Concussions impact teen drivers

This article explains how concussions can impact teen drivers.

Researchers at Cincinnati Children's Hospital Medical Center are currently studying teenagers who have suffered concussions in order to help doctors determine when teen drivers are ready to get back behind the wheel of a vehicle.

A driving study is currently taking place that uses assessments of eye tracking within a driving simulator to evaluate potential impairments to reaction times following a concussion.

"This is the only pediatric driving study that I know of that's examining the behavior of concussed patients," said Dr. Adam Kiefer, assistant professor of pediatrics at Cincinnati Children's Sports Medicine. "We are looking for novel ways to assess these teens and to allow them to return to the road safely."

Cincinnati Children's Sports Medicine recently received a grant from the Ohio Department of Transportation to perform the study. Researchers are testing patients between the ages of 16-19 who have suffered a concussion within 7-10 days. They are comparing them to their peers of the same age who are healthy and driving.

They will collect the data over the next several months. The research team with expertise in sports medicine, behavioral medicine and neurology will then analyze the results.

"One of the biggest issues teens and adults face when dealing with concussions is a decreased ability to react quickly to objects in their environment," said Dr. Kiefer. "This can be a major problem, especially during driving, and that's why I think it's important for this type of research to be done."

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Study: Drivers with ADHD are at a greater risk for crashes

A study shows that drivers who have ADHD are significantly more likely to be in a serious car crash.

Drivers with attention-deficit/hyperactivity disorder (ADHD) are nearly 50 percent more likely to be in a serious car crash, a new study suggests.

Further, men with ADHD can dramatically decrease their risk of traffic accidents if they take medication for their condition, the Swedish researchers said.

"This study confirms the importance of treatment and medication for adults with ADHD as well as teens," said Ruth Hughes, CEO of Children and Adults With Attention-Deficit/Hyperactivity Disorder, a patient advocacy group.

"The core symptoms of ADHD include problems with sustained attention and impulsivity, which can have an adverse effect on driving safely," said Hughes, who was not involved in the new study. "All drivers with ADHD need to responsibly manage their treatment to reduce driving risks."

The new findings come from a review of more than 17,000 people in Sweden with ADHD, aged 18 to 46. Researcher Henrik Larsson and colleagues at the Karolinska Institute used databases to track whether the patients had been in a car accident between 2006 and 2009, and if they had a prescription for ADHD medication at the time.

Overall, having ADHD increased a man's risk of a traffic crash by 47 percent and a woman's risk by 45 percent, the researchers found.

They then investigated the role of medication in preventing crashes by determining whether people involved in a wreck had filled a prescription for ADHD medicine within the previous six months.

Dr. Lenard Adler, a professor of psychiatry at NYU Langone Medical Center in New York City, said despite a broad definition of taking medication, "men [who were] treated substantially lowered their risk for accidents."

Access to ADHD medication reduced men's risk of a car wreck by 58 percent compared to men who did not take medication, according to the study. Women with ADHD, however, did not receive any significant benefit from medication in terms of car crashes.

The study, published online Jan. 29 in the journal JAMA Psychiatry, did not receive any funding from drug companies.

Breaking down the numbers further, the researchers estimated that between 41 percent and 49 percent of the car accidents involving men with ADHD could have been avoided if they had been taking their medication as prescribed.

About three out of five children with ADHD carry the disorder with them into adulthood, according to the Anxiety and Depression Association of America. That amounts to about 8 million adults living with ADHD.

Previous research with ADHD patients in virtual-reality driving simulators found that they are more likely to speed, drive erratically, tap the breaks and accelerate into potential accidents, said Adler, who did not take part in the Swedish research.

"These sorts of things are more likely in individuals with ADHD than in people without ADHD," he said. "This is an important study that follows up on ... some of the shorter-term studies that have shown that people with untreated ADHD have more accidents."

Although the study found an association between having ADHD and greater risk of serious car crashes, it did not establish a cause-and-effect relationship.

Adler said, however, that you don't necessarily have to fear getting into a car with a driver who has ADHD.

"With ADHD, there tend to be two groups: a group that is distracted and impulsive, and a group that drives fine. Not everyone with ADHD has this problem, but a substantial percentage does," he said. "This study highlights another reason why getting an appropriate diagnosis for adult ADHD is important, and why it is important to get the ADHD treated."

People with ADHD also should to take extra precautions that will help them keep their mind on the road, Hughes said.

