Driving While ADD

Driving While ADD

Jim Windell

             Young adults with ADHD may be at increased risk for accidents while driving.

            So says a new study recently published in the Journal of the American Academy of Child and Adolescent Psychiatry.

            Analyzing data from 441 children with ADHD and 231 children without ADHD, researchers followed these individuals from age seven to 25 as part of a study that involved six centers in the United States and one in Canada. The researchers, led by author Arunima Roy, a postdoctoral fellow at the University of Ottawa in Ontario, Canada, looked at participants' ADHD symptoms and driving records, as well as other health conditions. The other conditions included oppositional defiant disorder, conduct disorder, antisocial personality disorder, and substance use during childhood and into adulthood.

           Compared with those people who had no history of ADHD, the rate of car crashes was 1.45 times higher for adults who had a history of childhood ADHD, and 1.81 times higher for those with continuing symptoms. However, crash rates were the same among adults who never had ADHD and those whose ADHD symptoms have decreased.

           Young adults with and without a history of ADHD got driving licenses at similar ages and at similar rates, the findings showed.

           "Extant research shows that ADHD is associated with more traffic violations, speeding violations, license suspensions and risky driving behaviors," said Arunima Roy. Roy noted in a journal news release that the likelihood of risky driving increases when childhood ADHD persists into adulthood.

           "Prior research from our group as well as by others also shows that, aside from driving behaviors, a persistence of ADHD into adulthood can impair functioning in other domains," Roy said. "These domains can include occupational performance, educational attainment, emotional functioning, substance use and justice involvement."

           A study, published in Pediatrics in 2019, cautioned parents of teens with ADHD that they would need to approach the topic of driving with extra care and concern.

           The study led by Allison E. Curry, Ph.D., M.P.H., who is with the Center for Injury Research and Prevention at the Children’s Hospital of Philadelphia, found that new drivers with ADHD are more likely to drive while intoxicated, neglect using seatbelts and speed. In fact, the research found a 62 percent higher crash risk for teen drivers with ADHD in the first month after getting licensed, and a 37 percent higher risk in the first four years after receiving their license — regardless of their age when getting their license.

           “Their higher rate of citations suggest that risky driving behaviors may account for why they crash more,” said Curry.

           Curry’s team evaluated information from 1,769 adolescents with ADHD who got their driver’s licenses between 2004 and 2014. They were all patients at six Children’s Hospital of Philadelphia practices in New Jersey.

           Drivers with ADHD experienced higher rates of crashes that involved passengers, being at fault, injuries, and alcohol. Drivers with ADHD had a 109 percent higher risk of driving drunk compared to those without ADHD.

           Earlier studies suggested that drivers with ADHD tend to be more accident-prone because they are used to taking risks, have increased hyperactivity, are impulsive, may be easily distracted and have increased vulnerability to factors that interfere with driving.

           The American Academy of Pediatrics (AAP) contends that the benefits of giving drivers with ADHD medications are uncertain, but note that adults with ADHD on medication saw a 40 percent reduction in emergency visits as a result of crashes compared to months when they had not taken medication. The AAP recommends that pediatricians meet with patients prior to allowing adolescents to get their driver’s license to discuss driving challenges and pinpoint children at risk for driving dangerously.

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The Roy et al. (2020) study is available at: Roy, A., et al. (2020) Effects of Childhood and Adult Persistent Attention-Deficit/Hyperactivity Disorder on Risk of Motor Vehicle Crashes: Results From the Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child and Adolescent Psychiatry. doi.org/10.1016/j.jaac.2019.08.007.

And the Curry et al. (2019) study can be found at: 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) e20182305; DOI: https://doi.org/10.1542/peds.2018-2305

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