Attention deficit hyperactivity disorder (ADHD) is a common neurological condition characterized by inattention, hyperactivity and impulsiveness. It affects about 5% of children and adolescents and often persists into adulthood (1).
ADHD can significantly impact daily functioning, including the ability to drive safely. Individuals with ADHD are at a higher risk for motor vehicle crashes, traffic violations and poor driving performance compared to the general population (2, 3).
However, this does not mean that individuals with ADHD cannot drive or should lose their driving privileges. With proper treatment and management strategies, many people with ADHD learn to compensate for their symptoms and become safe drivers.
This article provides an overview of how ADHD can impact driving abilities, steps to take if you have ADHD and want to drive, and strategies to drive safely with ADHD.
How Does ADHD Affect Driving Ability?
ADHD affects driving performance in several key ways:
Inattention
Difficulty sustaining focus is a hallmark of ADHD. Individuals may become easily distracted by sights, sounds or thoughts unrelated to driving. This distractibility raises the risk of missing critical events on the road like stop signs, pedestrians or sudden braking by other cars (4).
Hyperactivity and Impulsiveness
People with ADHD often feel restless and fidgety. They may have trouble sitting still for long periods behind the wheel. Impulsiveness and tendencies to seek stimulation can lead to reckless behaviors like speeding, tailgating, inappropriate passing, running red lights or ignoring traffic rules (5).
Poor Planning and Organization
Drivers with ADHD may have problems staying organized, planning routes and managing time behind the wheel. They are more likely to get lost or frustrated in unfamiliar areas (6).
Emotional Reactivity
ADHD is associated with mood swings and emotional outbursts. Drivers may become angry, aggressive or overwhelmed while driving. Road rage behaviors are more common (7).
Cognitive Function
Studies show that adolescents and adults with ADHD exhibit deficits in executive functions including working memory, planning, problem-solving and verbal fluency. These cognitive difficulties can impair abilities to multi-task, anticipate hazards and make quick, safe driving decisions (8).
Sleep Disturbances
Many adults with ADHD suffer from sleep disorders like insomnia, sleep apnea or restless leg syndrome (9). Drowsy driving raises accident risks substantially.
Requirements for Driving with ADHD
Laws regarding medical fitness to drive vary by state in the U.S. However, there are some general requirements for those with ADHD who wish to drive:
– Have a valid driver’s license and vehicle registration.
– Inform your state’s Department of Motor Vehicles (DMV) that you have been diagnosed with ADHD. Some states may require additional testing.
– Show that your ADHD symptoms are well-controlled with medical treatment and appropriate driving behaviors. Your physician may need to submit documentation.
– Meet any license restrictions that may be imposed – for example, you may need to provide periodic medical reports, take a road test, only drive certain types of vehicles or avoid driving during high risk conditions like rush hour, bad weather or at night.
– Carry adequate auto insurance coverage. Let your agent know about your ADHD diagnosis as this may affect your premiums.
– Continue to follow your treatment plan. You may need periodic license renewal exams to confirm that your ADHD remains well-managed.
Steps to Driving Safely with ADHD
If you have ADHD, taking proactive steps can help compensate for the added challenges to safe driving. Strategies include:
Get Evaluated
Consult your physician and have a formal driving assessment with an occupational therapist. This can identify specific weaknesses to work on and determine your fitness to drive.
Take Prescribed Medications
Medications are first-line treatments for ADHD. Stimulants like methylphenidate, amphetamine salts and atomoxetine boost focus and impulse control (10). Take medications regularly as prescribed to optimize their benefits for driving abilities.
Practice Defensive Driving Techniques
– Drive with both hands on the wheel and sit upright to stay alert.
– Set a safe following distance from the car ahead of you.
– Scan mirrors and blind spots frequently.
– Watch the road ahead for potential hazards.
– Obey all traffic signs, signals, speed limits and lane markings.
– Signal lane changes well in advance.
– Brake early and gradually when stopping.
– Pull over and take breaks if needed to refocus.
