Distracted Driving: Teens with ADHD

For teens, passing a road test and receiving a driver’s license are exciting milestones. As drivers, teenagers gain the freedom and autonomy that they crave, and their parents are happily released from their carpooling duties! While there are many positives that come with driving, there are also significant risks that can’t be ignored. It is widely known that newly licensed adolescent drivers are at high risk for motor vehicle accidents. In fact, the risk of being in an accident is almost 3 times higher for teenagers than it is for adults over the age of 20.1 This risk explains why insurance rates are much higher for adolescent drivers, and why many states have graduated driver licensing programs in place (e.g., driving is only allowed until 9pm, no passengers are allowed in the car, etc.). Texting and using a cell phone while driving only compound these risks, and cell phone use accounts for 10% of all fatal car accidents.2 Despite laws in many states banning text messaging while driving, over 44% of teens say that they still text and drive.3 While the risks are already high for teen drivers, they are even greater when ADHD is added into the mix.

The cognitive skills involved in driving a car are the very skills that are impaired in kids, teens, and adults with ADHD. ADHD is associated with deficits in the executive functioning skills responsible for staying focused, planning ahead, managing emotions and impulses, and reacting quickly to changes in the surrounding environment – all of which come into play while driving. With this in mind, it’s not surprising that the rates of car accidents, speeding tickets, and other traffic citations are even higher among teens with ADHD than teens without ADHD.4 Recent studies using driving simulators have found that teens with ADHD had difficulty staying in their lane and driving at a consistent speed. In simulator tasks that included texting, both the teens with ADHD and the teens without ADHD drove more poorly – but the texting-related impairment in teens with ADHD was significantly worse than in the teens without ADHD.4

Knowing that driving risks are higher for teens with ADHD, parents are encouraged to take extra steps to help their adolescents develop safe driving skills.

  1. Effective treatment with ADHD medication improves teen driving. ADHD medication has been shown to improve teen driving skills during driving simulator tasks. If your teen takes medication for ADHD, require them to take their medication consistently once they start driving.
  1. Teach your teen about the risks of driving with ADHD. Feeling invincible is a hallmark of the teenage years, and many teens with ADHD underestimate the negative effects that their ADHD symptoms have on every day activities – including driving. Make sure your teen is aware of the increased risks that come with having ADHD, and the reasons why their driving will become even more impaired if they text or face other distractions while driving.
  1. Lack of sleep will impair driving abilities. The effects of sleep deprivation on driving performance are profound, and under extreme conditions can be as impairing as alcohol. Poor sleep also negatively impacts ADHD – worsening the symptoms of inattention and impulsivity, and slowing down reaction times. Mix poor sleep, ADHD, and driving in teenagers and the result is a very risky combination. Encourage your teen to get at least 8 hours of sleep each night, and when they can’t, consider not allowing them to drive that day.
  1. Develop your own house rules around driving. Many states limit the time of day when teens can drive and the number of passengers allowed in the car. While these limits are protective, teens with ADHD may need even more stringent rules. If you think that your teen’s ADHD symptoms are interfering with their driving ability or they are not demonstrating the level of maturity needed for safe driving, then create your own driving rules. Consider requiring more practice driving hours than what is mandated by state law, not allowing friends in the car even after the state-based limits have been lifted, limiting driving to short distances and only on weekdays during daylight hours, and having your teen use an app that reduces cell phone distractions while driving.
  1. Create a driving contract. Work with your teen to draw up a driving contract that outlines driving rules that you can both agree to. Whenever possible involve your teen writing the actual contract. Your teen will be more invested and respectful of the contract if their input was valued when it was created.

ADHD symptoms pose a serious risk for teen drivers, but there are steps that parents can take. Encouraging your teen to take their ADHD medication daily, get good sleep, and work collaboratively to develop driving rules and a driving contract, can help keep them safe on the road.

1 Insurance Institute for Highway Safety (IIHS). Fatality facts: teenagers 2015. Arlington (VA): The Institute; http://www.iihs.org/iihs/topics/t/teenagers/fatalityfacts/teenagers
2 National Highway Traffic Safety Administration (2017). Traffic Safety Facts: Summary of Statistical Findings. Washington D.C.: NHTSA’s National Center for Statistics and Analysis; https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/812_381_distracteddriving2015.pdf
3 Olsen, Shults, Eaton (2013). Texting while driving and other risky motor vehicle behaviors among US high school students. Pediatrics, 131, e1708-e1715,
4 Narad et al. (2013). Impact of distraction on driving performance of adolescents with and without ADHD. JAMA Pediatrics; 167, 933-938.

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