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Original Investigation |

Impact of Distraction on the Driving Performance of Adolescents With and Without Attention-Deficit/Hyperactivity Disorder

Megan Narad, MA1,2; Annie A. Garner, PhD1; Anne A. Brassell, BA1; Dyani Saxby, PhD2; Tanya N. Antonini, MA1,2; Kathleen M. O’Brien, BA1,2; Leanne Tamm, PhD1; Gerald Matthews, PhD2; Jeffery N. Epstein, PhD1
[+] Author Affiliations
1Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
2University of Cincinnati, Cincinnati, Ohio
JAMA Pediatr. 2013;167(10):933-938. doi:10.1001/jamapediatrics.2013.322.
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Importance  This study extends the literature regarding attention-deficit/hyperactivity disorder (ADHD)–related driving impairments to a newly licensed, adolescent population.

Objective  To investigate the combined risks of adolescence, ADHD, and distracted driving (cell phone conversation and text messaging) on driving performance.

Design, Setting, and Participants  Adolescents aged 16 to 17 years with (n = 28) and without (n = 33) ADHD engaged in a simulated drive under 3 conditions (no distraction, cell phone conversation, and texting). During each condition, one unexpected event (eg, another car suddenly merging into driver’s lane) was introduced.

Interventions  Cell phone conversation, texting, and no distraction while driving.

Main Outcomes and Measures  Self-report of driving history, average speed, standard deviation of speed, standard deviation of lateral position, and braking reaction time during driving simulation.

Results  Adolescents with ADHD reported fewer months of driving experience and a higher proportion of driving violations than control subjects. After controlling for months of driving history, adolescents with ADHD demonstrated more variability in speed and lane position than control subjects. There were no group differences for braking reaction time. Furthermore, texting negatively impacted the driving performance of all participants as evidenced by increased variability in speed and lane position.

Conclusions  To our knowledge, this study is one of the first to investigate distracted driving in adolescents with ADHD and adds to a growing body of literature documenting that individuals with ADHD are at increased risk for negative driving outcomes. Furthermore, texting significantly impairs the driving performance of all adolescents and increases existing driving-related impairment in adolescents with ADHD, highlighting the need for education and enforcement of regulations against texting for this age group.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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