Motor vehicle accidents are the number one cause of death of young people from ages 16 to 24 in the United States. Teenagers with Attention Deficit/Hyperactivity Disorder (ADHD) are more likely than their neurotypical peers to have a car accident, get a speeding ticket, drive drunk, drive without a seatbelt, and drive without a valid license. ADHD’s core symptoms of distractibility, inattention, and impulsivity all contribute to poor driving. Difficulties in executive functioning, poor judgment, and risk-taking tendencies add to the increased risk. One comparison study suggested that the untreated symptoms of ADHD in a teen driver can impair the driver’s ability so much that it resembles driving while intoxicated. Your teen with ADHD is also likely to overestimate how well she drives, even though she may exhibit objectively poorer driving skills than other teens. If your teen is diagnosed with ADHD, talking with her about the risks of driving and making a plan that takes her symptoms into account is one of the best things you can do to decrease some of the risk.
A recently published study found that teen drivers with ADHD were more likely to experience a crash or a moving violation from the first month of driving all the way through four years of driving experience. The pattern held for all subtypes of crashes, moving violations, and license suspensions, including those involving alcohol or resulting in a moderate or severe injury. The only exception was for nighttime crashes, for which there was no difference found.
Treatment can significantly help to reduce this risk. Previous research has suggested that teens who are treated for ADHD are better drivers than teens who receive no treatment. Teens who have never been treated with stimulant medication are involved in more crashes than those who have taken medication for at least three years.
Parents are encouraged to remind their teens that driving is a privilege rather than a right, a privilege regulated by states to ensure that each person who gets behind the wheel knows how to operate the vehicle properly and safely. A teen’s driving privileges should be discussed within the context of his ADHD symptoms and treatment. Co-existing disorders, medication effectiveness over the course of the day, and any issues with alcohol or other substances should all be considered in decision making. Parents should set expectations for safe driving. A teen should not be rushed to get a permit or license if he has shown or said he’s not ready to drive. It is a good idea to check with your local school district for driver’s education courses or driving schools that are familiar with the needs of a young person with ADHD.
The ADHD Safe Driving Program, developed by researchers Russell Barkley, PhD, and Daniel Cox, PhD, offers a step-by-step approach for teens with ADHD to earn driving privileges. The program outlines three level of independence:
- Level One (0 to 6 months): Drive only during the daytime
- Level Two (6 to 12 months): Driving extended into evening hours
- Level Three (12 to 18 months): Drive freely while following agreed upon rules
The program recommends that the teen keep a log of each driving experience, with entries including medication status, destination, route/miles, time out and time returned, and odometer. While driving, he must:
- Keep the music low
- Use radio presets only
- No eating
- No texting or phone use
- No others in the car
- No alcohol or other substances
Researchers recommend that parents use an app or device that actively monitors driving behaviors, such as speed, to stay on top of risky behavior. Parents can use such technology to reward teens for safe driving. It is also recommended that teens drive the safest cars available, ideally with plain dashboard displays and controls. Finally, research suggests that cars with a manual transmission are a better choice for teens with ADHD because of the need for increased attention to driving technique.
Paige Fegan, Psy.D.
Licensed Clinical Psychologist
Research for this blog post was obtained from:
-Curry, A.E., Yerys, B.E., Metzger, K.B. , Carey, M.E., Power, T.J. (2019) Traffic Crashes, Violations, and Suspensions Among Young Drivers with ADHD. Pediatrics, 143 (6).