What is the problem, exactly?
People with ADHD may have trouble with attention and impulsivity beyond what is expected in the teen years. Attention deficits cause a person's mind to wander off of the road and the driving task. Impulsivity can result in speeding and other dangerous risk taking in a vehicle. Also, people with ADHD tend to overestimate their driving abilities.
How can you tell when your teen is ready to learn?
Your teen may be ready if he or she...
- consistently shows good judgment
- is able to listen to constructive criticism and make change
- understands that rules are for safety, not for control
- responsible/mature enough to not push to have their license until he or she is a safe driver
- remembers to take prescribed medication for ADHD regularly
- is able to ignore his or her cell phone when the situation demands it, or willing to leave it behind or silence it while driving.
- has issues with substance abuse, including alcohol.
- has uncontrolled symptoms of oppositional defiant disorder or antisocial personality disorder.
- is unwilling to take medication or doesn't remember to take medication on a regular basis.
- consistently has poor judgment.
- is unwilling or unable to abide by safety rules, including those regarding cellphone usage
What can help?
Does extra training help?
Yes, as with any skill, extra training can help. Prior to driving, teens may benefit from narrating their parents' driving--talking through what their parent is doing and seeing to get an idea of what driving involves. Teens with ADHD probably should have formal driving instruction. Parents should be prepared to put in extra practice time (and possibly an extra passenger side brake (cheaper than repairs and medical bills after an accident)) before and after licensing. A formalized driving practice program such as the Teen Driving Plan, may help parents to understand how to help their teen understand the key skills they need to master, and when they are ready to move toward licensing. Some patients may benefit from driving rehabilitation, which helps people with neurological problems such as strokes, to safely drive with neurological deficits. A physician usually refers patients to this type of a program.
Does medication help?
A recent review concluded that stimulants improve driving performance in teens with ADHD, but that the effect tended to diminish over the course of the day. Studies involving atomoxetine have mixed results, so it is not possible to conclude whether it helps driving or not. Teens and younger adults showed the greatest improvements with stimulants.
While many adults with ADHD do not necessarily need medication to drive safely, people who are learning to drive should strongly consider at least temporarily increasing their focus with medication. This is because driving is a complex task involving many distractions that has potentially lethal consequences if not done right the first time.
Does taking away the cell phone help?
Extensive research demonstrates that texting and driving can be lethal in people regardless of their ADHD status. However, teens with ADHD in at least one study have been shown to spend more time looking at their phones while driving than teens without ADHD, even in a hands free situation. It's a great idea for anyone who is driving to pull over to talk or text on their phone. However, for people with ADHD, it's probably an even better idea to minimize distractions.
That being said, taking away a teen's phone during the learning phase is probably a measure a parent should approach in a diplomatic fashion. You might discuss it as a matter of fact kind of measure, like this: "So, after you put on your safety belt, you'll want to make sure your phone is off, so you can focus on driving, especially while you are learning." and later, "Now that you can pull on and off the road safely, we can talk about what you want to do about your cell phone."
Does having a driving contract help?
Having a driving contract will help you communicate with your teen the types of behaviors which are responsible and which will help keep them safe. It spells out consequences so that there should not be any arguments about what is fair. There are sample contracts out online from a number of different organizations, but a good contract will stipulate that driving is a privilege not a right, and that the parent has the right to confiscate keys or have a license revoked if needed. It should also cover expectations and consequences for issues such as traffic violations, use of cell phones, adjusting/use of music, passengers, and allowed destinations. It should make clear that passing the driver's test is not the end of your supervision and that part of the learning process will be ongoing discussions of driving experiences with the parent or guardian. Many teen crashes occur even several years after the teen gets their license, so its important to continue to supervise their driving and emphasize critical safety skills such as not speeding when in a hurry or upset, scanning carefully at intersections, especially when turning left, etc.
That being said, many teens with ADHD do not remember the terms of a contract and may find going over everything at once to be boring and therefore difficult to attend to fully. A contract by itself will not guarantee compliance with safety rules. As you are teaching them to drive it is important to continually return to safety rules so that they are more likely to remember your expectations. It is also important to be a good example and model of how to handle different situations, such as what to do when you get a call on your cell phone.
Teens with ADHD do have some elevated risks when driving, but with a plan and practice, many go on to be safe and successful drivers.
Teens with ADHD do have some elevated risks when driving, but with a plan and practice, many go on to be safe and successful drivers.
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