Teens with ADHD Get Licenses Later and Have More Motor Vehicle Crashes

June 13, 2017

Teens with ADHD Get Licenses Later and Have More Motor Vehicle Crashes

  1. Jenny Radesky, MD

Findings support informing patients and parents of crash risk and offering practical steps to reduce it.

  1. Jenny Radesky, MD

Previous studies documenting a link between attention-deficit/hyperactivity disorder (ADHD) and motor vehicle crash risk are limited by self-report of accidents, small sample size, or inclusion of only male participants. To further study this association, researchers linked electronic health records with New Jersey state traffic safety database records for approximately 18,000 adolescents (2500 with ADHD) receiving primary care within one hospital system.

Adjusting for important confounders including race/ethnicity, insurance, income, seizure disorder, disruptive behavior disorder, and prescription of ADHD medications, researchers conducted survival analyses to examine time to licensure and first motor vehicle crash. Compared with patients without ADHD, licensure rates were lower in both females and males with ADHD, but this difference diminished by age 19 years in males. Crashes occurred sooner and more frequently in both males and females with ADHD (hazard ratio, 1.36), regardless of whether they had recently been prescribed stimulants or their length of driving experience.

Comment

This study is the first to use state traffic databases to document links between ADHD and crash risk, and findings support current practices of informing families of this heightened risk and offering commonsense steps to reduce it — such as avoiding nighttime driving, use of mobile devices in the car, or transporting friends. Although ADHD medication did not lower crash risk in this study, it has been protective in prior studies. As the authors acknowledge, patients might have received stimulant prescriptions from providers outside the single hospital system, which could mask a protective association.

Editor Disclosures at Time of Publication

  • Disclosures for Jenny Radesky, MD at time of publication Grant / Research support University of Michigan Department of Pediatrics; Academic Pediatric Association; NIH

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