Study looks at motor vehicle accident risk in young drivers with ADHD

By Dr. Ananya Mandal, MDJun 12 2017

Earlier studies have pegged the risk of motor vehicle crashes with teenagers suffering from attention-deficit hyperactivity disorder (ADHD) behind the wheel, as much higher than what a recent study has revealed. Now it is known that the risk of a motor vehicle crashes with adolescents with ADHD is 36% higher than all other newly licensed teenagers and young drivers. This is high but earlier the risk was considered to be four times higher than this.

A study published in JAMA Pediatrics today is the first large-scale study to look at this issue in such detail. The study taken up by researchers at the Children's Hospital of Philadelphia (CHOP) linked more than 18,500 electronic health records (EHR) of children born from 1987 through 1997 and the crash data and licensing data from New Jersey. They looked at the three way associations between presence of ADHD in the young drivers, their licensure, and involvement in the crashes. They noted that among these 18,500 records, around 2,500 patients were diagnosed with ADHD. They kept in mind other factors such as gender, age at which license was obtained and other factors. The results showed that the crash risk is similar during initial driving years irrespective of these factors.

Lead researcher of the study, Allison E. Curry, PhD, MPH, a senior scientist at the Center for Injury Research and Prevention (CIRP) at CHOP said that although the risk of a teenager with ADHD crashing is higher than other teenagers, it is a “manageable risk”. She added that there should be a more structured “evidence-based training and education” for adolescents with ADHD who wish to drive. However many experts have pointed out that any rise in the risk of crashes be it small is unacceptable.

There have been earlier studies looking at reduction of crash risk among ADHD sufferers on medications. However this study showed that only 12% of the drivers who had ADHD were prescribed medication within 30 days of their acquiring the license. This negates the effect of medication in reducing the risk of crashes. This low number of ADHD sufferers on prescription medications also came as a surprise said study co-author Thomas J. Power, PhD, ABPP, director of the Center for Management of ADHD at CHOP. He added that the medications can reduce crash risk only if the drivers are using it while driving.

As such teenagers are risky drivers with their easy distractibility, impulsive behaviors; inattention and difficulty in regulating emotions say experts. This study points at future need for more studies to understand the effect of ADHD on teen behavior in terms of driving. With this in depth knowledge, a tailor made education programme could be devised for these young drivers feel researchers. Until then, the researchers recommend that teenagers with ADHD who wish to drive need to seek help to reduce the risks of crashes. Caregivers are advised to seek help for their ward to improve impulse control, increase attention and improve communication issues. This would reduce the risk significantly.

ADHD

ADHD includes a wide range of behavioral symptoms that include lack of attention or concentration, hyperactivity, tendency towards impulsive behavior and immature communication skills. There are other problems such as sleep disturbances and learning problems. Diagnosis of this condition is usually made in childhood by primary care physicians. The usual age of diagnosis is between 3 and 7 years.

There are classically three different types of ADHD that include predominantly inattentive, predominantly hyperactive and a combination of these types. Around 3-9% of all school-going children in the UK suffer from ADHD. The numbers are similar in the United States (3-7% of all school going children). ADHD affects 2% of the adult population worldwide and is commoner among males.

Children with ADHD have 3 times higher problems with their peers than their friends. They are more likely to get into trouble, suffer major injuries, emergency department, hospital in or outpatient admissions, go on to develop anxiety and depressive disorders than others. Older children and teenagers are also at higher risk for drunk driving, automobile accidents and violations of traffic rules. At present there are no definitive cures for ADHD but symptoms may be controlled using medications, behavioral, psychological and social therapy.