Examining Patterns and Predictors of ADHD Teens' Skill-Learning Trajectories During Enhanced FOrward Concentration and Attention Learning (FOCAL+) Training.

OBJECTIVE: Examine patterns and predictors of skill learning during multisession Enhanced FOrward Concentration and Attention Learning (FOCAL+) training. BACKGROUND: FOCAL+ teaches teens to reduce the duration of off-road glances using real-time error learning. In a randomized controlled trial, teens with ADHD received five sessions of FOCAL+ training and demonstrated significant reductions in extended glances (>2-s) away from the roadway (i.e., long-glances) and a 40% reduced risk of a crash/near-crash event. Teens' improvement in limiting long-glances as assessed after each FOCAL+ training session has not been examined. METHOD: Licensed teen (ages 16-19) drivers with ADHD (n = 152) were randomly assigned to five sessions of either FOCAL+ or modified standard driver training. Teens completed driving simulation assessments at baseline, after each training session, and 1 month and 6 months posttraining. Naturalistic driving was monitored for one year. RESULTS: FOCAL+ training produced a 53% maximal reduction in long-glances during postsession simulated driving. The number of sessions needed to achieve maximum performance varied across participants. However, after five FOCAL+ training sessions, number of long-glances was comparable irrespective of when teens achieved their maximum performance. The magnitude of reduction in long-glances predicted levels of long-glances during simulated driving at 1 month and 6 months posttraining but not naturalistic driving outcomes. FOCAL+ training provided the most benefit during training to teens who were younger and had less driving experience. CONCLUSION: FOCAL+ training significantly reduces long-glances beginning at the 1st training session. APPLICATION: Providing five FOCAL+ training sessions early on during teen driving may maximize benefit.

A pressure solution flow law for the seismogenic zone: Application to Cascadia.

We develop a linear viscous constitutive relationship for pressure solution constrained by models of deformed metasedimentary rocks and observations of exposed rocks from ancient subduction zones. We include pressure and temperature dependence on the solubility of silica in fluid by parameterizing a practical van't Hoff relationship. This general flow law is well suited for making predictions about interseismic behavior of subduction zones. We apply the flow law to Cascadia, where thermal structure, geometry, relative plate velocity, and Global Positioning System velocity field are well constrained. Results are consistent with the temperature conditions at which resolvable ductile strain is recorded in subducted mudstones (at depths near the updip limit of the seismogenic zone) and with relative plate motion accommodated completely by viscous deformation (at depths near the downdip limit of the seismogenic zone). The flow law also predicts the observed forearc tapering of slip rate deficit with depth.

Evaluation of a 3M (mistakes, mentoring, and mastery) training program for transfer of control situations in a level 2 automated driving system.

Drivers must actively supervise automation as it can only function in limited conditions. A failure to supervise the system has negative consequences in terms of missed requests to take over control and may cause crashes or jeopardize safety. The objective of this study is to determine the effect of a novel, 3M (Mistakes, Mentoring, and Mastery) training program on drivers' behavior while using level 2 driving automation systems. To achieve this, 36 participants were assigned randomly to three different training programs (3M training, User manual, and Placebo) and drove through scenarios on a fixed-based driving simulator. The results showed that drivers in the 3M training group took back control more effectively when the driving automation system reached its limits compared to drivers who received User manual or Placebo training. Drivers in the 3M training Group also had higher situation awareness and improved trust in automation. The results indicate that an interactive approach to training with regards to vehicle automation can help drivers more safely interact with automation systems.

Novice driver crashes: The relation between putative causal factors, countermeasures, real world implementations, and policy - A case study in simple, scalable solutions.

Novice drivers are at a greatly inflated risk of crashing. This led in the 20th century to numerous attempts to develop training programs that could reduce their crash risk. Yet, none proved effective. Novice drivers were largely considered careless, not clueless. This article is a case study in the United States of how a better understanding of the causes of novice driver crashes led to training countermeasures targeting teen driving behaviors with known associations with crashes. These effects on behaviors were large enough and long-lasting enough to convince insurance companies to develop training programs that they offered around the country to teen drivers. The success of the training programs at reducing the frequency of behaviors linked to crashes also led to several large-scale evaluations of the effect of the training programs on actual crashes. A reduction in crashes was observed. The cumulative effect has now led to state driver licensing agencies considering as a matter of policy both to include items testing the behaviors linked to crashes on licensing exams and to require training on safety critical behaviors. The effort has been ongoing for over a quarter century and is continuing. The case study highlights the critical elements that made it possible to move from a paradigm shift in the understanding of crash causes to the development and evaluation of crash countermeasures, to the implementation of those crash countermeasures, and to subsequent policy changes at the state and federal level. Key among these elements is the development of simple, scalable solutions.

