The results of the recommendations can be summarized under appropriate headings.
Stimulant medication timing and vehicular crashes: There is clear evidence that medication increases driving safety and reduces vehicular crashes. Driving without medication, taking a lower dose, or driving after the effects of the medication has worn off all negate the medication effects. Individuals may drive worse after the medication has worn off compared to when they do not take the medication. This is called the “rebound effect”. No suggestions can be made about nonstimulant medications as there is a lack of data.
Drive stick and turn off cruise control: This keeps the driver engaged. If the driver loses attention, there is immediate feedback of grinding gears/stalled car. Cruise control is more likely to let attention drift in people with ADHD. They should avoid cruise control.
Don’t drink and drive: While this is true for all drivers, it is even more important for those with ADHD. This group is less likely to notice they had too much to drink as well as lower levels of alcohol cause greater dysfunction, impaired attention and judgement than those without ADHD. The “no questions asked” policy of picking up the teen anywhere or setting up a rideshare account is important.
Devices and technological tools: This group should not use the cell phone while driving as attentional impairment may be greater. Technological tools such as a video camera can help monitor the sudden changes in care movement and are useful in providing behavioral feedback.
Peers and Parents matter: The relationship with the teen is key. Greater the relationship, more likely the teen is bound to listen to the parent. Parents may consider a driving contract with the teen. Many states have “graduated driver’s licensing laws,” which limit the number of teens in the car as this had a relationship to traffic accidents. Parents may consider the teen having a checklist. Often teens with ADHD lack the motivation to learn driving mostly due to the ADHD as it is to complete school tasks. The task can be broken down to simplify.
Obtaining a permit/driver’s license: Parents need to work with the teen and also consider using a third party such as a driving school. Teens with ADHD may need more support and accountability than those without. Teens with ADHD also need to practice more, and a driving log should be maintained.
It’s not just ADHD: Often, these individuals have other comorbid conditions such as depression, autism spectrum disorder, oppositional defiant disorder which are also associated with negative driving outcomes.
Should Licensure be delayed?
Drivers with ADHD earn their permit later at age 20-21 while those without ADHD are typically licensed by age 17-18. The delay may be due to parental concerns. The experts in the field disagreed on this point. Those in favor of delaying suggest that there are greater practice opportunities and that individuals with ADHD are behind in development. Those not in favor of delaying licensure suggest that teens with ADHD are more likely to drive without a license, and this is backed up by research.