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Living with AD/HD: A lifespan disorder


Driving and Adults

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Adults affected by ADHD have many of the same challenges with inattentiveness and distractibility while driving that teens and younger adults do. While additional years of experience can help to improve driving habits, adults with ADHD must constantly  be aware of how symptoms can affect their driving. Vehicle accidents caused by ADHD symptoms remain a risk, along with an increased possibility of receiving traffic tickets and driving without a license or on a suspend license.2

It is estimated that 4-5 percent of adults are affected by ADHD.1 Because most  adults are also drivers 2, this means that there are over 10 million adults (between ages 25 and 69) coping with the symptoms of ADHD as they are driving. Knowing how those symptoms affect the individual can help drivers improve their driving skills and make better decisions for safety while driving.

Greater Risks

Adults affected by ADHD have a higher risk for poor driving incidents than typical adults. Even when other disorders are taken into account, adults with ADHD have more accidents than adults without ADHD.3 In a striking comparison, the untreated symptoms of ADHD in an adult driver can impair the ability to drive in such a way that it can resemble intoxicated driving.2

Difficulties in executive function related to ADHD, including poor judgment, risk-taking and thrill-seeking tendencies, all contribute to these increased risks.. Inattention can lead to distraction and impulsivity can lead to poor reactions to other drivers or traffic conditions. Adults affected by ADHD tend to overestimate their driving abilities, even though they may have poorer driving experiences than their peers.2

Distracted Driving

Most states have distracted driving laws, and many include laws forbidding texting and talking on a hand-held cellphone while driving. In 2010, over 3,000 people died in what the National Highway Traffic Safety Administration (NHTSA) describes as "distraction-affected" crashes -- a measurement of accident caused by texting, initiating a phone call, or answering a phone call while driving.4

NHTSA also found that more than three-quarters of all drivers are likely to answer cellphone calls on all, most, or some trips while driving. These drivers also admit to rarely considering traffic situations when deciding when to use cellphones.3

Drivers with ADHD appear particularly at risk to distractions during periods of low stimulus, or dull, driving 5. This would typically describe the experience of long-distance and highway driving, where accelerated speed raises the stakes immensely. Distraction can be found in simple things, including changing radio stations, checking make-up, drinking, eating, talking with another person in the car, as well as daydreaming. Parents who drive young children need to be aware of distractions caused by children or from in-vehicle entertainment systems designed for backseat occupants. When coping with the symptoms of ADHD, these factors increase the risks of poor driving and can lead to car accidents and tragedy.

For adults affected by ADHD, leaving cellphones and MP3 players put away or turned off, along with no eating or drinking can help to increase attention and prevent accidents. To limit impulsivity, know driving routes beforehand and be familiar with directions to the destination. Visit the U.S. Department of Transportation's website, www.distraction.gov, for additional safety suggestions.

Theory and Practice

Adults affected by ADHD have an advantage over younger drivers with ADHD due to more years of driving practice. However, the main symptoms of the disorder continue to cause problems for drivers throughout their driving careers. When necessary, remedial driver training needs to be focused more on controlling negative emotions rather than on skills to pay attention.6

All drivers need to be aware of state laws regarding motor vehicle operation. Drivers affected by ADHD need to be especially aware of their own driving abilities as part of their behavioral management of the disorder.

Repeated research has shown that stimulant medication greatly improves driving performance for adults affected by ADHD.2 As part of a multimodal treatment plan, employing medication can make a big difference in reducing the risk of negative driving experiences, including vehicle accidents.