Rock properties and sediment caliber govern bedrock river morphology across the Taiwan Central Range.

Feedbacks between surface and deep Earth processes in collisional mountain belts depend on how erosion and topographic relief vary in space and time. One outstanding unknown lies in how rock strength influences bedrock river morphology and thus mountain relief. Here, we quantify boulder cover and channel morphology using uncrewed aerial vehicle surveys along 30 kilometers of bedrock-bound river corridors throughout the Taiwan Central Range where regional gradients in rock properties relate to tectonic history. We find that boulder size systematically increases with increasing metamorphic grade and depth of exhumation. Boulder size correlates with reach-scale channel steepness but does not explain observations of highly variable channel width. Transport thresholds indicate that rivers are adjusted to mobilize boulders and are well in excess of the threshold to transport gravel and cobbles, as previously assumed. The linkage between metamorphic history, boulder size, and channel steepness reveals how rock properties can influence feedbacks between tectonics and topography throughout the life span of a mountain range.

Executive Functioning as a Predictor of Adverse Driving Outcomes in Teen Drivers With ADHD.

OBJECTIVE: The present study examined the association between executive functioning (EF) and risky driving behaviors in teens with ADHD. METHOD: Teens diagnosed with ADHD (n = 179; Mage = 17.4 years) completed two 15-min drives in a fixed-base driving simulator. EF was assessed using parent- and self-report Behavior Rating Inventory of Executive Functioning (BRIEF-2), a temporal reproduction task, and a Go/No-Go task (GNG). Driving outcomes included known predictors of crashes: count of long (>2 s) off-road glances, standard deviation (SD) of lane position (SDLP), mean speed, and SD speed. Generalized linear mixed models, controlling for intelligence and driving experience, were conducted. RESULTS: Higher rates of GNG commission errors predicted higher rates of long off-road glances. Lower parent-rated EF and increased rates of GNG omission errors predicted SDLP. Higher rates of GNG commission errors also predicted faster average driving speed. CONCLUSION: Heterogeneity in EF is associated with differences in teen ADHD risky driving behaviors.

Trial of Training to Reduce Driver Inattention in Teens with ADHD.

BACKGROUND: Teens with attention deficit-hyperactivity disorder (ADHD) are at increased risk for motor vehicle collisions. A computerized skills-training program to reduce long glances away from the roadway, a contributor to collision risk, may ameliorate driving risks among teens with ADHD. METHODS: We evaluated a computerized skills-training program designed to reduce long glances (lasting ≥2 seconds) away from the roadway in drivers 16 to 19 years of age with ADHD. Participants were randomly assigned in a 1:1 ratio to undergo either enhanced Focused Concentration and Attention Learning, a program that targets reduction in the number of long glances (intervention) or enhanced conventional driver's education (control). The primary outcomes were the number of long glances away from the roadway and the standard deviation of lane position, a measure of lateral movements away from the center of the lane, during two 15-minute simulated drives at baseline and at 1 month and 6 months after training. Secondary outcomes were the rates of long glances and collisions or near-collisions involving abrupt changes in vehicle momentum (g-force event), as assessed with in-vehicle recordings over the 1-year period after training. RESULTS: During simulated driving after training, participants in the intervention group had a mean of 16.5 long glances per drive at 1 month and 15.7 long glances per drive at 6 months, as compared with 28.0 and 27.0 long glances, respectively, in the control group (incidence rate ratio at 1 month, 0.64; 95% confidence interval [CI], 0.52 to 0.76; P<0.001; incidence rate ratio at 6 months, 0.64; 95% CI, 0.52 to 0.76; P<0.001). The standard deviation of lane position (in feet) was 0.98 SD at 1 month and 0.98 SD at 6 months in the intervention group, as compared with 1.20 SD and 1.20 SD, respectively, in the control group (difference at 1 month, -0.21 SD; 95% CI, -0.29 to -0.13; difference at 6 months, -0.22 SD; 95% CI, -0.31 to -0.13; P<0.001 for interaction for both comparisons). During real-world driving over the year after training, the rate of long glances per g-force event was 18.3% in the intervention group and 23.9% in the control group (relative risk, 0.76; 95% CI, 0.61 to 0.92); the rate of collision or near-collision per g-force event was 3.4% and 5.6%, respectively (relative risk, 0.60, 95% CI, 0.41 to 0.89). CONCLUSIONS: In teens with ADHD, a specially designed computerized simulated-driving program with feedback to reduce long glances away from the roadway reduced the frequency of long glances and lessened variation in lane position as compared with a control program. During real-world driving in the year after training, the rate of collisions and near-collisions was lower in the intervention group. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT02848092.).

