Driving is a serious responsibility, and those parents with neurotypical teens are frightened by the prospect of their teen driving, but if you ADHD into the mix it can even be more anxiety-provoking, if not paralyzing.
Not unlike neurotypical teens, teens who have ADHD have difficulty controlling their actions and regulating their emotions. They also have difficulty with their attention and impulse control. These issues translate into specific problems for them when they get behind the wheel.
Scary right? As if it isn't terrifying enough to have your child behind the wheel of a car. These statistics aren't meant to scare you, but to have you put some new thought, planning, and caution into this stage that most of our teens are expected to move through without much incident.
Think for a minute about what skills are required to be a good driver. Those very ones that are impaired by ADHD, and being a teenager! It's a perfect storm.
Having poor attention and impulsivity can lead to many issues when driving.
Driving skills that require attention and impulse control include defensive driving, lane changes, vehicle control, the smoothness of abrupt acceleration and deceleration, and keeping a steady and constant vehicle speed.
Good driving skills require attention and patience to monitor the changes in the flow of traffic on the road. You also need good attention to ensure if you glance away from the road that you quickly return your focus. These abilities are impaired by ADHD.
When considering your plan to ensure your child with ADHD is safe and ready to drive, it helps to know how your child's executive functioning (ef) skills may be impacted specifically. Remember, every child and person with ADHD is different. One teen may have more trouble with impulse control and attention while another may be more anxious and hesitant. One teen may overestimate their ability to drive well or the time it takes to learn which may lead them to be defiant and difficult to teach. Each one of these issues may require a different approach. One resource that can help with this is Peg Dawson's Smart but Scattered for Teens.
How? This book helps you and your teen see where their ef strengths and weaknesses are. Information here can be extrapolated to include help for driving.
It's important for teens to understand their ADHD, how they can help themselves work on areas that may be impeding their life, and focus on their strengths. This tool is helpful to that effect.
Stimulant medications improve the outcome of and reduce crashes. Finding the best medicine requires partnering with your doctor and sharing when your teen does the most driving and how his or her meds might be adjusted.
Some of the problems for teens are forgetting to take the medication, taking too low a dose of medicine, or driving after the effects have worn off.
"The Rebound Effect". If you drive after your stimulant medications have worn off, your driving skills may worsen. If driving shortly after waking up, it's important to take a rapid onset med.
If driving late at night, even the most long-acting medication isn't likely to be effective. Some psychiatrists will prescribe a short-acting booster med.
Talk to your doctor to see when you do the most driving, and see how medications might be adjusted to help you
Currently, there is a lack of evidence regarding non-stimulant medications and ADHD driving safety
In some studies, using a manual transmission during stop and go driving had the equivalent benefit of using a stimulant on improving attention! However, on long open stretches of road, there is no benefit when gear shifting is not utilized and these are known to increase accidents. For this same reason, it is dangerous to use cruise control.
A great strategy to teach teens in these situations is a mantra with sequencing. Look ahead, check mirrors, look ahead, check side traffic, look ahead, check speedometer repeat.
What should you do if you have a child with ADHD and it's time for them to drive but they act uninterested?
While it might be easy to assume you should never let your teen get their license, this isn't practical nor realistic.
It may be wise, depending on the circumstances to delay your ADHD teen from getting their license. Most ADHD teen's executive functioning skills are delayed 3- 4 years. They may not be ready for developmental tasks when their peers are. However, this varies from child to child depending on their ability to handle this responsibility, their desire to do so, and whether they will doing this without your consent or support.
A child ADHD may need to be pushed to do difficult things, as they have difficulty with dopamine levels and motivation. This has to be weighed on a case by case basis, but just because your child hasn't expressed interest, doesn't mean that you don't push them to pursue it. Eventually they will need to drive.
If your teen has an adversarial relationship with you in relation to their driving, you may want someone else to teach them. Get to know their drivers education instructor, or if possible have your teen complete a private drivers education program, which can be very helpful. ADHD teens may be slower to learn. They may need to take a class twice.
Although it is a commonly accepted practice, it is found that neurotypical drivers are adversely affected while using a mobile phone, whether they are using it with hands-free technology or not. They are less likely to see a traffic signal, have delayed brake time, are less likely to stop on time. Talking to passengers in the car can have a similar effect. Any distractions while driving can impair driving. As you can imagine this is likely more true for ADHD teenagers.
Parents can purchase apps for phones that teens can use to lock phones during drive times, so they can get in the habit of not using them for texting and calling. Usually, this allows for 911 and emergency calls.
Modeling good driving behavior is of paramount importance here.
Teens with ADHD are particularly vulnerable to substance abuse problems. It's important that they know these risks, but also that there is safety and trust in the relationship and open and honest communication so they are not fearful to call their parents at any time to pick them up if alcohol should be involved.
Aduen, P., Cox, D., Fabiano, G., Garner, A., & Kofler, M. (2019). Expert Recommendations for Improving Driving Safety for Teens and Adult Drivers with ADHD. The ADHD Report, 27(4), 8-14. doi: 10.1521/adhd.2019.27.4.8