December 29, 2022 – Nadia Tawfik was 17 when she got her first car. Two months later, Taufik was following her mother’s car when her mother continued going straight and she quickly decided to divert and turn left. The light is green, but there is no green arrow. Halfway through the turn, Tawfik was so distracted by watching her mother drive away that she didn’t see the car heading straight for her.
She went head-on.
“I didn’t pay enough attention,” Tawfik said four years after the accident.
Tawfik, a nursing senior with ADHD, isn’t the only one who struggles with concentration on the road. According to the CDC, teens ages 16 to 19 are at higher risk of being involved in a motor vehicle accident than any other age group. Driving accidents are also the leading cause of death among teens.
For teens with attention deficit hyperactivity disorder (ADHD), the risk of crashing is higher.according to Research published in JAMA Pediatricsadolescents diagnosed with ADHD are 36% More likely to be involved in a car accident than other teenage drivers.Some Research Having ADHD has also been shown to be associated with a higher likelihood of multiple collisions.
Thankfully, Taufik was not seriously injured in the crash, but her car needed to be replaced. But misfortune shook her. She began to fear driving more.
About eight months later, the teen saw an ad on social media for a test Computerized Driving Skills Training Program For teen drivers with ADHD. She happily signed it.
The purpose of this randomized controlled trial was to determine whether a computerized intervention could reduce prolonged road gaze and reduce the risk of driving in adolescents with ADHD, said Dr. Jeffrey Epstein, lead author of the study studypublished this month in New England Journal of Medicine.
The study showed that, for adolescents with ADHD, the intervention significantly reduced the frequency of prolonged time away from the road, as well as measures of lane weaving, compared with a control program. What’s more, those in the intervention group had significantly lower rates of crashes and near-collisions while driving in the real world in the year following the training.
These were the most surprising and important findings for Epstein, who is also a pediatric psychologist and director of the ADHD Center at Cincinnati Children’s Hospital, the main site of the study.
“I had my doubts when our results did generalize to real-world driving, and I was delighted,” Epstein said.
Epstein said he decided to focus this research on reducing long-term gaze away from the road (greater than 2 seconds) because earlier ADHD research study, He is the author of which found Teens with ADHD not only take their eyes off the road longer when distracted, but they see more.
“So we determined that this was a possible cause of accidents in teens with ADHD, and we said, ‘Okay, let’s try to fix this. Let’s see if we can fix this.'”
In this study, a total of 152 teenage drivers (ages 16 to 19) with ADHD were assigned to an intervention or control group. All teens are licensed drivers and drive at least 3 hours per week. Each person receives training for 5 weeks, once a week.
Those in the intervention group received training in a program called Focused Attention and Attention Learning (FOCAL), which aims to reduce prolonged sight-out from the road. Those in the control group learned information typically taught in typical driver training programs, such as the rules of the road, but they didn’t learn anything about long glances and focusing on the road.
The FOCAL program was developed by Dr. Donald Fisher of the University of Massachusetts, who has been working to reduce the amount of time spent looking at the road in adolescents without ADHD. Epstein’s research team knew they needed to make the program more intensive in order to work with teens with ADHD, so they modified it to include multiple sessions. They also added a driving simulator that teens had to enter after completing the computerized FOCAL program, and they were alerted if they glanced for more than 2 seconds. The only way to get the alarm to stop is to look at the road again. In reality, the training involved teaching teens not to take their eyes off the road for more than 2 seconds.
Multiple sessions lasted more than seven hours, Epstein said.
“We literally taught them the skill until it became rote.”
One of the main differences between the intervention and control groups was that the intervention group received auditory feedback when the adolescents looked away from the simulated road for more than 2 seconds, while the control group did not receive auditory feedback training.
Participants in the intervention group averaged 16.5 long glances per drive at 1 month and 15.7 long glances per drive at 6 months, compared with 28 and 27 for the control group, respectively. Second-rate. Lane weaving indicators were also significantly lower in the intervention group at 1 and 6 months compared to the control group.
“We found very large differences between the two groups, and very statistically significant differences,” Epstein said.
Skill levels don’t change much between 1 and 6 months.
“They remembered these skills that we taught them,” Epstein said.
Secondary trial outcomes were the incidence of prolonged glances and collisions/near collisions during 1 year of real-world driving.
To measure them, the team placed cameras in most of the teens’ cars. The camera detects and records the moment of driving events triggered by high g-forces on the vehicle due to sudden changes in the vehicle’s momentum such as hard braking, sharp turns or collisions.
During real-world driving a year after training, participants in the intervention experienced a 24 percent reduction in prolonged glances per gravity event and a 40 percent reduction in collision or near-collision per gravity event. Mandatory events are compared to controls.
Tawfik, who is part of the intervention team, said the study was something she was really interested in. Being a part of it also gave her a better understanding of why these accidents happen.
“The simulation itself has really impressed me over the years,” she said. “It’s helpful because it reminds me to pay more attention to my surroundings and not just focus directly on the road.”
“Training really works,” says John Ratey, MD, best known for writing books on ADHD such as the “Driven to Distraction” series co-authored with Edward Hallowell, MD.
“It’s like any learning, if you study it over and over again, it helps,” Ratey said.
“I think the ADHD field is moving toward skills-based learning. Just like we need to teach skills to teens with ADHD,” Epstein said.
However, at least one study limitation exists. Although the researchers monitored real-world driving for 1 year after the teens completed their training, they were unable to monitor the teens’ drug use during that study period. In other words, it’s unclear whether the teens were taking ADHD medications at the time of the crash or near-crash. That said, the rates of medication in the intervention and control groups were very similar, Epstein noted.
Tawfik said she feels more comfortable on the road now. She learned to be self-aware and not “panic” while driving. She also internalized the message not to take your eyes off the road for more than 2 seconds, an important conclusion she drew from research she says she still applies today.
Sometimes, her friends would try to show her something on their phone while she was driving.
“I don’t watch it because I know that a quick glance can turn into something scary,” Tawfik said.
Parents and teens interested in learning more about the program can visit this siteDr. Jeffrey Epstein, lead study author, said he hoped one day the intervention could be performed using virtual reality or a smartphone app. (Anyone is welcome to attend the training—currently five weeks—onsite at Cincinnati Children’s beginning January 2023).