Improving ADHD Teen Driving

Operating a motor vehicle requires a complex set of skills, the most important of which is
the ability to continuously visually attend to the roadway. Glances away from the roadway
significantly increase one's risk for a motor vehicle crash (MVC). Teen drivers evidence far
more extended glances away from the roadway than experienced drivers. Further, teens with a
diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) emit 3-times more extended
glances away from the roadway than typical teens. There is a clear need for interventions,
particularly one that targets extended glances away from the roadway, to address the driving
deficits of teens with ADHD. The proposed research will test the efficacy of the FOcused
Concentration and Attention Learning (FOCAL) intervention, which targets reducing the number
of extended glances away from the roadway, among teens with ADHD. The PC-based FOCAL training
provides teens with an operational understanding of the dangers of extended glances away from
the roadway and trains them on limiting the length of the teens' glances. The investigators
have enhanced the FOCAL intervention (now termed FOCAL+) to include multiple training
sessions and to integrate practice on a driving simulator with immediate feedback regarding
extended glance behavior. In this randomized trial, teens with ADHD will be randomly assigned
to receive either FOCAL+ or a sham placebo group. Immediately after 1 month of training
sessions and 6-months post-training, teens' driving skills will be assessed using a driving
simulator. In addition, teens will have cameras installed in their cars for 12-months which
record driver behavior and road conditions during irregular events (e.g., hard-braking,
swerving). Using data from driving simulation, cameras installed in the teen's car, and teen
driving records, the investigators will examine the short- and long-term efficacy of the
FOCAL+ intervention on 1) decreasing rates of extended glances away from the roadway among
teens with ADHD, and 2) improving driving performance among teens with ADHD.

Inclusion Criteria:

1. Aged 16-19.

2. Must meet DSM-5 ADHD criteria for ADHD-Predominantly Inattentive Presentation or
ADHD-Combined Presentation based on the K-SADS interview.

3. Possess a valid driver's license and regularly spend at least 3 hours per week engaged
in unsupervised driving.

4. IQ ≥80 as measured by the Wechsler Abbreviated Intelligence Scale-II (WASI-II)

5. Parent willing to participate..

Exclusion Criteria:

1. On ADHD medication that cannot be washed out on assessment days.

2. Drug or alcohol dependence according to K-SADS interview.

3. On psychotropic or neuroleptic medications.

4. Require eye glasses (contacts acceptable) for driving (corrective vision restriction
on driver's license).