Insurance Institute for Highway Safety, Highway Loss Data Institute. Fatality facts 2008: teenagers. Available at: http://www.iihs.org/research/fatality_facts_2008/teenagers.html Accessed May 27, 2010.
National Center for Statistics and Analysis, National Highway Traffic Safety Administration (NHTSA), Department of Transportation. Traffic safety facts research notes: fatal crashes involving young drivers. Washington, DC: NHTSA, November 2009. Available at: http://www-nrd.nhtsa.dot.gov/Pubs/811218.PDF Accessed May 27, 2010.
Delhomme P. Verlhiac JF. Martha C. Are drivers' comparative risk judgments about speeding realistic? J Safety Res. 2009;40:333-339.
Ivers R, Senserrick T, Boufous S, et al. Novice drivers' risky driving behavior, risk perception, and crash risk: findings from the DRIVE study. Am J Public Health. 2009;99:1638-1644. Abstract
Braitman KA, Kirley BB, McCartt AT, et al. Crashes of novice teenage drivers: characteristics and contributing factors. J Safety Res. 2008;39:47-54. Abstract
Mantyla T, Karlsson MJ, Marklund M. Executive control functions in simulated driving. Appl Neuropsychol. 2009;16:11-18. Abstract
Malta LS, Blanchard EB, Friedenberg BM. Psychiatric and behavioral problems in aggressive drivers. Behav Res Ther. 2005;43:1467-1484. Abstract
Nada-Raja S, Langley JD, McGee R, et al. Inattentive and hyperactive behaviors and driving offenses in adolescence. J Am Acad Child Adolesc Psychiatry. 1997;36:515-522. Abstract
Woodward LJ, Fergasson DM, Horwood LJ. Driving outcomes of young people with attentional difficulties in adolescence. J Am Acad Child Adolesc Psychiatry. 2000;39:627-634. Abstract
Weiss G, Hechtman L, Perlman T, et al. Hyperactives as young adults: a controlled prospective ten-year follow-up of 75 children. Arch Gen Psychiatry. 1979;36:675-681. Abstract
Barkley RA, Guevremont DC, Anastopoulos AD, et al. Driving-related risks and outcomes of attention deficit hyperactivity disorder in adolescents and young adults: a 3- to 5-year follow-up survey. Pediatrics. 1993;92:212-218. Abstract
Lambert NM. Analysis of driving histories of ADHD subjects. Publication number DOT HS 808 417. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1995. (A summary of this article can be found on-line as: "Study shows that young adults diagnosed with severe attention deficit hyperactivity disorder as children have more driving risks." Available at: http://www.nhtsa.gov/staticfiles/DOT/NHTSA/Communication%20&%20Consumer%20Information/Studies%20&%20Reports/Associated%20Files/tt131.pdf)
Fischer M, Barkley RA, Smallish L, et al. Hyperactive children as young adults: driving abilities, safe driving behavior, and adverse driving outcomes. Accid Anal Prev. 2007;39:94-105. Abstract
Thompson AL, Molina BSG, Pelham W Jr, et al. Risky driving in adolescents and young adults with childhood ADHD. J Pediatr Psychol. 2007;32:745-759. Abstract
Barkley RA, Cox DJ. A review of driving risks and impairments associated with attention-deficit/hyperactivity disorder and the effects of stimulant medication on driving performance. J Safety Res. 2007;38:113-128. Abstract
Biederman J, Fried R, Monuteaux MC, et al. A laboratory driving simulation for assessment of driving behavior in adults with ADHD. Ann Gen Psychiatry. 2007;6:4.
Weafer J, Camarillo D, Fillmore MT, et al. Simulated driving performance of adults with ADHD: comparisons with alcohol intoxication. Exp Clin Psychopharmacol. 2008;16:251-263. Abstract
