Car crashes are the leading cause of death for teens, who crash vehicles at a higher rate
of any age group. But hidden within the numbers is a critical but often overlooked subgroup:
Teens with attention deficit hyperactivity disorder (ADHD) – who are more than twice as likely
to be involved in multiple car crashes.

Jeffrey Epstein, a pediatric psychologist and University of Cincinnati professor, reported this risk in a National Institutes of Health-funded study in 2022, adding that 8% of teens have ADHD.

This shows teens with ADHD who have started driving or who are hoping to get their
license are faced with far more challenges than teens without the disorder. ADHD can affect and look different in teens, especially while driving.

ADHD is a neurodevelopmental disorder that affects the prefrontal cortex of the brain
and can be present in people of all ages, including teenagers. Teens with ADHD can have
trouble controlling impulsive behaviors, be overly active, and, overall, have a harder time paying attention.

Teens with ADHD should be especially careful not to create additional distractions for
themselves. Distractions such as radio, disruptive passengers or mobile devices can make
driving riskier for anyone. These distractions can be particularly problematic for individuals with
ADHD as they are often more susceptible to external stimuli.

Jack Barnes, a junior with ADHD at Annandale High School, takes extra precautions
behind the wheel.

“I keep the volume of music down and the windows up to minimize sounds that may
distract me,” said Barnes. “I also make sure that when I am driving, I look at the whole road and
things around me to avoid being fixated on just the thing in front of me.”

A downside of driving with ADHD is impulsivity, which is common to the disorder. This can include speeding, abrupt lane changes and failure to consider potential consequences.

Ligairi and Sewall

Another downside of driving with ADHD is impulsivity, which is common to the disorder.
While driving, impulsive behaviors can lead to many dangerous situations that can not only
harm the driver but also others on the road. Some impulsive manners are speeding, abrupt lane
changes, or failure to consider potential consequences.

“There’s that level of impulsivity where somebody else [without ADHD] might be able to
say, ‘I forgot to put my phone on silent, and I really want to know who just texted me, but I
can’t,’ whereas that isn’t necessarily going to be the trajectory for someone with ADHD,” said
Kathy Essig, who owns Essig Education Group in Northern Virginia, which tutors and coaches
children and adults with ADHD and executive function disorder.

These impulsive behaviors can be hard to control, and the danger created by them is so
great that Essig recommends teens with ADHD should wait a year or two before getting their
driving permits and licenses.

“They have proven, through studies, that somebody with ADHD during these
developmental years can be up to five years behind others in their self-regulation, (and) boys
more than girls,” Essig said.

Young people applying for driving permits or licenses need to understand the impact of
impulsivity and challenges with self-regulation. Operating a motor vehicle while distracted can
make drivers anxious, especially in high-stress situations. Some drivers may experience anxiety
around even the idea of driving. Anxiety reduces the brain’s ability to control the processing of
emotions. The amygdala and prefrontal cortex (executive functions) work together, so if one
gets affected the other one is affected, too.

When dealing with anxiety on the road, Essig says it’s important that drivers with ADHD
remember to make “really good choices” and recognize that safety “is way more important
than the timing of where you should have been somewhere.” Keeping things in perspective is
vital for staying safe.

Drivers without ADHD must be aware of the risks that come with sharing the road with
ADHD drivers. Increased distractibility, impulsivity, poor judgment and decision-making, and
thrill-seeking are all tendencies that may appear in drivers with this disorder.

“I believe that having a bad attention to things around me puts me and others on the
road at risk, forcing me to put much more effort in while driving than other people might
need,” said Barnes.

Nonetheless, there are many safety measures these drivers can take to reduce the
number of crashes and traffic violations that are common among drivers with ADHD.
Essig recommends that all drivers, especially those with ADHD, eliminate cell phone
use, limit GPS when possible, do not listen to anything or only listen to instrumental tracks and
avoid challenging situations, like rush hour traffic or bad weather.

ADDtitude magazine also recommends that drivers with ADHD choose their passengers
carefully, create travel plans and organize their trips beforehand to allow enough time to arrive,which can help limit the temptation to make impulsive decisions or take risky actions on the road.

Additionally, the group, Children and Adults with Attention-Deficit/Hyperactivity
Disorder (CHADD), recommends that ADHD stimulant medications be considered since taking
them “significantly improves the driver’s ability to pay attention to traffic on the road and to
better follow traffic laws.”

About 22% of car crashes involving people with ADHD could have been avoided if the
person had been using medication, according to a 2017 report in the journal, JAMA Psychiatry.
While medication is not for everyone, it can make driving safer by regulating ADHD tendencies.

It worked for Hannah Henderson, a sophomore at Annandale, though she knows she’s
still at higher risk.

“Though driving is still tough, my new medication has helped me remain on task and
more focused and able to pay attention to the road and what’s in front of me,” Henderson said.

—Zoe Ligairi and Sophia Sewall are juniors at Annandale High School in Northern Virginia, one of Youthcast Media Group’s journalism class partners. (See the first-person piece on ADD and driving from Hannah Henderson of Youthcast Media Group here).