Study urges doctor's OK before teen with ADHD (attention deficit hyperactivity disorder)can drive

Study urges doctor's OK before teen with ADHD can drive

When patients visit my office I have to go over an informed consent form. One item that might seem odd is that I have to inform patients that I am required by law to report impaired driving. That doesn't mean driving while intoxicated ...well, it does, but it means more. It means if you have a head injury, a stroke or other disability that makes your driving dangerous to others, I need to file a report with the proper authorities. Your medical doctor needs to do this too, he or she just doesn't inform every patient that comes through the door. As a matter of fact, medical doctors never do any informed consent until a major treatment intervention is at hand ....but that's another story. Bt impaired driving is one of those critical issues for mental health providers here in BC. Research is clear that ADHD can and often does impair driving. People with untreated ADHD (attention deficit hyperactivity disorder) are more likely to get in accidents, more likely to be injured and when injured spend more time and money in the hospital. Those are the simple facts.

This interesting little article points our thatthe opinion of many that behaviour disorders should be listed among official conditions that force young drivers to get doctors' approval before earning and maintaining their licence. This new study that finds behaviour issues are behind a significant portion of vehicle crashes among teen boys.

The study led by Dr. Donald Redelmeier at the University of Toronto said conditions such as attention deficit hyperactivity disorder (ADHD) could reasonably be added to an existing list of conditions that require medical clearance before driving.

"Maybe ADHD ought to be considered just like diabetes, epilepsy . . . or narcolepsy — that is the patient must show they are in good medical condition if they wish to maintain their driver's licence," said Redelmeier, who is also a physician at Sunnybrook Hospital in Toronto. "I don't think it should be a prohibition, but think it should be on the list of notifiable medical conditions.

He said, however, that the prominence of crashes involving teens between the ages of 16 and 19 aren't limited to when the teens are behind the wheel. "The risks don't end when you stop driving. We find teenagers with ADHD are also predisposed to be pedestrians involved in motor vehicle crashes." Now think about that! Not only are teenage boys in more accidents, its both as the driver and the victim! OFten parents with children on ADHD medication want to just give the medication to their child when they are at school, "It's for learning, right?" they say to me. I tell them it's for life, not just learning. The medication and behavioural treatments are designed to reduce impulsive and RISKY behaviour, something teens are already doing too much of, and teens with ADHD increase the frequency and severity of risk taking behaviour (that includes drugs, sex, and jumping from places you just shouldn't jump from! - wathc youtube for examples of this behaviour).

The test group in this study included 3,421 Ontario teens who were hospitalized following a car crash over a seven-year period. Of those, some 767 were diagnosed with a behaviour issue within the last decade, including 402 cases of ADHD. The researcher said the test group's demographic are the riskiest for vehicle crashes, citing that teen boys between 16 and 19 represent roughly three per cent of all drivers, but about six per cent of all crashes.

"(Teen boys) are so overrepresented in serious crashes, despite their low amounts of driving and despite excellent physical health otherwise," said Redelmeier. "(They have) wonderful reaction times, great visual acuity and a relative freedom from cognitive decline or alcoholism or heart attacks or many other conditions that can impair adults behind the wheel." Redelmeier said the main limitation of the study, which was published this week in PLoS Medicine, is the rate of incorrect diagnosis or diagnosis by someone other than a medical professional. That is no suprise (see my MANY posts on the need to get a proper and comprehensive diagnosis for ADHD). Another problem with the study is that although it accounted for thousands of crashes, the study did not record whether the teen males involved were at fault for the crashes. But, lack of attention doesn't only CAUSE accidents, it keeps you from AVOIDING accidents. We all know this from experience.

So should we add ADHD (attention deficit hyperactivity disorder) to the list of disorders for which you need clearance before getting your driver's permit? Some point out this will just keep parents and teens away from doctors, an incentive NOT to be diagnosed and not to be noticed. And would this make teens even more reluctant to accept the diagnosis of ADHD? And what effect would it have on medication compliance? Regretfully ADHD (attention deficit hyperactivity disorder) still has a stigma that you don't find with other disorders. We have a long way to go in dealing with ADHD (attention deficit hyperactivity disorder) including dealing with the stigma of both the diagnosis itself and the treatment (medication and cognitive behaviour therapy).

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This blog is not offered as medical advice or as a means of diagnosing or treating ADHD or any other disorder. Don't go on line and take an ADHD "test." The diagnosis is complex, and it involves not just looking for symptoms of ADHD, but also ruling out other disorders that might look just like ADHD. So avoid these on line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for that. Medical doctors can diagnose ADHD, but the diagnosis is complex and often they will make a referral to a Registered Psychologist. You can obtain a referral from the British Columbia Psychological Association for a psychologist near you.

My web page lists a number of resources you can make use of yourself in dealing with Attention Deficit Hyperactivity Disorder (ADHD). Please visit it at or one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site.

Attention Deficit Hyperactivity Disorder (ADHD) assessment and treatment services are offered for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

Dr. Jim Roche
Registered Psychologist, British Columbia 01610