Cox DJ, Mikami AY, Cox BS, et al. Effect of long-acting OROS methylphenidate on routine driving in young adults with attention-deficit/hyperactivity disorder. Arch Pediatr Adolesc Med. 2008;162:793-794. Abstract
Cox DJ, Merkel RL, Moore M, et al. Rebound effects with long-acting amphetamine or methylphenidate stimulant medication preparations among adolescent male drivers with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2008;18:1-10. Abstract
Sobanski E, Sabljic D, Alm B, et al. Driving-related risks and impact of methylphenidate treatment on driving in adults with attention-deficit/hyperactivity disorder (ADHD). J Neural Transm. 2008;115:347-356. Abstract
Verster JC, Bekker EM, de Roos M, et al. Methylphenidate significantly improves driving performance of adults with attention-deficit hyperactivity disorder: a randomized crossover trial. J Psychopharmacol. 2008;22:230-237. Abstract
Mikami AY, Cox DJ, Davis MT, et al. Sex differences in effectiveness of extended-release stimulant medication among adolescents with attention-deficit/hyperactivity disorder. J Clin Psychol Med Settings. 2009;16:233-242. Abstract
Kay GG, Michaels MA, Pakull B. Simulated driving changes in young adults with ADHD receiving mixed amphetamine salts extended release and atomoxetine. J Atten Disord. 2009;12:316-329. Abstract
Jerome L, Segal A, Habinski L. What we know about ADHD and driving risk: a literature review, meta-analysis and critique. J Can Acad Child Adolesc Psychiatry. 2006;15:105-125. Abstract
Steele M, Jensen PS, Quinn DM. Remission versus response as the goal of therapy in ADHD: a new standard for the field? Clin Ther. 2006;28:1892-1908.
Cox DJ, Merkel RL, Penberthy JK, et al. Impact of methylphenidate delivery profiles on driving performance of adolescents with attention deficit/hyperactivity disorder: a pilot study. J Am Acad Child Adolesc Psychiatry. 2004;43:269-275. Abstract
Steele M, Weiss M, Swanson J, et al. A randomized, controlled effectiveness trial of OROS-methylphenidate compared to usual care with immediate-release methylphenidate in attention deficit-hyperactivity disorder. Can J Clin Pharmacol. 2006;13:e50-e62. Abstract
Lage M, Hwang P. Effect of methylphenidate formulation for attention-deficit hyperactivity disorder on patterns and outcomes of treatment. J Child Adolesc Psychopharmacol. 2004;14:575-581. Abstract
Ramos-Quiroga JA, Bosch R, Castells X, et al. Effect of switching drug formulations from immediate-release to extended-release OROS methylphenidate : a chart review of Spanish adults with attention-deficit hyperactivity disorder. CNS Drugs. 2008;22:603-661. Abstract
Chou WJ, Chou MC, Tzang RF, et al. Better efficacy for the osmotic release oral system methylphenidate among poor adherents to immediate-release methylphenidate in the three ADHD subtypes. Psychiatry Clin Neurosci. 2009;63:167-175. Abstract
Cox DJ, Merkel RL, Moore M, et al. Relative benefits of stimulant therapy with OROS methylphenidate versus mixed amphetamine salts extended release in improving the driving performance of adolescent drivers with attention deficit/hyperactivity disorder. Pediatrics. 2006;118:e704-e710. Abstract
Canadian Medical Association. Determining Medical Fitness to Operate Motor Vehicles:CMA Driver's Guide. 7th ed. Ottawa, Canada: Canadian Medical Association, 2006:35. Available at: http://www.cma.ca/index.php/ci_id/18223/la_id/1.htm
Barkley RA, Anderson DL, Kruesi M. A pilot study of the effects of atomoxetine on driving performance in adults with ADHD. J Atten Disord. 2007;10:306-316. Abstract
