Your Teen and Driving

When your teenaged son or daughter starts driving, it will be the greatest risk to your teen’s health and safety is a motor vehicle. Of all possible risks—including illness, substance use and violence—none has the greater potential to cause serious injury or even death to a young person than a motor vehicle accident. Motor vehicle accidents are the biggest killer of young people aged 16 to 24 in the United States, accounting for more than 7,500 deaths and 350,000 injuries in 2010.

Talking with your teen driver about the risks of driving and making a plan for safe driving that takes ADHD symptoms into account is one of the most important things you can to decrease some of these driving-related risks.

The risks are greater for teens with ADHD

Young drivers with ADHD are more likely to have poor driving than other teenagers, caused by ADHD’s core symptoms of distractibility, inattention and impulsivity. Compared with his peers, your teen with ADHD is at greater risk for vehicle accidents and is more likely to receive traffic tickets for speeding, failure to obey traffic laws, and reckless driving. Teens with ADHD are more likely to drive on a suspended license or without a license when there has been a problem. In a striking comparison, the untreated symptoms of ADHD in a teen driver can impair the driver’s ability so much that resembles intoxicated driving. Most sobering is the fact that young people with ADHD are overrepresented among crash and fatality statistics than their non-ADHD peers.

Difficulties in executive function and other symptoms, including poor judgment, risk-taking and thrill-seeking tendencies, all contribute to these increased risks. Inattention can lead to distraction and impulsivity can lead to poor reactions to other drivers or traffic conditions. Your teen might overestimate how well she drives, even though she may have poorer driving experiences than other teenagers.

Treatment improves safety

Helping your teen develop safe driving habits, including following a comprehensive treatment plan, is essential for his or her safety, as well as the safety of his passengers, other drivers and pedestrians.

Research shows that teens who are treated for ADHD are better drivers than teens receiving no treatment. Teenagers who have never been treated with stimulant medication are involved in more vehicle crashes than those who had medication treatment for at least three years.

Your teen needs to remember that driving is a privilege, not a right. It’s a privilege regulated by states to ensure that everyone who gets behind the wheel knows how to operate the vehicle and has passed a licensing exam. You should discuss your teen’s privileges to drive within the context of overall his ADHD treatment. Co-existing disorders, changes in medication effectiveness throughout the day, and issues with alcohol and substance use should all be considered before your teen gets the keys to the car. You can and should set expectations and rules for your teen to follow for safe driving.

Know your state’s law

States have different licensing requirements, so you should know the specifics of your state law regarding driver education, learner’s permits, provisional licenses, and other limits on teen licenses. Operating a vehicle safely requires a set of skills that teens generally learn from an experienced adult, often a parent or a driving instructor. Don’t rush your teen to get a driving permit or a driver’s license if he has shown or said he’s not ready to drive; some teens with ADHD delay driving. Many driving-aged teens affected by ADHD lack the maturity needed to drive safely and could benefit from waiting to learn to drive or taking the driving exam. How long your teen should wait depends on you and your teen, but your teen should demonstrate sufficient maturity in other areas of life before taking to the road.

New drivers benefit from driving courses that teach traffic laws and reinforce driving skills. For teens affected by ADHD, a driver education program designed for their specific needs is especially helpful. Check with your local school district for driver education courses or look in your community for driving schools that are familiar with the needs and requirements of a young person affected by ADHD. Many states have graduated or tiered licensing programs for all teen drivers and you, the parent, will be expected to enforce the law’s requirements.

Starting to drive

The ADHD Safe Driving Program developed by researchers Russell Barkley, PhD, and Daniel Cox, PhD, offers a step-by-step approach for teens to earn driving privileges and for you, the parent, to keep a careful eye on your teen’s developing driving skills. The following is adapted from the ADHD Safe Driving Program:

Three levels of independence:

• Level one (0 to 6 months): Drive only during daytime.
• Level two (6 to 12 months): Extend driving time through the evening hours.
• Level three (12 to 18 months): Drive freely while following agreed upon rules.