Booster Dose of Attention Training Program for Young Novice Drivers: A Longitudinal Driving Simulator Evaluation Study.

OBJECTIVE: We examined the effectiveness of a second exposure to ACCEL, a novel driving training program, on latent hazard anticipation (HA) performance several months after their first exposure. BACKGROUND: Past research has demonstrated that PC-based driver training programs can improve latent HA performance in young novice drivers, but these improvements are below the ceiling level. METHOD: Twenty-five participants were randomly assigned to either the Placebo group, the ACCEL-1 group, or the ACCEL-2 group. Following the completion of the assigned training program, participants drove a series of eighteen scenarios incorporating latent hazards in a high-fidelity driving simulator with their eyes tracked. Participants returned two to six months following the first session and completed either the placebo program (ACCEL-1 and Placebo groups), or a second dose of training program (ACCEL-2 group), again followed by simulated evaluation drives. RESULTS: The ACCEL-2 group showed improved HA performance compared to the ACCEL-1 and Placebo groups in the second evaluation. CONCLUSION: ACCEL enhances young novice drivers' latent HA performance. The effectiveness of ACCEL is retained up to 6 months, and a second dose further improves HA performance. APPLICATION: Policy makers should consider requiring such training before the completion of graduate driver license programs. Young novice drivers that do not show successful latent HA performance could be required to complete additional training before being allowed to drive without restrictions.

Aging and the Future of Decent Work.

The United Nations identified decent work and economic growth as a sustainable development goal for 2030. Decent work is a term that sums up aspirations for people in their working lives. One of the factors that influences the achievement of decent work is aging. This article examines how aspects of aging and organizational factors affect work ability across the lifespan and throughout one's work career. Additionally, the critical issue of worker physical mobility was also addressed as a practical limitation to functional aging. Through our investigation, we identified gaps in the literature where research and interventions should be promoted. These include early disability studies; population dashboards of workers' health metrics; intervention and cost effectiveness in health promotion and prevention of early functional aging at work; policies for tailoring demands to individual needs and abilities; and inequities of social protection for aging workers.

Impact of L2 automated systems on hazard anticipation and mitigation behavior of young drivers with varying levels of Attention Deficit Hyperactivity Disorder symptomatology.

Level 2 (L2) driving automation systems that maintain latitudinal and longitudinal control of the vehicle decrease mental workload and result in drivers failing to monitor and respond to potential roadway hazards. This issue is potentially important for young drivers with symptoms of Attention Deficit Hyperactivity Disorder (ADHD) since they have known difficulties anticipating and mitigating potential hazards on the road, a skill which requires attention. The objective of this study is to investigate how the use of partially automated (L2) systems and manual systems impacts hazard anticipation and mitigation among young drivers with varying levels of ADHD symptomatology. Sixty-eight drivers, classified into two groups - high and low ADHD symptomatology-navigated twice through three scenarios on a driving simulator, once with an L2 and once with a manual system. The results indicated that: (i) the hazard anticipation skills of drivers with both high and low ADHD symptomatology were depressed in the L2 condition relative to the manual condition; (ii) the hazard mitigations skills of drivers with both high and low ADHD symptomatology were depressed in the L2 condition relative to the manual condition on two measures, but improved on a third measure; and (iii) the hazard anticipation and mitigation skills of drivers with high and low ADHD symptomatology were differentially impacted, both within and across the two levels of automation. Taken together, the results indicate the pernicious and often hard to predict consequences of higher levels of automation for different populations of younger drivers.

The effect of hazard awareness training on teen drivers of varying socioeconomic status.

