ADHD & Accidents Crashes Violations Suspensions in Motor Vehicles - New Data

 Do teens with ADHD have more accidents? More Moving Violations?

Yes. For Years,

Traffic Crashes, Violations, and Suspensions Among Young Drivers With ADHD

Allison E. Curry, PhD, MPH,a,b Benjamin E. Yerys, PhD,c,d Kristina B. Metzger, PhD, MPH,a Meghan E. Carey, MS,a and Thomas J. Power, PhDb,d

Abstract

Methods: We identified patients of New Jersey primary care locations of the Children's Hospital of Philadelphia who were born in 1987-1997, were New Jersey residents, had their last primary care visit at age ≥12 years, and acquired a driver's license (N = 14 936). Electronic health records were linked to New Jersey's licensing, crash, and violation databases. ADHD diagnosis was based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes. We calculated monthly per-driver rates of crashes (at fault, alcohol related, nighttime, and with peers), violations, and suspensions. Adjusted rate ratios were estimated by using repeated-measures Poisson regression.

Objectives: To compare monthly rates of specific types of crashes, violations, and license suspensions over the first years of licensure for drivers with and without attention-deficit/hyperactivity disorder (ADHD).

Results: Crash rates were higher for drivers with ADHD regardless of licensing age and, in particular, during the first month of licensure (adjusted rate ratio: 1.62 [95% confidence interval: 1.18-2.23]). They also experienced higher rates of specific crash types: their 4-year rate of alcohol-related crashes was 2.1 times that of drivers without ADHD. Finally, drivers with ADHD had higher rates of moving violations (for speeding, seat belt nonuse, and electronic equipment use) and suspensions. In the first year of driving, the rate of alcohol and/or drug violations was 3.6 times higher for adolescents with ADHD.

Conclusions: Adolescents with ADHD are at particularly high crash risk in their initial months of licensure, and engagement in preventable risky driving behaviors may contribute to this elevated risk. Comprehensive preventive approaches that extend beyond current recommendations are critically needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6564068/figure/fig2/?report=objectonly

Children with ADHD and traffic accidents

Children with ADHD may be more likely to get into traffic accidents due to impulsivity.

Children with attention-deficit hyperactivity disorder (ADHD) may be more likely to have accidents when crossing busy intersections on their bicycles because they're impulsive and have trouble paying attention, a new study suggests.

Researchers said it was known that these children were at increased risk, but the reasons were unclear.

"Crossing roads on a bicycle requires decision and action. What we found is children with ADHD have deficits in both areas," study corresponding author Molly Nikolas said in a University of Iowa news release. Nikolas is an assistant professor in the department of psychological and brain sciences.

Bicycle crashes are a leading cause of severe injuries in children. Each year, nearly 400,000 kids are treated in U.S. emergency departments for bicycle-related injuries, according to the study.

Using a lab-based stationary bicycle, researchers studied how 27 children with ADHD and 36 children without the disorder crossed busy intersections, shown by computer simulation. The children were between the ages of 10 and 14. None of those with ADHD was on medication at the time.

Overall, children crossed when there were similar-sized gaps between cars. But those with ADHD were less precise in timing when to enter the intersection and had less time to spare, according to the study in the December issue of Journal of Child Psychology and Psychiatry.

Moreover, after being exposed to heavy traffic with shorter gaps between cars, youngsters with ADHD had difficulty readjusting when traffic eased and gaps between cars widened. Rather than waiting for the wider gaps, the children with ADHD continued to choose shorter gaps, increasing their risk of an accident.

"The timing issues were more related to symptoms of inattention while the decisions about which gaps to cross were related to hyperactivity and impulsivity -- all core symptoms of ADHD," Nikolas said.

The best way to help children with ADHD cross busy intersections may be to teach them to look for longer gaps between cars, no matter how heavy the traffic, she said.

"Even if their timing remains off, if they have a big enough gap, they will be OK," Nikolas said. "If we can have some intervention or prevention strategies that focus on the decision-making, that may help compensate for the timing deficit."

Almost 6 million American children between the ages of 3 and 17 have ADHD, according to the U.S. Centers for Disease Control and Prevention.

Read more here

Negative effects of sleep deprivation

This article discusses how important sleep is for people, and how detrimental sleep deprivation can be.

There's a tendency to see sleep as a giant time suck - some unfortunate biological need to be kept at bay until someone's finished their English paper or beaten a tricky level on Candy Crush Saga.

Robert Wittig sees it differently.

"The only time you cannot possibly waste is when you're sleeping," said Wittig, medical director at the Aspirus Keweenaw Sleep Disorder Center in Laurium.

Perceiving those work, school or social demands as more important than a restful night is the leading cause of sleep deprivation, Wittig said.

A good night's sleep has been redefined downward over the past century as advances in technology and luminosity have extended shopping and recreation to a 24/7 distraction. The average person got nine hours of sleep a night in 1900; now, it's under seven.

"You can see that as a great improvement in human efficiency, or you can see it as a looming disaster," Wittig said. "Personally, as a child of the 60s, I think it might explain the loss of creativity in popular music."

But there's more to fear from drowsiness than Karmin. About two-thirds of single-vehicle accidents on the road are due to falling asleep, Wittig said.

"It probably wasn't a problem when people had horses, because you could fall asleep and the horse would still get you there," he said. "You're going down a highway in a car that's supposed to be comfortable, and a car that's supposed to be quiet and luxurious, you're more likely to fall asleep."

