among both boys and girls with ADHD, and it endured for a few years after the new license was obtained.
What's more, in the month before driving, only roughly 12 percent of the ADHD group had been prescribed any ADHD medication. In theory, such drugs might boost safety behind the wheel, the study team noted. And that could suggest a way to lower risk among new drivers with ADHD.
Curry explained that ADHD patients could often struggle with inattention, distractibility, impulsivity and self-regulation.
To explore to what degree such concerns affect the safety of young new drivers, investigators pored over the electronic health records (indicating ADHD status) of more than 18,500 New Jersey residents born between 1987 and 1997. All had been primary care patients at CHOP.
Those records were then paired with New Jersey driver's license data and crash incident records.
Of the nearly 2,500 teens with ADHD included in the final analysis, almost 43 percent had gotten into a car accident during the study period.
That figure was just 36 percent among the study teens without ADHD, the investigators found.
As to whether the findings reflect teen crash risk across the country, the team said it's unclear given that New Jersey is both more urbanized than average and sets a higher age for obtaining a license than some states.
The study authors also noted that teens with ADHD constituted a higher percentage of the overall study group than they do among the American public at large.
Regardless, Curry said there is a clear need to "develop effective programs to manage that risk so that adolescents with ADHD who want to drive can do so safely," and that parents need to get involved in this effort early.
"A primary care provider or behavioral health specialist can help to guide that conversation with questions regarding readiness to drive," Curry noted. "During this visit, be sure to address any concerns -- such as attention issues or impulsivity -- and whether ADHD medication may be helpful to ensure safe driving behaviors."
In addition, she said, "Families may want to consider seeking the advice of a certified driver rehabilitation specialist who has training in working with individuals with special needs, or an occupational therapist who specializes in driving."
Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Cohen Children's Medical Center of New York, said he wasn't surprised by the findings.
"Parents of teenagers with or without ADHD need to give consideration to their child's level of maturity and responsibility when deciding if they should allow their child to get their driver's license," he said.
"Although getting a driver's license may be considered a legal entitlement from the state's standpoint, parents must use their discretion when making this decision about when their teenager should be allowed to get their license and be permitted to drive," Adesman advised.
Curry and her colleagues reported their findings online June 12 in the journal JAMA Pediatrics.
There's more about ADHD and driving at CHADD.
Posted: June 2017
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