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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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Young Adult Outcome of Hyperactive Children: Adaptive Functioning in Major Life Activities
Barkley, R. A., Fischer, M., Smallish, L., & Fletcher, K. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000189134.97436.e2 · Cited by 1,027
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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].”
Reaction time variability in ADHD: A meta-analytic review of 319 studies
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“…adults with Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV)-diagnosed ADHD and 23 adults without ADHD, driving behavior was assessed using the Manchester Driving Behavior Questionnaire (DBQ) and 10 questions from a driving history questionnaire (Fried et al., 2006).”
BackgroundMethodInfluentialSelf-citationAtomoxetine improved response inhibition in adults with attention deficit/hyperactivity disorder
Chamberlain, S. R., del Campo, N., Dowson, J., Müller, U., Clark, L., Robbins, T. W., & Sahakian, B. J. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2007.03.003 · Cited by 288
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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