Teenager-plus-car already can equal trouble. Add in attention deficit hyperactivity disorder—an increasingly common diagnosis—and the risk only accelerates.
Drivers with ADHD are two to four times more likely to be in an accident, three times more likely to suffer injuries, four times more likely to be at fault for crashes and up to eight times more likely to have their licenses suspended, according to research either performed or collected by the Virginia Driver Safety Laboratory in Charlottesville, Virginia.
“Focused driving isn’t staring at the white lines disappearing beneath your car,” says Dr. Wes Crenshaw, a Kansas-based psychologist who has written about living successfully with ADHD. “It’s multi-tasking all the little details that it takes to get safely down the road. And that’s exactly what’s hard for people with ADD. They tend to pick out the most interesting thing from the universe of things to notice, instead of the most important.”
About 11 percent of children ages 4 to 17 in the United States have been diagnosed with ADHD, a figure that’s climbing about 5 percent a year, based on statistics from the Centers for Disease Control and Prevention. The neurological condition causes distracted and impulsive behaviors and can delay development of some areas of brain function by two to five years.
Drivers may miss or respond slowly to signs and traffic signals, drift between lanes or vary their speed unpredictably. The risk generally is highest at night—often when short-acting medication has worn off—and on highways, where “zoning out” is easier.
Parents need to build extra time into the learning process, says Kayson Stoner, a Chesapeake, Virginia-based driving instructor. While younger teens are still in the passenger seat, they should practice looking about 30 seconds ahead and commenting on what they see: stoplights, road markers, merge lanes and, especially on highways, closely-packed cars that require backing off to create extra space.
“You want to look into the mind of that future driver,” Stoner says. “They’ve got to be actively searching their environment and deciding what’s important, never falling into a passive state. That’s key for any driver, but especially one with ADHD.”
Once a teen is behind the wheel, Crenshaw recommends twice the number of supervised driving hours compared to kids without ADHD: “So it’s okay to start young if the teen can handle it, but only to log hundreds of hours by the time they are about 17. If possible, delay solo driving until at least 17, or at least limit it to work and school.”
Be ready to repeat lessons often and progress gradually to bigger roads, faster speeds and after-dark trips, adds Matthew Pagels, a certified driver rehabilitation specialist who lives in Hampton, Virginia. “It’s also best to pull over for in-depth conversations or instructions, if possible,” he says. “You don’t want to be talking too much when they’re driving.” (To find a local driver rehabilitation specialist, who can help anyone with a health challenge, go to aded.net.)
A few more tips:
• Work with a doctor on medication. After finding the right dose, know when stimulant medicines are in full effect and drive then. “For guys, the accident rate is really improved with meds,” Crenshaw says.
• Eliminate distractions. Put cell phones in the glove compartment or trunk, or turn them off. Avoid dashboard apps, especially social networking sites. If listening to music, stick to a pre-set playlist or one radio station at a low volume. Don’t eat, put on makeup, etc.
• Make a pre-trip checklist a habit. Put on seatbelts, adjust mirrors and seats, check gas levels and set GPS systems before hitting the road.
• Limit passengers. The ideal is one adult co-pilot— or possibly one mature friend—whose job is to keep the driver focused on the road, especially on longer highway stretches.
• Be extra aware of alcohol. Teenagers with ADHD are even more impaired by very low doses.
• Go low-tech. Some drivers with ADHD do better with manual transmissions, which require more active focus than automatics. Teens also may want to avoid cruise control to stay more engaged (although another school of thought holds that the feature will curb mindless speeding), but use helpful technology. Certain devices and GPS-based apps—some free— can block texting and other selected cell phone functions or send auto-replies to texts, while still allowing 911 calls and sometimes hands-free features. For example, the ORIGOSafe system (driveorigo.com, $399 with installation) requires phones to be in a docking station before a car starts. A few apps to test are Cellcontrol, AT&T DriveMode, DriveSafe.ly and text-STAR. Investigate options with wireless carriers and car dealers.
• Make driving is a privilege, not a right. Hold teens responsible for car insurance payments so they’d pay increased rates after accidents. Sign a contract on rules, such as recording when they’ve taken medication and where they’ve driven, and check cell phone records for times they were on the road.
Overall, be optimistic but careful, Crenshaw says. “I have kids who drive across the country with ADD and do just fine,” he notes. “Just assume that it won’t go as easily for an ADHD kid as it does for others, and go slowly.”