ADHD and Driving: Risks and Strategies

Mom, can I have the keys to go meet Cheryl at the mall?”

“Dad, I just need the car for about an hour so I can take my friends to get some ice-cream.”

“Mom, it’s so hot out! Can I just drive to the pool?”

Not only do adults often drive more in the summer, particularly on highways while on vacation, but teens who are no longer confined to the school setting often drive more as well.

If you are an adult with ADHD or have a teen diagnosed with ADD, extra caution may be needed.

An increasing body of research demonstrates that individuals with ADHD are far more likely to have lapses and errors while driving, get stopped by the police for traffic investigations, receive citations, and be involved in collisions than those without ADHD.

ADHD: Risk Factors When Driving

Driving requires the brain to be focused and aware of many different situations – what is happening inside the car, what is occurring just outside the car (on all sides) and where the car is going. Being unaware of how much gas is in the tank or slick conditions from rain or missing an exit can cause major problems. So it is no surprise that a number of the common symptoms of ADD can create driving-related risks.

In particular, the top three adult ADHD symptoms – impulsivity, distractibility, and inattention – can magnify the risk. Impulsivity can often lead to speeding or other risky maneuvers (ADHD Frustration: Get Out of My Way or I Shall Taunt You a Second Time), while various types of distraction (from companions in the car to billboards on the highways) pulls attention away from the traffic. And inattention leads to delayed use of strategies to ameliorate or avoid a dangerous outcome, as well as a tendency to miss a turn and get lost.

Other related risk-factors present in some individuals having ADHD include slow processing speed, visual processing and memory challenges, sensation seeking, poor risk-perception (resulting in risk taking), difficulty with rule-following, and difficulty in managing emotions and anger (Putting the Brakes on ADHD-Fueled Road Rage). Additionally, conditions that can co-occur with ADHD, in particular Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), are factors in negative driving outcomes.

For teens, the maturational lag common with ADHD creates another risk factor. Even when teens can master the information needed to drive, maturity of judgment is a critical factor: a safe driver needs to apply rules learned at the right time, in the right place, and under the right circumstances.

Driving and Adult ADHD: Risk-Reduction Strategies

Before and when learning to drive, steps can be taken to assure a well-trained, well-prepared driver.

1) Get treated for adult ADHD. Medication, particularly methylphenidate, has been shown to positively impact attention during driving. Attention, speeding and irritability with other drivers are some of the factors positively impacted when medication is “on board.”

Of course, it’s important to make sure the medication is effective when behind the wheel, so long-acting doses are worth considering. Be aware that driving at night, when meds have worn off, may increase risk.

2) Take extra time in the driver-training phase. Teens with ADD, and perhaps other new drivers, benefit from increased practice and supervision when learning to drive. Some experts have recommended up to two years of supervised driving for teens with ADHD to assure that sufficient practice in a wide variety of driving situations can occur to enable teens to drive safely when on their own.

3) Look for a specialized training program to substitute for or supplement standard drivers-ed training. Two options include:

• a program designed specifically for drivers with ADHD and/or
• a driving rehabilitation course which zeroes in on attention, judgment, and impulsivity in driving.

4) Assure a good role-model for the driver-in training. New drivers learn a lot from just watching others!

5) Before a teen starts driving, consider developing a contract outlining safety rules and related expectations as well as potential consequences for violating these driving agreements.

Next time, we will talk about important driving practices for teens and adults with ADHD so everyone is prepared to make this a safe year!