Montoya A, Hervas A, Cardo E, et al. Evaluation of atomoxetine for first-line treatment of newly diagnosed, treatment-naive children and adolescents with attention deficit/hyperactivity disorder. Curr Med Res Opin. 2009;25:2745-2754. Abstract
Glazer WM. In the pipeline: non-stimulant ADHD meds: stimulant side effects drive development of alternative medications. Behav Healthcare. 2010;30:30-31.
Busch B. Use of stimulants to treat ADHD in children. 2009 ADHD CME Update Series, an Internet CME Program. Available at: http://www.apsard.org Accessed May 27, 2010.
Dingus TA, Klauer SG, Neale VL, et al. The 100-car naturalistic driving study: Phase II - results of the 100-car field experiment. (Interim Project Report for DTNH22-00-C-07007, Task Order 6, Report No. DOT HS 810 593.) Washington DC: NHTSA; 2006. Available at: http://www.nhtsa.dot.gov/staticfiles/DOT/NHTSA/NRD/Multimedia/PDFs/Crash%20Avoidance/Driver%20Distraction/100CarMain.pdf Accessed May 27, 2010.
Ouimet MC, Simons-Morton BG, Zador PL, et al. Using the U.S. national household travel survey to estimate the impact of passenger characteristics on young drivers' relative risk of fatal crash involvement. Accid Anal Prev. 2010;42:689-694. Abstract
Allen J, Brown B. Adolescents, peers, and motor vehicles: the perfect storm? Am J Prev Med. 2008;35:S289-S293.
Just MA, Keller TA, Cynkar J. Decrease in brain activation associated with driving when listening to someone speak. Brain Res. 2008;1205:70-80. Abstract
Parkes A, Hooijmeyer V. The influence of the use of mobile phones on driver situation awareness. Washington DC: National Highway Traffic Safety Administration, 2000. Available at: http://www-nrd.nhtsa.dot.gov/departments/Human%20Factors/driver-distraction/Topics013010002.htm#A2 Accessed May 27, 2010.
Horrey WJ, Wickens CD. Examining the impact of cell phone conversations on driving using meta-analytic techniques. Hum Factors. 2006;48:196-205. Abstract
Drews FA, Pasupathi M, Strayer DL. Passenger and cell phone conversations in simulated driving. J Exp Psychol Appl. 2008;14:392-400. Abstract
Insurance Institute for Highway Safety. Status report special issue: Phoning while driving. Available at: http://www.iihs.org/externaldata/srdata/docs/sr4502.pdf Accessed May 27, 2010.
Shope JT. Graduated driver licensing: review of evaluation results since 2002. J Safety Res. 2007;38:165-175. Abstract
Insurance Institute for Highway Safety. Licensing ages and graduated driving systems. Washington DC: Insurance Institute for Highway Safety; 2010. Available at: http://www.iihs.org/laws/pdf/us_licensing_systems.pdf Accessed May 27, 2010.
Richards TL, Deffenbacher JL, Rosen LA, et al. Driving anger and driving behavior in adults with ADHD. J Atten Disord. 2006;10:54-64. Abstract
Richards TL, Deffenbacher JL, Rosen LA. Driving anger and other driving-related behaviors in high and low ADHD symptom college students. J Atten Disord. 2002;6:25-38. Abstract
Barkley RA. Deficient emotional self-regulation: a core component of attention-deficit/hyperactivity disorder. J ADHD Relat Disord. 2010;1:5-37.
Insurance Institute for Highway Safety (IIHS). When parents are watching. Status report special issue: teenage drivers. Available at: http://www.iihs.org/externaldata/srdata/docs/sr4405.pdf Accessed May 27, 2010.
National Highway Traffic Safety Administration. NHTSA traffic safety facts 2007 data: young drivers. NHTSA DOT HS 811001. Available at: http://www-nrd.nhtsa.dot.gov/Pubs/811001.PDF Accessed May 27, 2010.
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Author(s)

