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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.
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“Driving accidents are increased in young adults with ADHD as a result of being distracted, impulsive and having an increased need for stimulation [124-127].”
From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [124]
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“Unidentified students with ADHD have also been shown to exhibit occupational deficits (Barkley & Fischer, 2011) and poor driving ability (Fischer et al., 2007) into adulthood.”
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“Fischer et al. (2007), on the other hand, found that young adults who had been diagnosed with ADHD between the ages of 4 and 12 made significantly more impulsive errors in an on-road drive and generated a higher frequency of impulsive-and inattention-related errors in driving simulator tests…”
BackgroundDriving safety among adolescents with health conditions: An integrative review
DiFusco, L. A., Liu, X. (., Curry, A. E., & McDonald, C. C. (2025) · Journal of Transport & Health · doi:10.1016/j.jth.2025.102040 · Cited by 1
Brancati, G. E., Ventura, L., Froli, A., Gemignani, S., Gift, T. E., Marchant, B. K., & Perugi, G. (2025) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2025.100908
Transitional Care for Children With Neurologic Disorders
Camfield, C., CAMFIELD, P. R., & Nabbout, R. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-10944-7.00015-9
The behavior of minors and road safety – case study of Poland
Wrona, R., Rybicka, I., & Stoma, M. (2025) · Open Engineering · doi:10.1515/eng-2025-0111
Long-term Efficacy of ADHD: Pharmacotherapy in Children
Gilchrist, R. H., & Arnold, L. E. (2008) · Pediatric Annals · doi:10.3928/0090-4481-20080101-10
Examining Attention, Impulsiveness, and Cognitive Failures in Driving Behaviors
Fox, R. T. (2012) · Digital Commons - East Tennessee State University (East Tennessee State University)
Haag, A. C., Garner, A. A., Weaver, T. L., Ruppert, P. D., & Schmank, C. J. (2026) · Psychological Reports · doi:10.1177/00332941261457371
Accident risk and driving performance in traffic among individuals with ADHD. A rapid review
Åhsberg, E., & Ginsberg, Y. (2026) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2026.2735474
“Two studies investigated accident risk [11,12], while four studies investigated various outcomes on general driving performance [12–15].”
InfluentialIt wasn't my fault : does crash culpability improve predictive outcomes in a self-report study?
Freeman, J., Barraclough, P., af Wåhlberg, A. E., & Watson, B. C. (2014) · QUT ePrints (Queensland University of Technology)
Metadata
- Authors
- Fischer, M., Barkley, R. A., Smallish, L., & Fletcher, K.
- Affiliations
- Medical College of Wisconsin (US)
- Medical University of South Carolina (US)
- University of Massachusetts Chan Medical School (US)
- Corresponding author
- Barkley, Russell A.
- Venue
- Accident Analysis & Prevention
- Publisher
- Elsevier BV
- Published
- 2007-01
- Volume
- 39
- Issue
- 1
- Pages
- 94-105
- ISSN
- 0001-4575 (ISSN-L)
- OpenAlex
- W2020136426
- Cited by
- 200
- References
- 34
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 1 · 2023: 6 · 2022: 6 · 2021: 8 · 2020: 8 · 2019: 8 · 2018: 10 · 2017: 8 · 2016: 16 · 2015: 15 · 2014: 12 · 2013: 15 · 2012: 16
- FWCI
- 7.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Accident Analysis & Prevention (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH042181, MH42181)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
- Health Sciences › Medicine › Geriatrics and Gerontology › Older Adults Driving Studies
- Keywords
- attention deficit hyperactivity disorder, hyperactivity, driver behavior, traffic accidents, traffic citations, license suspension, reaction time, impulsivity, driving instructors, young adults, long-term follow-up
- MeSH terms
- Accidents, Traffic, Adolescent, Adult, Age Factors, Attention Deficit Disorder with Hyperactivity, Automobile Driving, Child, Computer Simulation, Female, Humans, Licensure, Male, Pilot Projects, Prospective Studies, Psychomotor Performance, Reaction Time, Risk Factors, Risk-Taking, Safety, Wisconsin, Case-Control Studies, Risk Assessment
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