"In addition to medication, this can mean limiting distractions like texting or cell phones, fewer passengers, breaking up monotonous drives with frequent breaks and being more vigilant about driving defensively," she said.

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Both ADHD and texting impair driving in teenagers

A study claims that both ADHD and texting while driving were distracting to teenage drivers and impaired their driving abilities.

ADHD and texting both significantly impair driving performance among teenagers, according to a study published online today in JAMA Pediatrics.

Researchers from Cincinnati Children's Hospital Medical Center used a driving simulator to test the driving performance of 16- and 17-year-old drivers; approximately half of the study's 61 participants had been diagnosed with ADHD, the other half had not. During the 40-minute driving simulation, researchers measured the speed and lane position of the young drivers as they texted and talked on the phone.

Texting significantly affected drivers' speed and lane position for all study participants and further increased the risk for drivers with ADHD, according to researchers.

"Texting is especially dangerous because it involves visual, manual and cognitive distractions," said senior author Jeffery N. Epstein, PhD, director of the Center for Attention Deficit/Hyperactivity Disorder at Cincinnati Children's. "Those are the very kinds of distractions that lead to car accidents."

The study found that even when no distractions were present, drivers with ADHD demonstrated significantly more variability in speed and lane position than did teens without ADHD. Researchers report texting added to existing ADHD driving impairments, essentially doubling the amount of time kids with and without ADHD strayed from their lane.

The Cincinnati Children's study is believed to be the first to investigate the effects of texting on the driving performance of adolescent drivers with ADHD.

"Teens as a group are already at increased risk of distracted driving accidents. Now we know that an ADHD diagnosis and texting while driving increase those risks," added Dr. Epstein. "Our results demonstrate the need for increased education and enforcement of regulations against texting while driving for this age group."

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Taking catch-up naps may reduce risk of crashing for young tired drivers

An Australian study shows that young drowsy drivers who take catch-up naps reduce their risk of crashing.

Young drivers who get behind the wheel while drowsy run a higher risk of getting into car crashes, but Australian researchers have found that not catching up on missed sleep on weekends puts them in even greater danger of having an accident at night.

"This is another challenge to adolescents that comes with lack of sleep," said Dr. Flaura Winston, co-scientific director and founder of the Center for Injury Research and Prevention at Children's Hospital of Philadelphia.

"You have to be ready, body and mind, to drive," she said. "If you are exhausted, you are neither ready body nor mind."

In tackling this challenge, both parents and the community have roles to play, said Winston, who was not involved with the study.

"This is a safety concern," she said. "If the teen doesn't get enough sleep, then they are at increased risk for crashes, so parents need to step in."

Parents should see their role as one that helps their teenager stay safe without being controlling, Winston explained. They can encourage their children to get more sleep, and provide rides at night to ensure that their teens are not driving exhausted.

One of the more positive things parents can do is let their teen sleep late on the weekends, Winston noted. "Teens need their catch-up sleep," she said. "They do need to sleep late on the weekends."

There are also social factors that limit teens' sleep. For example, many high schools start classes very early, cutting into students' sleep time, Winston pointed out. "Studies have shown that later school start times are better for adolescents," she said.

Not only do they start school early, but "they have long days. They have sports, after-school activities and studying, so there are things that are way beyond the family that put these teens at risk when it comes to driving," Winston said.

The report was published online May 20 in the journal JAMA Pediatrics.

To look at what role sleep plays in teen car crashes, a team led by Alexandra Martiniuk, an associate professor at the George Institute for Global Health in Sydney, collected data on more than 20,000 drivers aged 17 to 24.

The investigators found that those who said they slept six or fewer hours a night had a 21 percent higher risk of having a car accident than those who got more than six hours of sleep.

Moreover, those who got less sleep on the weekends had a 55 percent increased chance of having a single-car accident, where the car drifts or swerves off the road, they added.

Most accidents (86 percent) happened between 8 p.m. and 6 a.m., the researchers noted.

"Sleeping six hours a night is enough to put young drivers at significant risk of having a car crash. With work, study and social commitments, especially on weekends, it is easy to miss out on the extra hours of sleep we need," Martiniuk said in a statement.

More than 3,000 people die every day in car crashes around the world -- that's more than 1.3 million car-related deaths a year, with between 20 million and 50 million people injured or disabled, the researchers noted.

In the United States alone, it is estimated that 20 percent of all car crashes are the result of drowsy driving, which adds up to 1 million crashes, 50,000 injuries and 8,000 deaths a year, the study found.

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