OBJECTIVE: To compare the effectiveness of the Risk Awareness and Perception Training (RAPT) program among teens of various socioeconomic status (SES). METHODS: A secondary analysis was undertaken of data collected from 5036 teen participants for a study in 2011. They were randomly assigned to either receive RAPT or a placebo training. The total number of crashes (property damage only and injury) within the first 12 months after licensure was recorded. A Poisson regression model was employed to investigate the effectiveness of RAPT in terms of crash frequency among teens in different levels of SES, as measured by SES level (high or low) or poverty rate. RESULTS: Poverty rate was significantly associated with participants' crash frequency within the first 12 months after licensure such that when poverty rate increased, the crash frequency increased. The interacting effect of poverty rate and training was also significant. When compared to participants who did not receive RAPT, participants who received RAPT had fewer crashes when poverty rate increased. CONCLUSION: The RAPT program attenuated the negative effect of teen drivers' SES on crashes. No significant effect of sex or age was found, indicating that in terms of crashes, regardless of age or sex, RAPT is equally effective at reducing crashes for lower SES teens.

Effectiveness of visual warnings on young drivers hazard anticipation and hazard mitigation abilities.

Previous studies have demonstrated that young drivers fail both to scan for and mitigate latent hazards mostly due to their cluelessness. This study aims to investigate whether these skills could be improved by providing young drivers with alerts in advance of the upcoming threat using a driving simulator experiment. In particular, the warning was presented on the head-up displays (HUD) either 2 s, 3 s or 4 s in advance of a latent threat. The hazard anticipation, hazard mitigation and attention maintenance performance of forty-eight young drivers aged 18-25 was evaluated across eight unique scenarios either in the presence or in the absence of latent threat alerts displayed on a HUD. There were four groups overall: one control group (no alert) and three experimental groups (2 s alert, 3 s alert and 4 s alert). The analysis of the hazard anticipation data showed that all three experimental groups with HUD warnings (2 s, 3 s, 4 s) significantly increased the likelihood that drivers would glance towards latent pedestrian and vehicle hazards when compared to the control group. The hazard mitigation analysis showed that in situations involving a pedestrian threat, HUD alerts provided 3 or 4 s in advance of a potential threat led drivers to travel significantly slower than the control group or the 2 s group. No significant effect of a HUD alert on drivers' speed was found when the latent hazard was a vehicle. An analysis of eye behaviors showed that only 7 out of 597 glances at the HUD were longer than 2 s safety-threshold, indicating that the warnings do not seem to distract the driver.

Effective cues for accelerating young drivers' time to transfer control following a period of conditional automation.

OBJECTIVE: During conditional automated driving, a transition from the automated driving suite to manual control requires the driver to take over control at a moment's notice. Thus, it is critical that a driver be made situationally aware as quickly as possible in those conditions where he or she may not be paying full attention. Recent research suggests that specific cues about upcoming hazards (e.g., "crosswalk ahead") can increase the drivers' situation awareness during these safety-critical take-over situations when compared with a general cue ("take over control"). The current study examines whether this increased situation awareness which occurs as a result of more specific cues translates into improved hazard mitigation performance within the same limited time window. METHOD: Fifty-seven drivers were randomly assigned to one of five between-subjects conditions (one control condition and four experimental auditory cue conditions) that varied in the specificity of information provided about an upcoming hazard. The four experimental conditions included a period of conditional automated driving where the driver was engaged in a driving-irrelevant task and looked away from the forward roadway prior to a take-over request. Drivers in the fifth condition had no cue and drove manually throughout. The same six simulator scenarios were used in all five conditions to evaluate how well the driver mitigated a hazard. The average velocity, standard deviation of velocity, and average absolute acceleration were recorded along with the glance behaviors of drivers. RESULTS: In general, during the 4s prior to a latent hazard (following the alerting cues in the automated driving conditions), the more likely a driver was to glance towards a latent hazard, the more likely the driver was to reduce his or her speed. Moreover, analyses focusing solely on hazard mitigation behavior revealed patterns that mirrored the glance behavior results. Specifically, drivers that were presented with cues that described the environments in which hazards were likely to occur were more likely to demonstrate vehicle behaviors that were consistent with speed reductions (lower velocity, higher speed variability, and higher absolute acceleration) than were drivers who were presented general cues or cues about the identity of the upcoming hazards. CONCLUSION: Even in as little as 4s prior to a potential hazard, cues that inform the driver of the environment in which the hazard is likely to occur increase the likelihood that the driver mitigates the crash compared with drivers who are provided general information or threat identity information.

Eye Tracking: A Novel Approach for Evaluating and Improving the Safety of Healthcare Processes in the Simulated Setting.

