Research In Action

Learning to drive is an important milestone for many teens, including those with attention-deficit hyperactivity disorder (ADHD). While previous research suggests that teens with ADHD have higher crash rates than their peers without ADHD, little is known about what contributes to this elevated crash risk or how the types of crashes ADHD drivers are most commonly involved in might differ.

To address this gap, we recently published a study in the Journal of Adolescent Health with colleagues from the Perelman School of Medicine at the University of Pennsylvania and the Center for Injury Research and Prevention at CHOP to compare the real-world crash circumstances for newly licensed drivers with and without ADHD.

Our findings reveal that newly licensed teen drivers with ADHD were more likely to be at fault for their crash than their peers without ADHD. However, we found that the types of crashes that drivers with and without ADHD were involved in were similar. The data we used for this study involved a unique linkage of CHOP electronic health records and police-reported crash reports among teen drivers in New Jersey. Within this group we identified 934 teens with childhood-diagnosed ADHD and compared their crash circumstances with those of similarly aged drivers without ADHD.

Study Highlights

Why did teen drivers with and without ADHD crash?

• Among those involved in a crash over the first 48 months of licensure, drivers with ADHD were 9% more likely to be at fault for their crashes (74% vs. 67% of those without ADHD).
• The most common crash contributing actions among drivers with and without ADHD were inattention, followed by unsafe speed, and failure to yield the right-of-way.
  • Drivers with ADHD were 15% more likely to be inattentive compared to those without ADHD.
  • The proportion of females with ADHD whose crashes were due to unsafe speed was more than 1.5 times higher than those without ADHD.

How did teen drivers with and without ADHD crash?

• Among drivers who were at fault for their crashes, the most common types of crashes for those with and without ADHD were striking a vehicle in a rear-end crash, crashing with a non-motor vehicle, and crashing at a right angle.
  • We found similar distributions of crash types among drivers with and without ADHD.
  • Teens with ADHD, however, were less likely to crash while making a left- or U-turn than those without ADHD.

Future driving research using naturalistic data is needed to identify more nuanced driving performance differences that might not be detected in police-reported data. This information will help to optimize driving training for teens with ADHD.

Clinical Guidance

The results of this study, as well as our previous study on moving violations in teens with ADHD, suggest that when pursuing licensure for teens with ADHD, families should:

• Develop strong house rules for driving, including Graduated Driver Licensing restrictions on nighttime driving and peer passengers.
• Monitor their teens’ driving for about two years after getting licensed, focusing on crash-contributing factors such as attention, speed management, and right-of-way.
• Partner with their child’s health care provider who can discuss medication support and may be able to provide driving-specific resources.
• Seek out the support of a certified driving rehabilitation specialist who has training in working with individuals with neurodevelopmental differences.

Click here to access and share resources with families about learning to drive with ADHD from CHOP experts.