Betsy Busch, MD

Associate Clinical Professor of Pediatrics, Tufts University School of Medicine, Chestnut Hill, Massachusetts

Disclosures

Disclosure: Betsy Busch, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Forest Laboratories, Inc.; Ortho-McNeil-Janssen Pharmaceuticals, Inc.
Owns stock, stock options or bonds from: Johnson & Johnson Pharmaceutical Research & Development, L.L.C.

Dr. Busch intends to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.
Dr. Busch does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editor(s)

Priscilla Scherer

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Priscilla Scherer has disclosed no relevant financial relationships.

CME Reviewer(s)

Laurie E. Scudder, DNP, NP

Accreditation Coordinator, Continuing Professional Education Department, Medscape, LLC; Clinical Assistant Professor, School of Nursing and Allied Health, George Washington University, Washington, DC; Nurse Practitioner, School-Based Health Centers, Baltimore City Public Schools, Baltimore, Maryland

Disclosures

Disclosure: Laurie E. Scudder, DNP, NP, has disclosed no relevant financial relationships.

CME

Behind the Wheel With ADHD: Advice to Young Drivers With ADHD, Their Parents, and Their Physicians

Authors: Betsy Busch, MD
CME Released: 6/10/2010
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 6/10/2011, 11:59 PM EST

Start Activity

Target Audience and Goal Statement

This activity is intended for psychiatrists and primary care providers including pediatricians, nurse practitioners, and physician assistants involved in the care and advising of children and adolescents with ADHD and their parents.

The goal of this activity is to provide guidance for discussions with young drivers with ADHD, to support and enable safe driving practices.

Upon completion of this activity, participants will be able to:

Describe the impact of ADHD on driving performance
Discuss how pharmacologic and nonpharmacologic treatment of ADHD can improve safe driving skills and thus reduce the frequency and severity of motor vehicle accidents
Formulate a safe driving guideline for young drivers with ADHD

Disclosures

Author(s)

Betsy Busch, MD

Associate Clinical Professor of Pediatrics, Tufts University School of Medicine, Chestnut Hill, Massachusetts

Disclosures

Disclosure: Betsy Busch, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Forest Laboratories, Inc.; Ortho-McNeil-Janssen Pharmaceuticals, Inc.
Owns stock, stock options or bonds from: Johnson & Johnson Pharmaceutical Research & Development, L.L.C.

Dr. Busch intends to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.
Dr. Busch does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editor(s)

Priscilla Scherer

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Priscilla Scherer has disclosed no relevant financial relationships.

CME Reviewer(s)

Laurie E. Scudder, DNP, NP

Accreditation Coordinator, Continuing Professional Education Department, Medscape, LLC; Clinical Assistant Professor, School of Nursing and Allied Health, George Washington University, Washington, DC; Nurse Practitioner, School-Based Health Centers, Baltimore City Public Schools, Baltimore, Maryland

Disclosures

Disclosure: Laurie E. Scudder, DNP, NP, has disclosed no relevant financial relationships.

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For Physicians

Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Medscape, LLC designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should only claim credit commensurate with the extent of their participation in the activity.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

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For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

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There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page.

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Read the target audience, learning objectives, and author disclosures.
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Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. MedscapeCME encourages you to complete the Activity Evaluation to provide feedback for future programming.

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Resources For Families

Information, Articles, and Brochures for Parents and Teens

Insurance Institute for Highway Safety. Questions & Answers: Teenagers. Washington, DC: Insurance Institute for Highway Safety. Available at: http://www.iihs.org/research/qanda/teens.html
Articles from the "Great Schools" Website:
1. When teens with AD/HD are learning to drive: parent strategies. Available at: http://www.greatschools.org/LD/ADHD/teens-learning-to-drive.gs?content=895
2. Keeping licensed teen drivers with AD/HD Safe: Parent Strategies. Available at: http://www.greatschools.org/LD/ADHD/teen-drivers-with-ad-hd.gs?content=896
3. Teen drivers with AD/HD: realities and risk factors. Available at: http://www.greatschools.org/LD/ADHD/teen-drivers-with-ad-hd-realities-and-risk-factors.gs?content=894
4. Teaching kids with LD to drive: a complex family matter. Available at: http://www.greatschools.org/LD/family-home-life/teaching-kids-with-ld-to-drive-a-complex-family-matter.gs?content=892
LD Online. ADHD basics: teenagers with ADHD. Available at: http://www.ldonline.org/adhdbasics/teens
National Highway Traffic Safety Administration (NHTSA). Teen Drivers: A comprehensive approach to teen driver safety. Available at: http://www.nhtsa.gov/Driving+Safety/Driver+Education/Teen+Drivers/Teen+Drivers+-+Parents+&+Teens
US Department of Transportation, National Highway Traffic Safety Administration. Statistics and facts about distracted driving. Available at: http://www.Distraction.gov/stats-and-facts/
Insurance Institute for Highway Safety. Beginning teenage drivers(a brochure for parents). Arlington, Va: Insurance Institute for Highway Safety. Available at: http://www.iihs.org/brochures/pdf/beginning_drivers.pdf
Virginia Driving Safety Lab. ADHD and teen driving. This is an on-line, interactive questionnaire for teens that asks them to reflect on their own driving, and then provides them with great information about driving risks and how to minimize them. Highly recommended. Available at: http://www.web.virginia.edu/TEENADHD/login.asp (Free registration provided to access Website.)