INTRODUCTION: Eye tracking, used to evaluate a clinician's eye movements, is an example of an existing technology being used in novel ways by patient safety researchers in the simulated setting. The use of eye-tracking technology has the potential to augment current teaching, evaluation, and research methods in simulated settings by using this quantitative, objective data to better understand why an individual performed as he or she did on a simulated or naturalistic task. METHODS: Selected literature was reviewed with the purpose of explicating how eye tracking can be used by researchers and educators to evaluate error-prone processes. The literature reviewed was obtained by querying the databases PubMed, CINHAL, and Google Scholar using the key words eye tracking, patient safety, and medical errors from 2005 through 2015.An introduction to the use of eye tracking, including both theoretical underpinnings and technological considerations, is presented. In addition, examples of how eye tracking has been used in research studies conducted in both simulated and naturalistic settings are provided. CONCLUSIONS: The use of eye-tracking technology to capture the eye movements of novice and expert clinicians has provided new insight into behaviors associated with the identification of medical errors. The study of novices' and experts' eye movements provides data about clinician performance not possible with existing evaluation methods such as direct observation, verbal reports, and thinking out loud. The use of eye tracking to capture the behaviors of experts can lead to the development of training protocols to guide the education of students and novice practitioners. Eye-tracking technology clearly has the potential to transform the way clinical simulation is used to improve patient safety practices.

Age-Related Differences in Vehicle Control and Eye Movement Patterns at Intersections: Older and Middle-Aged Drivers.

Older drivers are at increased risk of intersection crashes. Previous work found that older drivers execute less frequent glances for detecting potential threats at intersections than middle-aged drivers. Yet, earlier work has also shown that an active training program doubled the frequency of these glances among older drivers, suggesting that these effects are not necessarily due to age-related functional declines. In light of findings, the current study sought to explore the ability of older drivers to coordinate their head and eye movements while simultaneously steering the vehicle as well as their glance behavior at intersections. In a driving simulator, older (M = 76 yrs) and middle-aged (M = 58 yrs) drivers completed different driving tasks: (1) travelling straight on a highway while scanning for peripheral information (a visual search task) and (2) navigating intersections with areas potential hazard. The results replicate that the older drivers did not execute glances for potential threats to the sides when turning at intersections as frequently as the middle-aged drivers. Furthermore, the results demonstrate costs of performing two concurrent tasks, highway driving and visual search task on the side displays: the older drivers performed more poorly on the visual search task and needed to correct their steering positions more compared to the middle-aged counterparts. The findings are consistent with the predictions and discussed in terms of a decoupling hypothesis, providing an account for the effects of the active training program.

Large reductions are possible in older driver crashes at intersections.

Among all crash types, the largest percentage of older driver fatalities occur at intersections. Many explanations have been offered for older drivers' increased risks of crashing at intersections; however, only recently was it determined that older drivers were much less likely to glance for latent threats after entering an intersection than middle-aged drivers. In response, training programmes were designed to increase the frequency of such glances. The programmes have proven effective, doubling the frequency of these glances for up to a period of two years post-training. The programmes take only an hour to administer and are not directly targeted at remediating any of the underlying declines in cognitive, visual or motor function that can explain the decrease in the frequency of glances for threat vehicles among older drivers. The first question we addressed was, what are the basic declines that can explain the decrease in glances for threat vehicles? The second question we addressed was, how did the training programme achieve the results it did without directly addressing these declines? We hypothesise that drivers are learning to decouple hand, foot and head movements in the training programmes and that this serialisation of behaviour essentially sidesteps the major declines in cognitive, visual and motor functions. We provide evidence that the assumptions of the decoupling hypothesis about the capabilities of older drivers when the movements are decoupled, are consistent with the evidence from existing experiments. More research is needed to evaluate this hypothesis.

The effects of brief visual interruption tasks on drivers' ability to resume their visual search for a pre-cued hazard.

