ADHD and Driving: The RisK And The Safety Tips

/ Attention Deficit Hyperactivity Disorder, Special Needs / By

Adults and teens with ADHD have many challenges with inattentiveness and distractibility while driving. Studies suggest that ADHD can put individuals at a higher risk of car accidents. This is because the untreated symptoms of ADD/ADHD in an adult driver can impair the driver’s ability to drive in such a way that it resembles intoxicated driving. Adults with ADD/ADHD sometimes overestimate their driving abilities, even though they may have poorer driving experience than their peers. Therefore, they need years of practice to help them improve their awareness of their driving symptoms and habits.

Why Are Drivers With ADHD at Increased Risk?

Poor Judgment

  • As their symptoms of inattention, hyperactivity and impulsivity affect their decision-making process, they may procrastinate when trying to make a decision or be more likely to make a split decision at the last minute.
  • They have impaired working memory, meaning they cannot hold several thoughts and ideas long enough to decide.
  • They may have difficulty evaluating several options.
  • For example, when a driver with ADHD approaches a scenario (roundabout, traffic lights, traffic jam, etc.), they may have difficulty generating options, selecting the most suitable options, and executing the action.

Risk Taking

  • Studies show that due to their difficulty regulating and controlling impulsive behaviour, they may have poorer vehicle control, greater frustration with other road users (including greater frequencies of negative comments), and a trend towards less safe driving when changing lanes/overtaking on the motorway.
  • For example, ADHD is associated with emotional dysregulation, if they become impatient when stuck in a traffic jam, they may have a higher possibility of changing lanes without properly looking out for other cars.

Thrill-seeking Tendencies

  • They are often drawn to activities that are stimulating. 
  • For example, they often neglect the speed limit on the road to pursue excitement due to impulsivity. 

Distracted Driving

  • Distraction affects a driver’s ability to safely perform the driving task, and inattention symptoms will cause drivers with ADHD more difficulty focusing on driving.
  • For example, drivers with ADHD tend to be distracted by phone calls, noise, and music; hence, they may drive erratically and tap the brakes at inappropriate times, resulting in car accidents.

Safe Driving Tips

Supplemental Driver Training 

  • In a study conducted in Australia, young drivers with ADHD who received hazard perception training using computer technology known as Drive Smart showed increased hazard perception skills.
  • Some experts think teens with ADHD should be taught to drive at an earlier age, which is 14 years old, to provide the most benefit. This extra time allows parents or caregivers to control the teen’s learning. They can accompany the teens with ADHD for a longer supervised driving time and create awareness of driving challenges.
  • Car schools may offer specialised programs or provide longer training hours for teens with ADHD.

Stimulant Medications For Driving

  • Driving performance of adults with ADHD can be improved by taking Methylphenidate (Brand name: Ritalin), a central nervous system stimulant medication. 
  • Canadian guidelines recommend long-acting amphetamine mixture, methylphenidate, or lisdexamfetamine as first-line pharmacologic options, with atomoxetine or short-acting dextroamphetamine or methylphenidate as second-line options for patients whose ADHD do not respond to first-line treatments.
  • British guidelines recommend psychostimulants as first-line treatment for adults, with atomoxetine considered as first-line treatment in some clinical situations (substance use disorder, contraindications to stimulants).

Keep Car Organized 

  • Create a car basket to put things inside. So the car environment won’t be a mess and pose as a distraction.
  • Reduce distractions in the car, including avoiding cell phones or disabling all notifications from the cell phone. Mute the handphone.
  • Minimise excessive background noise and music.
  • Try to limit the talk to passengers and avoid dealing with children or pets
  • Avoid doing other stuff in the car, such as smoking, makeup, and grooming
  • Drive while you calm down. Avoid driving while sad, angry, or confused. If you need to drive, try to take a deep breath or call someone who is close to you and have a talk first to calm down.

When Individuals With ADHD Want To Drive A Car In Malaysia

In Malaysia, people with ADHD belong to one of the categories of Persons with Disabilities (in Malay: Orang Kurang Upaya (OKU)). After obtaining an OKU Card, they can apply for the Disabled Class A and A1 driving licenses. 

Currently, the Malaysian government, through the Road Transport Department (JPJ), will offer a full motor vehicle licence fee (road tax) exemption for electric vehicles (EVs) and motor vehicles for OKU. And this exemption will take effect from January 1, 2022, to December 31, 2025. 

As for car insurance, there is a list of insurance companies offering comprehensive insurance coverage for private motor cars to people with ADHD.

Conclusion

From traffic citations to serious crashes, drivers with ADHD are more likely than drivers without ADHD to experience adverse driving outcomes if they do not practice safe driving routines. Many studies show that stimulants, additional car training, and fewer distractions in the in-car environment will help them to build up safe driving behaviours. Other than that, participants in society should be aware and try to be empathic about the situations drivers with ADHD are in as they cannot control their symptoms. Remind them and take appropriate action if unsafe driving behaviours are seen. Encourage them to use technology to help them track and cope with their driving behaviour.

References:

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  2. Randell NJS, Charlton SG, Starkey NJ. Driving With ADHD: Performance Effects and Environment Demand in Traffic. J Atten Disord. 2020 Sep;24(11):1570-1580. doi: 10.1177/1087054716658126. Epub 2016 Jul 9. PMID: 27401237.
  3. Cox DJ, Merkel RL, Kovatchev B, Seward R. Effect of stimulant medication on driving performance of young adults with attention-deficit hyperactivity disorder: a preliminary double-blind placebo controlled trial. J Nerv Ment Dis. 2000 Apr;188(4):230-4. doi: 10.1097/00005053-200004000-00006. PMID: 10790000.
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  5. https://danarayburn.com/keep-a-car-organized-with-adult-adhd/
  6. https://www.topdriver.com/education-blog/driving-courses-for-individuals-with-adhd/
  7. https://www.additudemag.com/adhd-driving-risks-research-safety/
  8. https://joelniggphd.com/traffic-risk-and-adhd/
  9. https://troymedia.com/health/adhd-driving-guidelines/

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