Research Centers Team Up to Help Teens With ADHD and ASD Drive Safely

A new teen driver with attention-deficit/hyperactivity disorder (ADHD) jumps behind the wheel and steps on the gas, looking for freedom and adventure. Could his inexperience on the road combined with the inattention, distraction, and impulsivity that are the signature symptoms of his ADHD increase his risk of crashing?

Teen driving safety researchers suspect the answer is, “probably,” but there is a surprising lack of rigorous scientific studies focusing on teen drivers with ADHD, according to Allison Curry, PhD,  a senior scientist and director of epidemiology and biostatistics at the Center for Injury Prevention and Research (CIRP) at The Children’s Hospital of Philadelphia. Using a unique database, Dr. Curry is leading a research project to help fill this knowledge gap from an epidemiological perspective.

As the first study of its kind, the study team will provide a new methodological advancement in the field of young driver research, in order to examine the risk of adverse driving outcomes among a general population of adolescents and young adults ages 16 to 25 diagnosed with ADHD. The database combines two data-rich sources:

1. electronic health record information for about 1,800 children with ADHD and 10,000 children without ADHD who were born from 1987 to 1995 and patients at CHOP’s Care Network in New Jersey
2. a linked traffic safety database that contains the full licensing, citation, and crash history of every New Jersey driver from 2004 to the present

“The data are really valuable because they can help us look at teens who are typically developing and other teens who have developmental disabilities to see whether there are differences in when they get licensed and in their risk of crashing,” Dr. Curry said. “If we know what kind of crashes teens with ADHD are getting in, we can begin to develop interventions that are tailored to address the driving skill deficits common among this group of new drivers.”

Motor vehicle crashes are the leading cause of death and disability among adolescents. Inattention, distraction, and unsafe driving behaviors are major contributors to teens’ car accidents, but little is known about how ADHD influences driving and how those factors could vary with gender, age, driving experience, comorbidities, and long-term ADHD medication.

Dr. Curry has spent four years creating NJ’s traffic safety database, and it already has spurred multiple published studies on teen crash rates among the general population in N.J. Her current work includes the ADHD study — funded as a three-year grant by the Eunice Kennedy Shriver National Institute of Child Health & Human Development in August 2014 — and a pilot study of teen drivers with autism spectrum disorder (ASD) that addresses similar research questions funded by a CHOP Foerderer Grant for Excellence.  Dr. Curry hopes findings from the pilot study will provide the basis for a future NIH research project grant application.

Two-thirds of high functioning adolescents with ASD of legal driving age are either currently driving or plan to drive, according to previous research done at CHOP by Patty Huang, MD, a developmental pediatrician at The Children’s Hospital of Philadelphia. However, little is known about the ability of teens’ with ASD to drive safely. ASD is characterized by deficits in communication and social interaction and can be associated with impairments in body coordination and ability to regulate emotions, which could come into play while driving. The research team will use the novel database to determine rates of licensure, police-reported crashes, and moving violations among 500 to 600 adolescents with autism treated at CHOP who were born from 1987 to 1994 and live in New Jersey and then compare them to rates among all New Jersey adolescents.

“We hope these projects will help to set the scientific foundation for the development of interventions that tailor the learning-to-drive process for teens with developmental disabilities,” Dr. Curry said.

In addition to the robustness of the database, both studies stand out to Dr. Curry because they are being conducted in collaboration with two other research centers at CHOP: The Center for Autism Research and the Center for the Management of ADHD. The research teams are in the process of finding and validating the ADHD and autism cases in the CHOP electronic medical record. Concurrently, they are preparing the licensing and crash database, and by the middle of next year, Dr. Curry expects they will be ready to begin analysis.

Dr. Curry hopes their novel research methods can be used to investigate the effect of other medical conditions or events, such as children who have had concussions or seizures, on driving licensure rates and traffic outcomes.

“The large patient population at CHOP gives us the opportunity to provide a unique perspective on teen drivers,” Dr. Curry said.

Understanding how each of these conditions impacts driving could lead to the development of more personalized driving assessments and educational tools for teens. Teen driver safety research is a major focus of CIRP, and the Center offers many universal resources and tips at teendriversource.research.chop.edu for navigating the learning-to-drive process.