Video and DVD Products for Purchase

American Automobile Association. Driver-Zed 3.0. Interactive DVD filmed from the driver's perspective; exposes teens to a range of risks and allows them to practice safe driving in a computer gaming format. Cost: $24.95. Available at: http://www.driverzed.org/home/
AAA's Teaching Your Teens to Drive: A Partnership for Survival. Illustrated handbook and video helps parents provide supervised driving experiences to novice drivers. An interactive CD–ROM is available. Cost: $29.95 to AAA members. More information is available at: http://secure.aaasne.com/public/news/trafficsafe/driversed.html

Examples of Teen-Parent Driving Contracts

"Checkpoints" Program. Parent-teen driving agreement. Available at: http://www2.nsc.org/issues/teendriving/agreement.pdf
American Automobile Association.
1. Parent-teen driving agreement. Excellent list of rules, very detailed and complete, 6 pages. Available at: http://www.web.aaasne.com/sne/public_affairs/media/docs/parent_teen_driving_agreement.pdf
2. Parent guidelines regarding novice drivers. Available for download at: http://www.aaany.com/safety/driver_training/story.asp?xml=welcoming_your_new_driver.xml&SrcID=51
American Academy of Pediatrics. parent-teen driving contract. Available at: http://www.aap.org/publiced/BR_TeenDriver.htm
Connecticut Teen Driving Safety Partnership. Parent-teen driving contract. Available at: http://www.ctsafekids.org/Parent_Teen_Driving_Contract.pdf
Travelers Insurance Company. Teen-parent driving contract. Available at: http://www.travelers.com/personal-insurance/auto-insurance/teendriver/docs/TeenParentContract.pdf
Parenting Teen Drivers
1. Dr. Wisely's most comprehensive, free teen driving contract. Available at: http://sites.google.com/site/parentingteendriverd2/Home/our-contract
2. There is an associated Webpage giving parents guidelines for how to use the teen driving contract prudently. Available at: http://sites.google.com/site/parentingteendriverd2/Home/getting-started/grim-facts-about-teen-driving/what-to-do/why-a-contract/getting-tough/guidelines-to-contract
The new driver car control clinic - teen driver contract. Available at: http://www.carcontrol.com/contract.htm

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References

Faculty and Disclosures

Author(s)

Betsy Busch, MD

Editor(s)

Priscilla Scherer

CME Reviewer(s)

Laurie E. Scudder, DNP, NP

CME

Behind the Wheel With ADHD: Advice to Young Drivers With ADHD, Their Parents, and Their Physicians

Target Audience and Goal Statement

Disclosures

Author(s)

Betsy Busch, MD

Editor(s)

Priscilla Scherer

CME Reviewer(s)

Laurie E. Scudder, DNP, NP

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Behind the Wheel With ADHD: Advice to Young Drivers With ADHD, Their Parents, and Their Physicians

Resources For Families

Information, Articles, and Brochures for Parents and Teens

Video and DVD Products for Purchase

Examples of Teen-Parent Driving Contracts