A simulated driving program that teaches focused attention can improve road safety among teens with ADHD, according to a study published in the New England Journal of Medicine. Teens who completed the program showed fewer long glances away from the roadway, less variation in lane position, and lower collision rates on the road.
Road accidents are a major issue among young drivers. Compared to adults, teenagers have greater difficulty maintaining their attention on the road and are more likely to be involved in collisions. This is especially the case for teenagers with attention deficit–hyperactivity disorder (ADHD), who are particularly likely to get distracted while driving and to take long glances away from the roadway.
“Approximately 3 million teens are diagnosed with ADHD,” said study author Annie Artiga Garner, an associate professor at Saint Louis University. “We know that ADHD negatively impacts major areas of life including school and peer and family relationships, but driving has been a relatively understudied area. Given teens with ADHD are twice as likely to be involved in a motor vehicle crash than their peers, we felt that addressing their driving problems was a public health issue.”
The researchers conducted a study to test whether a computer-simulated driving program may help reduce driver inattention among teens with ADHD. The researchers tested an adapted version of the Focused Concentration and Attention Learning (FOCAL) program, a software program designed to teach drivers to avoid glancing away from the roadway for extended periods.
The study sample involved 152 teens with ADHD who were between the ages of 16 and 19. The teens were randomly assigned to an intervention training or control training. Both training programs consisted of five 90-minute sessions.
The intervention training was based on the FOCAL program but included multiple sessions in addition to simulator training with auditory feedback. Using a computer, participants engaged in simulated driving while performing various distracting tasks like searching for street names on a map. An auditory tone alerted participants when glances away from the road lasted longer than two seconds.
The control training was a driver’s education program that taught various aspects of road safety and traffic laws but did not cover driver inattention. For example, participants went through a similar driving simulation but did not receive feedback to correct long glances.
To test the effects of the training, participants in both groups were evaluated during 15-minute simulated drives at baseline, one month following training, and six months following training. Additionally, for one year following the training, a vehicle recording system was installed in each participant’s car to evaluate any effects on real-world driving.
The results from the 1-month and 6-month evaluations revealed that teens in the intervention group showed fewer long glances away from the road and less weaving — as measured by lane variation — compared to the control group.
“Our study highlights that teens with ADHD can learn to be safer drivers with repeated and consistent training,” Garner told PsyPost. “Our study also shows that this training must be specific to the challenges that teens with ADHD experience: inattention to the roadway.”
Moreover, the effects of the training appeared to transfer to real-world driving in the year after training. Teens in the intervention group showed fewer long glances away from the road during g-force events (rapid changes in momentum). They also had lower rates of collisions or near-collisions during these g-force events.
“We were pleasantly surprised that our study had an impact on crashes in the real world. We trained teens to limit how often they look away from the road for too long (> 2 sec), and in theory we expected that improvement in this skill would reduce on-road crashes. It is very exciting that families have a nonpharmacological option for reducing crash risk among teen drivers with ADHD.”
These findings suggest that the focused attention driver’s training was able to successfully train the teens to limit their long glances away from the road and these improvements carried over into their real-life driving experiences.
A limitation of the study was that researchers were unable to detect whether ADHD medication had an impact on participants’ real-world driving. Stimulant medication has been found to improve driving skills among teens with ADHD but it was unknown whether the teens were taking stimulants at the time of the collisions or near-collisions.
“Our study measured the impact of the training on the real-world driving of teens. While we did ask whether teens were prescribed stimulant medication, we were unable to determine whether teens were taking their stimulant medication when they were driving,” Garner explained.
“This makes it difficult to draw any conclusions about the role of stimulant medication on the effect of the training on real-world driving. In future studies it will be important to measure daily stimulant medication usage including time of day that the medication was taken to determine whether the effects of the medication would be expected.”
“The next steps of this research are to find a way for this training program to be more easily accessible to the public,” Garner added.
“As a result of the success of the study, Cincinnati Children’s is now offering this training to teens with ADHD. The five-session program will cost $250. Those interested in participating can call 513-636-8107 or visit the website to see if they or their teen qualify.”
The study, “Trial of Training to Reduce Driver Inattention in Teens with ADHD”, was authored by Jeffery N. Epstein, Annie A. Garner, Adam W. Kiefer, James Peugh, Leanne Tamm, Ryan P. MacPherson, John O. Simon, and Donald L. Fisher.