How to get the keys:

Have your teen driver keep a log of each driving experience. Entries include medication (if prescribed), destination, route/miles, contact name and phone number, time/out and time/returned, and odometer. They must also follow the Everyday Rules:

1. Take medication as prescribed
2. Fill out the log every trip
3. While driving…
   1. Keep music low
   2. Use preset radio stations only
   3. No eating
   4. No texting or mobile phone use
   5. No other teens in the car
   6. Absolutely NO alcohol or other intoxicants

Steps to get started:

1. You and your teen enter into a contract that spells out each of your sets of responsibilities. Your teen accepts ADHD as a neurobehavioral disorder that affects his driving.
2. Your teen agrees to abide by the driving rules and understands that she can move to the next level only when she succeeds for six months in a row at her current level.

You agree to allow your teen to continue to drive if rules are followed. You both agree that you as the parent have the responsibility to check the accuracy of your teen’s driving log, to find out whether rules were followed, and if not, to give appropriate consequences and that can mean your teen loses driving privileges if agreements are broken.

Distracted driving

Becoming easily distracted is a big risk for your teen driver affected by ADHD. Most states and local communities have distracted driver laws, along with laws forbidding texting and talking on a hand-held mobile phone while driving. In 2010, over 3,000 people died in what the National Highway Traffic Safety Administration describes as “distraction-affected” crashes, a measurement of crashes caused by texting, phoning or answering a call while driving.

Safe driving requires focus and concentration, the exact things that are challenges for people with ADHD. Your teen can find distraction in simple things—changing radio stations, checking make-up, eating, talking with another person in the car and even daydreaming. When your teen is coping with the symptoms of ADHD, these behaviors increase the risks of poor driving and can lead to car accidents.

Your teen should limit the distractions before starting the engine. Cell phones and other devices should be turned off and put away. Food or drink should also be put away so that he or she can completely focus on operating the vehicle safely. You and your teen should map driving routes and agree on them ahead of time. Make your expectations clear for your teen’s driving behaviors and set reasonable limits.

Safe driving

Safe driving begins before your teen gets behind the wheel. You and your teen driver should do the following to help promote safe driving:

• know state traffic laws
• attend and pass a driver education program that addresses ADHD concerns
• follow an ADHD treatment plan and consider the role medication has been shown to play in improved driving ability
• limit passengers while your teen is learning to drive or has just received his license
• reduce distractions within the car
• select a vehicle that has few exciting options on the dashboard. You may want to consider research showing manual transmission to be a better choice for teens with ADHD because of the need for increased attention in driving habits.

Both teens and adults affected by ADHD need to be aware of inattention, impulsivity and distractibility and create a driving environment that allows them to better focus on the task of driving safely. As a parent, you can start modeling good driving habits for your children when they are young even before they reach the teenage years.

Insurance

Before your teen receives his or her learner’s permit, you should know the insurance laws for your state and find out if your teen driver will need additional insurance coverage. You and your teen should meet with an insurance agent or representative from a reputable insurance company to discuss all aspects of liability and collision insurance. Including your teen in this conversation helps reinforce that driving a car is serious business. The needs of your family as well as your teen driver should be considered. Additional umbrella liability policies can offer protection from personal injury lawsuits. You and your teen should discuss insurance issues and costs at length and decide on a family plan for insurance costs.

References

Fatality Analysis Reporting System (FARS). National Center for Statistics and Analysis, National Highway Traffic Safety Administration (NHTSA), U.S. Department of Transportation, Washington, DC. 2010.

Cox DJ, Merkel RL, Moore M, et al. (2006 September). Relative benefits of stimulant therapy with OROS methylphenidate versus mixed amphetamine salts extended release in improving the driving performance of adolescent drivers with Attention-Deficit/Hyperactivity Disorder attention-deficit/ hyperactivity disorder. Pediatrics. 118(3), pp. e704–10.

Katz, Mark, PhD. ADHD Safe Driving Program: A Graduated License Plan (2007 December). Attention. pp 6–7.

Tison, J., Chaudhary, N., and Cosgrove, L. (2011 December). National phone survey on distracted driving attitudes and behaviors. (Report No. DOT HS 811 555). Washington, DC: National Highway Traffic Safety Administration.

Cox, Daniel; Mohan, Punja; Powers, Katie;et al. (2006 November). Manual transmission enhances attention and driving performance of ADHD adolescent males: pilot study. Journal of Attention Disorders, 10(2), pp. 212–6.

^{Updated: October 2015}