ATTENTION DEFICIT HYPERACTIVITY DISORDER:
SAFETY ISSUES

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The 2/3 Rule

A number of years ago, psychologist Russell Barkley described a 2/3 rule. If you calculate 2/3 of your child's chronological age, that is their maturational level and social level. So if a child is 15, the 2/3 rule suggests that they will have the maturity of a 10 year-old.

THE ADHD STUDENT AND DRIVING

Early studies by Barkley (1993, 1996) found that while knowledge of driving was not affected by ADHD, teens and young adults with ADHD were more likely to have had automobile accidents, to have had more crashes than their non-ADHD peers, to be at fault for more crashes than control subjects, and to have had more physical injuries associated with the accidents. They are also more likely to have received traffic citations and more of them than control subjects (particularly for speeding). In a simulated driving task, young adults with ADHD had more crashes, scrapes, and erratic steering than their non-ADHD peers. As with younger children with ADHD, young adults who had comorbid conduct issues were at highest risk for problems. Subsequent research by Barkley as well as other investigators has supported the relationship between ADHD and driving problems.. task. 

Of especial note, Barkley and his colleagues (2002) compared 105 young adults with ADHD (age 17-28) to 64 community control adults on five domains of driving ability and a battery of executive function tasks. As expected, the ADHD subjects reported more driving problems (e.g., speeding tickets), license suspensions, and crashes. On cognitive measures, the ADHD group was less attentive than the controls, but there was no significant relationship between scores and driving skills in a simulated driving task or either measure and actual driving records. Other research, however, led Barkley (2004) to conclude that ADHD interferes with safe driving by its impact on attention and deficits in resisting distraction, deficits in response inhibition, slower and more variable reaction time, and deficits in self-monitoring or self-awareness that lead teens and adults with ADHD to overestimate their skills.

WOULD MEDICATION HELP?

Would taking a stimulant medication reduce any of the safety risks while driving? Studies and reviews published in the last few years [cf, Jerome et al. (2006); Barkley and Cox (2007)] all conclude that there is evidence that the use of stimulant medications may improve driving safety.

NOW WHAT?

Safety first. Many high schools or secondary schools offer drivers' education training programs to students. I have never seen a school district factor in ADHD to the training protocols or even inform their driving instructor that a particular student has ADHD and may require additional training and experience as part of the program. In general, driver's education programs seem to be a "one size fits all" approach. The teenager who has completed the course -- and the worried parents -- may have a false sense of security because the course was taken and completed. To complicate matters, many high school students' medications wear off in the afternoon, but the student may want to drive at night or on weekends when they may not be taking medication.

Educators who are aware of the safety risks might wish to share some of this information with parents and encourage them to arrange for additional supervised training or restriction to daytime driving until the teen gets more experience under their (seat)belt.