Driver visual distraction is known to increase the likelihood of being involved in a crash, especially for long glances inside the vehicle. The detrimental impact of these in-vehicle glances may carry over and disrupt the ongoing processing of information after the driver glances back up on the road. This study explored the effect of different types of visual tasks inside the vehicle on the top-down processes that guide the detection and monitoring of road hazards after the driver glances back towards the road. Using a driving simulator, 56 participants were monitored with an eye tracking system while they navigated various hazardous scenarios in one of four experimental conditions. In all conditions, a potential hazard was visible 4-5s before the driver could strike the potential hazard were it to materialize. All interruptions were exactly two seconds in length. After the interruption the potential hazard again became visible for about a half-second after which the driver passed by the hazard. The nature of the in-vehicle visual interruption presented to the participants was varied across conditions: (1) Visual interruptions comprised of spatial, driving unrelated, tasks; (2) visual interruptions comprised of non-spatial, driving unrelated, tasks; (3) visual interruptions with no tasks added; and (4) no visual interruptions. In the first three conditions drivers glancing on the forward roadway was momentarily interrupted (either with or without a task) just after the potential hazard first became visible by the occurrence of an in-vehicle task lasting two seconds. In the last condition (no interruptions) the driver could not see the potential hazard after it just became visible because of obstructions in the built or natural environment. The obstruction (like the interruption) lasted for two seconds. In other words, across all conditions the hazard was visible, then became invisible, and finally became visible again. Importantly, the results show that the presence of an interruption (as opposed to an obstruction) negatively impacted drivers' ability to anticipate the potential hazard. Moreover, the various types of interruptions had differential effects on hazard detection. The implications of this study for the design of in-vehicle displays are discussed.

Evaluation of the effectiveness of a multi-skill program for training younger drivers on higher cognitive skills.

Training programs exist that prove effective at teaching novice drivers to anticipate latent hazards (RAPT), mitigate hazards (ACT) and maintain attention (FOCAL). The current study (a) measures the effectiveness of a novel integrated training program (SAFE-T) that takes only a third as long to complete compared to the three individual training programs and (b) determines if integrating the training of all the three higher cognitive skills would yield results comparable to the existing programs. Three groups were evaluated: SAFE-T, RAPT and Placebo. The results show that the drivers in the SAFE-T-trained group were more likely to anticipate hazards, quicker and more effective at responding to hazards, and more likely to maintain glance durations under a critical threshold of 2 s as compared to drivers in the Placebo-trained group who received a control program that does not actively train on any of the three cognitive skills. Moreover, the results show that the drivers in the SAFE-T trained group were just as likely to anticipate hazards as the drivers in the RAPT trained group. Finally, when compared with prior studies, the drivers in the SAFE-T trained group showed similar effects of attention maintenance training.

SPIDER: A Framework for Understanding Driver Distraction.

OBJECTIVE: The objective was to identify key cognitive processes that are impaired when drivers divert attention from driving. BACKGROUND: Driver distraction is increasingly recognized as a significant source of injuries and fatalities on the roadway. METHOD/RESULTS: A "SPIDER" model is developed that identifies key cognitive processes that are impaired when drivers divert attention from driving. SPIDER is an acronym standing for scanning, predicting, identifying, decision making, and executing a response. CONCLUSION: When drivers engage in secondary activities unrelated to the task of driving, SPIDER-related processes are impaired, situation awareness is degraded, and the ability to safely operate a motor vehicle may be compromised. APPLICATION: The pattern of interference helps to illuminate the sources of driver distraction and may help guide the integration of new technology into the automobile.

Evaluation of a Risk Awareness Perception Training Program on Novice Teen Driver Behavior at Left-Turn Intersections.

Collisions at left turn intersections are among the most prevalent types of teen driver serious crashes, with inadequate surveillance as a key factor. Risk awareness perception training (RAPT) has shown effectiveness in improving hazard anticipation for latent hazards. The goal of this study was to determine if RAPT version 3 (RAPT-3) improved intersection turning behaviors among novice teen drivers when the hazards were not latent and frequent glancing to multiple locations at the intersection was needed. Teens aged 16-18 with ≤180 days of licensure were randomly assigned to: 1) an intervention group (n=18) that received RAPT-3 (Trained); or 2) a control group (n=19) that received no training (Untrained). Both groups completed RAPT-3 Baseline Assessment and the Trained group completed RAPT-3 Training and RAPT-3 Post Assessment. Training effects were evaluated on a driving simulator. Simulator (gap selection errors and collisions) and eye tracker (traffic check errors) metrics from six left-turn stop sign controlled intersections in the Simulated Driving Assessment (SDA) were analyzed. The Trained group scored significantly higher in RAPT-3 Post Assessment than RAPT-3 Baseline Assessment (p< 0.0001). There were no significant differences in either traffic check and gap selection errors or collisions among Trained and Untrained teens in the SDA. Though Trained teens learned about hazard anticipation related to latent hazards, learning did not translate to performance differences in left-turn stop sign controlled intersections where the hazards were not latent. Our findings point to further research to better understand the challenges teens have with left turn intersections.