Minimize Distractions
– Turn off phones and music while driving.
– Adjust mirrors, GPS and comfort controls before starting out.
– Keep passengers quiet and avoid complicated conversations.
– Focus just on driving – no eating, grooming or reading behind the wheel.
Plan Ahead
– Review maps and directions carefully before driving.
– Allow plenty of time to arrive without rushing.
– Avoid driving when you are tired, upset or overwhelmed.
– Consider using route guidance apps if you tend to get lost easily.
Drive Defensively Around Other Vehicles
– Watch for erratic behaviors from surrounding drivers.
– Keep distance from speeding, tailgating or weaving cars.
– Don’t take other drivers’ actions personally. Stay calm if other motorists cut you off or honk.
– Resist urges to retaliate or chase aggressive drivers who pass you.
Correct Unsafe Driving Habits
– If you have road rage tendencies or often speed and break traffic laws, seek counseling help to change high risk driving behaviors.
– Ask your doctor about cognitive behavioral therapy focused on improving driving skills.
– Enroll in traffic school or mature driver improvement courses.
Try ADHD Coaching
Coaches provide support with schedule planning, route preparation, emotion regulation and motivation while driving with ADHD. They can help instill good driving habits.
Practice, Practice, Practice
Repeated practice builds muscle memory and skills like scanning, turning, parking and merging. It helps make safe driving more automatic. Log many hours of supervised driving time in low risk conditions.
Conclusion
ADHD adds challenges to driving abilities, but appropriate treatment and management strategies enable most people with ADHD to drive safely. Getting thoroughly evaluated, following traffic laws, minimizing distractions and practicing defensive driving techniques can help compensate for the risks of inattention, impulsivity and disorganization. With the right precautions, people with ADHD can become conscientious drivers.
References
1. Attention-deficit/hyperactivity disorder (ADHD): Data and statistics. Centers for Disease Control and Prevention. Updated January 6, 2022. Accessed March 14, 2022. https://www.cdc.gov/ncbddd/adhd/data.html
2. Jerome L, Segal A, Habinski L. What we know about ADHD and driving risk: a literature review, meta-analysis and critique. J Can Acad Child Adolesc Psychiatry. 2006;15(3):105-125.
3. Fried R, Petty C, Surman C, et al. Characterizing impaired driving in adults with attention-deficit/hyperactivity disorder: a controlled study. J Clin Psychiatry. 2006;67(4):567-574.
4. Barkley RA, Murphy KR, Dupaul GI, Bush T. Driving in young adults with attention deficit hyperactivity disorder: Knowledge, performance, adverse outcomes, and the role of executive functioning. J Int Neuropsychol Soc. 2002;8(5):655-672.
5. Cox DJ, Madaan V, Cox BS. Adult attention-deficit/hyperactivity disorder and driving: why and how to manage it. Curr Psychiatry Rep. 2011;13(5):345-350.
6. Cox DJ, Taylor EM, Singh H, Pawlow A. Driving with attention-deficit/hyperactivity disorder: getting there safely. Ann Gen Psychiatry. 2020;19(1):58. Published 2020 Nov 24. doi:10.1186/s12991-020-00314-z
7. Richards TL, Deffenbacher JL, Rosen LA. Driving anger and other driving-related behaviors in high and low ADHD symptom college students. J Atten Disord. 2002;6(1):25-38.
8. Merkel RL Jr, Nichols JQ, Fellers JC, et al. Comparison of driving errors between teenagers with attention deficit hyperactivity disorder and control teenagers. J Neurosci Nurs. 2016;48(4):217-225.
9. Cortese S, Brown TE, Corkum P, et al. Assessment and management of sleep problems in youths with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2013;52(8):784-796.
10. Huss M, Ginsberg Y, Arngrim T, Philipsen A, Carter K, Chen CW, Kumar V. Modafinil for attention-deficit/hyperactivity disorder in children and adolescents: a systematic review and meta-analysis. Eur Neuropsychopharmacol. 2017;27(7):687-701.