Evidence-Based Review on Interventions and Determinants of Driving Performance in Teens with Attention Deficit Hyperactivity Disorder or Autism Spectrum Disorder

Objective: We conducted an evidence-based review of intervention studies and predictor studies related to driving outcomes in teens with attention deficit–hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). Methods: Ten primary studies were classified using the American Academy of Neurology's criteria (class I–IV, I = highest level of evidence). We provided recommendations including Level A: intervention/factors are effective/predictive or not; Level B: probably effective/predictive or not; Level C: possibly effective/predictive or not; Level U: no recommendations. Results: For the intervention studies we identified 1 Class II and 1 Class III study; for predictor studies, we identified 7 ADHD studies consisting of 1 Class II and 6 Class III studies. Only 1 Class III ASD study was found. In synopsizing the evidence, the following recommendations are made for the intervention studies pertaining to on-road performance in teens with ADHD: a multimodal intervention is possibly effective in improving driving performance (Level C); stimulants possibly do not affect driving negatively (Level C); no recommendations can be made for hazard perception training in ADHD or ASD (Level U). Consider the following recommendations useful for simulated driving performance: Stimulants possibly improve driving performance (Level C); ADHD diagnosis and being unmedicated possibly worsen driving performance (Level C); no recommendations for driving in low-stimulus conditions (Level U). From self-/proxy report, no recommendations can be made related to gender or ADHD subtype affecting adverse driving outcomes (Level U). Conclusion: Class I studies with Level A recommendations, currently lacking in the literature, are urgently needed to make clear the mechanism underlying driving performance outcomes in ADHD and ASD. Supplementary materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention for the following supplemental resource: Table: Evidence-based Synopsis of ADHD, ASD and Driving Performance: Variables, Sample, Findings & Rationale

[1]  L. Hedges,et al.  The Handbook of Research Synthesis , 1995 .

[2]  Eduard Zaloshnja,et al.  Incidence and Total Lifetime Costs of Motor Vehicle–Related Fatal and Nonfatal Injury by Road User Type, United States, 2005 , 2010, Traffic injury prevention.

[3]  R. Hanka.  The Handbook of Research Synthesis , 1994 .

[4]  M. Fillmore,et al.  Simulated driving performance of adults with ADHD: comparisons with alcohol intoxication. , 2008, Experimental and clinical psychopharmacology.

[5]  L. Jerome,et al.  What we know about ADHD and driving risk: a literature review, meta-analysis and critique. , 2006, Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent.

[6]  W. Pelham,et al.  Risky driving in adolescents and young adults with childhood ADHD. , 2004, Journal of pediatric psychology.

[7]  R. Perou,et al.  Increasing prevalence of parent-reported attention-deficit/hyperactivity disorder among children --- United States, 2003 and 2007. , 2010, MMWR. Morbidity and mortality weekly report.

[8]  G McIntosh,et al.  Graduated driver licensing in Wisconsin: a new law for teens and parents. , 2000, WMJ : official publication of the State Medical Society of Wisconsin.

[9]  R. Barkley,et al.  Driving in young adults with attention deficit hyperactivity disorder: Knowledge, performance, adverse outcomes, and the role of executive functioning , 2002, Journal of the International Neuropsychological Society.

[10]  W. Pelham,et al.  The Supporting a Teen's Effective Entry to the Roadway (STEER) Program: Feasibility and Preliminary Support for a Psychosocial Intervention for Teenage Drivers With ADHD , 2011 .

[11]  Wendy Macdonald,et al.  On-the-road evaluation of driving performance , 2006 .

[12]  Tova Rosenbloom,et al.  Thirty-day self-reported risky driving behaviors of ADHD and non-ADHD drivers. , 2011, Accident; analysis and prevention.

[13]  E. Hill.  Evaluating the theory of executive dysfunction in autism , 2004 .

[14]  D. O’Neill.  Practice Parameter update: Evaluation and management of driving risk in dementia: Report of the Quality Standards Subcommittee of the American Academy of Neurology , 2010, Neurology.

[15]  Sherrilene Classen,et al.  Traumatic brain injury and driving assessment: an evidence-based literature review. , 2009, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[16]  D. Segal.  Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) , 2010 .

[17]  M. Horswill,et al.  A Brief Office-Based Hazard Perception Intervention for Drivers With ADHD Symptoms , 2010, The Australian and New Zealand journal of psychiatry.

[18]  B. Reimer,et al.  The impact of distractions on young adult drivers with attention deficit hyperactivity disorder (ADHD). , 2010, Accident; analysis and prevention.

[19]  D. Cox,et al.  Rebound effects with long-acting amphetamine or methylphenidate stimulant medication preparations among adolescent male drivers with attention-deficit/hyperactivity disorder. , 2008, Journal of child and adolescent psychopharmacology.

[20]  C. Hass,et al.  Motor Coordination in Autism Spectrum Disorders: A Synthesis and Meta-Analysis , 2010, Journal of autism and developmental disorders.

[21]  Geoffrey Underwood,et al.  Brief Report: Driving Hazard Perception in Autism , 2010, Journal of autism and developmental disorders.

[22]  G. Kay,et al.  Simulated Driving Changes in Young Adults With ADHD Receiving Mixed Amphetamine Salts Extended Release and Atomoxetine , 2009, Journal of attention disorders.

[23]  S. Eisenschenk,et al.  Evidence-based review on epilepsy and driving , 2012, Epilepsy & Behavior.

[24]  J. Nigg,et al.  Behavioral and Cardiovascular Responses to Frustration During Simulated Driving Tasks in Young Adults With and Without Attention Disorder Symptoms , 2012, Journal of attention disorders.

[25]  J. Swanson,et al.  Weekend holidays during methylphenidate use in ADHD children: a randomized clinical trial. , 2004, Journal of child and adolescent psychopharmacology.