As car maker introduce new models, many state-of-the-art cars have options that include heads-up display, texting and cellphone integration and steering wheel cabin controls. Drivers affected by ADHD may want to pass up all the options available on newer models that can be distracting and consider research showing manual transmission to be a better choice because of the need for increased attention in driving habits.7 

Safe Driving Tips

Drivers affected by ADHD can improve their driving skills and increase their safety on the road by doing the following:

  • Reduce distractions within the car, including electronics. This means turning cell-phones off completely, or otherwise disabling all "notifications."
  • Know state traffic laws, including the correct use of turn signals/indicators, blinkers, and speed zone requirements. Contact your state department of motor vehicles if you have questions about particular laws.
  • Attend and pass a driver education program that addresses ADHD concerns if necessary.
  • With your health-care provider knowledgeable about the science of ADHD treatment, develop and follow your ADHD treatment plan. In doing so, consider the role medication has been shown to play in improved driving ability.2

Insurance

All drivers should be aware of their state's motor vehicle insurance requirements. Drivers affected by ADHD may also want to discuss additional insurance coverage that meets their needs with an insurance agent or representative from a reputable company. Additional umbrella liability policies can offer protection from personal injury lawsuits.

Drivers who have had repeated accidents, including fender-benders, often find their insurance premiums are increased. As drivers affected by ADHD tend to have more accidents than other drivers2, they can end up paying more for car insurance than other drivers. Drivers should discuss this concern and their personal driving record with an insurance agent and look for a plan that is within their budgets and has safe-driving rewards.

References

Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS) [Online]. (2010). National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer). [Cited 2010 Oct 18].

NHTSA [2009]. Fatality Analysis Reporting System (FARS), 2009. Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration, National Center for Statistics and Analysis

Laurence Jerome MB.Ch.B., M.Sc., M.R.C., Psych., F.R.C.P.C.; Alvin Segal Ph.D.; Liat Habinski B.Sc. (2006) What We Know About ADHD and Driving Risk: A Literature Review, Meta-Analysis and Critique. J Can Acad Child Adolesc Psychiatry 15:3, pp.105-125

Cox DJ, Merkel RL, Moore M, et al. Relative benefits of stimulant therapy with OROS methylphenidate versus mixed amphetamine salts extended release in improving the driving performance of adolescent drivers with

DMV - Department of Motor Vehicles is an online directory of state DMV websites. This is a free, private agency and not affiliated with a particular state. http://www.dmv-department-of-motor-vehicles.com



1. The National Institute of Mental Health (NIMH) funded the National Comorbidity Survey Replication (NCS-R), (American Journal of Psychiatry, April 2006). This study estimated that 4.4% of adults between ages 18 and 44 experience some symptoms and disabilities from ADHD.

2. Approximately 90% of adults between the ages of 25 and 65 are licensed drivers. (US Department of Transportation, Office of Highway Policy Information).

3. Laurence Jerome MB.Ch.B., M.Sc., M.R.C., Psych., F.R.R.C.P.C.(C)1; Alvin Segal Ph.D.2;Liat Habinski B.Sc.3. What We Know About ADHD and Driving Risk: A Literature Review, Meta-Analysis and Critique. J Can Acad Child Adolesc Psychiatry 15:3 August 2006 pp. 105-125.

4. Tison, J., Chaudhary, N., & Cosgrove, L. (2011, December). National phone survey on distracted driving attitudes and behaviors. (Report No. DOT HS 811 555). Washington, DC: National Highway Traffic Safety Administration.

5. Reimer, Bryan; Mehler, Bruce; D'Ambrosio, Lisa A.; Fried, Ronna. The impact of distractions on young adult drivers with attention deficit hyperactivity disorder (ADHD). Accident Analysis & Prevention, May 2010, v42 n3, pp. 842-851.

6. Oliver, Michele L.; Nigg, Joel T.; Cassavaugh, Nicholas D. Backs, Richard W.Behavioral and Cardiovascular Responses to Frustration During Simulated Driving Tasks in Young Adults With and Without Attention Disorder Symptoms. Journal of Attention Disorders, April 13, 2011

7. Cox, Daniel; Mohan, Punja; Powers, Katie;et al. Manual transmission enhances attention and driving performance of ADHD adolescent males: pilot study. Journal of Attention Disorders, November 2006, v10 n2, pp. 212-216.

Created: January 2014

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