There is clear, converging evidence from multiple prospective studies with well-diagnosed adolescents with ADHD and comparison, non-ADHD adolescents, that teen drivers with ADHD have more accidents (Fischer et al., 2007;Nada-Raja et al., 1997;Thompson et al., 2007;Weiss et al., 1979;Woodward et al., 2000) that result in greater costs (Fischer et al., 2007), injuries (Woodward et al., 2000), and fatalities (Lambert, 1995). Adolescent drivers with ADHD are also more likely to be cited for a traffic citation or reckless driving, driving without a license, having hit-and-run accidents, and having a revoked or suspended license (see Barkley &Cox, 2007 for a review). Available research indicates parental monitoring and limit-setting for adolescent drivers is one of the most effective interventions for preventing negative driving outcomes (e.g., Simons-Morton et al., 2007). For children with ADHD, interventions to promote parenting capacity to effectively oversee and intervene in teen driving will likely need to be intensive and require multiple treatment components. The present proposal aims to compare the standard care for teen drivers (driver's education classes and driving practice) to the Supporting a Teen's Effective Entry to the Roadway (STEER) program, that includes a parent- teen intervention, adolescent skill building, parent training on effective adolescent management strategies, joint parent-teen negotiations sessions, practice on a driving simulator, parental monitoring of objective driving behaviors, and the targeting of safe teen driving via contingency management strategies (i.e., parent-teen contracts). To facilitate teen and parent engagement the intervention will be preceded by a motivational interview.
The specific aims of the proposal are to investigate the efficacy of the STEER program relative to a standard care group in a randomized clinical trial (N=172) on measures of objective driving outcome and parenting capacity.

Public Health Relevance

This study holds substantial public health benefit as it will be the first randomized controlled trial for the behavior modification treatment of driving behavior for adolescents with ADHD. Relative to typical adolescents, those with ADHD are most at-risk for a number of negative driving outcomes including accidents, injury, and death. In addition, the study will enhance the understanding of how increasing the parenting capacity for monitoring and limit setting improves adolescent driving behavior as measured by innovative technologies as well as by typical measurement strategies.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD058588-05
Application #
8637094
Study Section
Psychosocial Development, Risk and Prevention Study Section (PDRP)
Program Officer
Haverkos, Lynne
Project Start
2010-04-12
Project End
2015-03-31
Budget Start
2014-04-01
Budget End
2015-03-31
Support Year
5
Fiscal Year
2014
Total Cost
$453,083
Indirect Cost
$150,086
Name
State University of New York at Buffalo
Department
Psychology
Type
Other Domestic Higher Education
DUNS #
038633251
City
Buffalo
State
NY
Country
United States
Zip Code
14260
Schatz, Nicole K; Fabiano, Gregory A; Morris, Karen L et al. (2014) Parenting behaviors during risky driving by teens with attention-deficit/hyperactivity disorder. Behav Ther 45:168-76