1. ADHD AND DRIVING What should we be telling adolescents?
Dr N N Onugha
Dr F Finlay
Royal United Hospital, Bath
RCPCH Conference May 2012

2. immature judgement
inattention
impaired
Executive
Function skills
thrill-seeking
tendencies
need for peer acceptance
impulsivity

3. ADHD
‘a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and is more severe than is typically observed in individuals at a comparable level of development’
DSM IV

4. METHODS Search term “ADHD AND DRIVING” PUBMED EMBASE 90 papers Limit
“All Child: 0-18 years”
42 papers
Search term
“Adolescents”
40 papers
12 irrelevant
28 papers

5. What does the literature tell us?

6. DRIVING OUTCOMES AND PERFORMANCE
Behviour rating scales
Driving simulators
more driving violations
driving without a licence
Meta analysis
motor vehicle collisions

7. DISTRACTIONS WHEN DRIVING
80% MVAs involve distractions
Teenage passengers
Reimer et al, 2000

8. DRIVING ANGER
Richards et al, 2002

9. Does anything make a difference?

10. MEDICATION Stimulant medication Methylphenidate
Sustained release methylphenidate
Cox et al, 2004
Other studies
Dexamphetamine
Cox et al, 2006
Atomoxetine
Kay et al, 2009

11. MANUAL TRANSMISSIONS
Cox et al, 2006

12. WHAT SHOULD WE BE TELLING ADOLESCENTS?
In summary….
Discussions about safe driving behaviours should include parents, should start before driving age and should continue through all subsequent outpatient visits. 
Teenage drivers with ADHD should be advised of the need to inform the DVLA of their diagnosis on application for a provisional driving licence. 

13. WHAT SHOULD WE BE TELLING ADOLESCENTS?
Advice……..

14. Drive carefully on your way home….!!
Bring list of references in handout
Drive carefully on your way home….!!