title: Hyperactive children as young adults: driving abilities, safe driving behavior, and adverse driving outcomes.
abstract: ADHD has been linked to poorer driving abilities and greater adverse outcomes (crashes, citations) in clinic-referred cases of teens and adults with ADHD. No study, however, has focused systematically on ADHD children followed into adulthood. The present paper does so while measuring driving-related cognitive abilities, driving behavior, and history of adverse driving outcomes. A multi-method, multi-source battery of driving measures was collected at the young adult follow-up on hyperactive (H; N=147; mean age=21.1) and community control children (CC; N=71; mean age=20.5) followed for more than 13 years. More of the H than CC groups had been ticketed for reckless driving, driving without a license, hit-and-run crashes, and had their licenses suspended or revoked. Official driving records found more of the H group having received traffic citations and a greater frequency of license suspensions. The cost of damage in their initial crashes was also significantly greater in the H than CC group. Both self-report and other ratings of actual driving behavior revealed less safe driving practices being used by the H group. Observations by driving instructors during a behind-the-wheel road test indicated significantly more impulsive errors. Performance on a simulator further revealed slower and more variable reaction times, greater errors of impulsiveness (false alarms, poor rule following), more steering variability, and more scrapes and crashes of the simulated vehicle against road boundaries in the H than in the CC group. These findings suggest that children growing up with ADHD may either have fewer driving risks or possibly under-report those risks relative to clinic-referred adults with this disorder. Deficits in simulator performance and safe driving behavior, however, are consistent with clinic-referred adults with ADHD suggesting ongoing risks for such adverse driving outcomes in children growing up with ADHD.
authors.affiliation: Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Mariellen
authors.initials: M
authors.lastname: Fischer
authors.forename: Russell A
authors.initials: RA
authors.lastname: Barkley
authors.forename: Lori
authors.initials: L
authors.lastname: Smallish
authors.forename: Kenneth
authors.initials: K
authors.lastname: Fletcher
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology / Q000523:psychology*; D001334:Automobile Driving / Q000523:psychology* / Q000592:standards; D016022:Case-Control Studies; D002648:Child; D003198:Computer Simulation; D005260:Female; D006801:Humans; D008004:Licensure; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology; D011930:Reaction Time / Q000502:physiology; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D012449:Safety / Q000706:statistics & numerical data*; D014922:Wisconsin / Q000453:epidemiology