People operating on fewer hours of sleep will also have less initiative and be less efficient, he said.

When people come into the clinic, the first thing Wittig does is take the patient's case history. This can include what drugs they're taking, how often they have substances like alcohol or caffeine and their usual sleep environment.

Wittig once treated a woman from Detroit with terrible insomnia. She was admitted to the sleep center, where she had an uneventful, restful night. They were puzzled until she remarked on how warm it was. As it turns out, her house had no heat.

"That's why you literally have to spend an hour asking these questions, because something simple and obvious can end up being the problem," Wittig said.

About two-thirds of the people who come to the center wind up going through a sleep study. The three main measurements used are electromyography (muscle response), electroencephalography (electrical activity in the brain) and eye movement.

"With those three things, you can tell if a person's awake, asleep, what stage of sleep they're in," Wittig said.

Other tools can include an electrocardiogram, strain gauges on the chest, electrodes to measure restless legs and an oximeter to measure the oxygen saturation of hemoglobin in the blood.

But about a third of patients don't need a sleep study to find the remedy, said Wittig. He cautioned against overtreating patients when simpler solutions exist, using the example of a man who only snores when he drinks.

"As a male, half snore by the age of 50," he said. "It doesn't mean we all need sleep studies."

Some remedies are surgical.sSleep apnea, which causes snoring can be caused by obesity, or by large tonsils or a jaw defect; surgery can be used to open up the throat. Another route is continuous positive airway pressure, in which a machine blows air into a tube connecting to a mask that goes over the nose and mouth.

"Literally, that can be an overnight miracle for someone who got into a problem over years and didn't realize," Wittig said. "Overnight, they're a new person, and they think you're wonderful."

Read more here

Sleepy teenagers are at greater risk of pedestrian accident

Pedestrian teenagers who are sleepy due to sleep deprivation are more likely to be hit by a car.

Sleep-deprived teens are at increased risk of getting hit by a vehicle while crossing the street, researchers warn.

The new study included 55 teens, aged 14 and 15, whose ability to cross a street safely was tested in a virtual-reality setting in the Youth Safety Lab at the University of Alabama at Birmingham.

Teens whose sleep was restricted to four hours the night before the test took more time to begin crossing a street, crossed with less time before contact with vehicles and had more close calls than those who slept for eight and a half hours. Four hours of sleep is half the amount considered adequate for 14- and 15-year-olds.

The sleep-deprived teens averaged 2.2 close calls or hits by vehicles on 25 of the simulated street crossings, compared with 1.42 close calls or hits for those who had an adequate amount of sleep, according to the study, which was published Sept. 3 in the Journal of Adolescent Health.

The findings suggest that teens' ability to cross the street safely can be compromised after only one night of too little sleep, said study author Aaron Davis, a psychology post-doctoral fellow in the Leadership Education in Adolescent Health program at the university.

"It is easy to discount the idea that this loss of sleep could have a significant impact if it occurs rarely, but this study demonstrates that adolescents' safety could be put at risk after just one night of inadequate sleep," Davis said in a university news release.

An estimated 8,000 teens aged 14 and 15 require medical attention for pedestrian-related injuries each year in the United States, according to background information in the news release.

Study co-author David Schwebel, director of the Youth Safety Lab, said the study "demonstrates the importance of sleep for human functioning. Our results show clearly that insufficient sleep influences adolescent safety; without sufficient sleep, they are inattentive, distractible and poor decision-makers."

Read more here

Seizures and Head Protection: BUYING A SEIZURE HELMET

:

I often get a question about helmets for children with seizures. The scariest seizures are drop seizures or  astatic seizures but generalized tonic clonic seizures can also cause injury. Its important to realize that with or without a helmet;  on or off medicines... accidental injury is more common in people with epilepsy.
 JR


Seizures and Head Protection: BUYING A SEIZURE HELMET

The doctor or another health care professional has just advised you to buy a protective helmet because you have been having seizures which have been causing sudden drops or falls that may lead to head injury. But what type of helmet is best? And where you should you go to get one?

To determine the best type of helmet, begin by thinking about your seizure behaviors. If you fall forward, a helmet with a face guard, face bar, or visor is needed. If you fall backward, the back of your head needs protection. A good helmet also needs a chinstrap that can be adjusted so that it is snug but not uncomfortable. No matter what direction you fall, the helmet should absorb the impact, so it will be useless if it does not remain securely on the head.

Not all types of helmets offer adequate protection. Bicycle helmets are comfortable and good-looking, but they do not offer the best protection for injuries from seizure activity. Coverage is insufficient in the back and on the sides of the head. When seizures cause forward falls, they do not protect the face, and if they are not adjusted properly, they move too much. Longevity of the helmet is another problem. With repeated hard falls, a bicycle helmet may crack.

Boxing helmets, made of soft leather, are comfortable but they offer no protection and do not allow adequate ventilation. Football helmets offer good protection but are large and uncomfortable to wear. Baseball batting helmets are loose-fitting and are made without a chinstrap, so they offer inadequate protection.

Suitable helmets are commercially available through sporting good stores, medical supply companies, and the rehabilitation departments of some hospitals. Hockey helmets (CCM and Bauer) are one of the best choices. They offer maximal protection, come in a variety of colors, fit all age groups (except infants) and can be purchased and fitted in any sporting goods store.

Other helmets are made especially to protect people with medical needs, including very small children. Some of them come in choices of style or color that may be more appealing to those who don't want to look like a hockey player.

Link Here