How to Manage ADHD and Driving

December 3, 2013

We previously posted about a "perfect storm" of inexperience, adolescence, and ADHD that increases driving crash risk. Today I’d like to discuss what we know about managing ADHD symptoms and driving among teens.

There have been a number of studies showing the benefit of stimulant medications (e.g., methylphenidate). One study that looked at different delivery systems (specifically, long-acting versus short-acting) suggests that longer-acting medications result in more consistently improved performance throughout the day. Each teen may respond differently, so parents should work with their child's pediatrician or psychiatrist to find the optimal medication and dosage. Since the beneficial effects of the meds occur while they are active in the body, parents should speak with their child's doctor to ensure that their teen is "covered" when driving in the late afternoon or evening. This can be a difficult juggling act, though, as stimulant medications may interfere with sleep. Thus, while we often try to avoid prescribing medications that are active in the body around bedtime, we also want to make sure that the medication is working when the teen needs it to work.

Individual training with a driving instructor may also be helpful for both teens and parents during the learning-to-drive process. This is what I typically recommend to my families who have concerns about their teen's driving. driver-ed.org has a directory of driving specialists, which you can search by location. To date, however, this type of intensive training is not always covered by insurance. 

Finally, there is some research being done to develop cognitive behavioral training programs to target the driving behaviors of teens with ADHD specifically. Dr. Gregory Fabiano’s STEER program from the University of Buffalo is an example of an intensive behavioral program that works with parents and teens together -- using monitoring, feedback, parent-teen agreements, and practice. Pilot data has demonstrated the feasibility of such an intensive program.

It’s so exciting to hear about these programs. I know that parents are really interested in finding the best help for their teens when it comes to the important task of driving. Click here for more information about driving among teens with developmental disabilities.