Principal Components Analysis of Driving Simulator Variables in Novice Drivers.

Objective: Although driving simulators are powerful tools capable of measuring a wide-ranging set of tactical and operational level driving behaviors, comparing these behaviors across studies is problematic because there is no core set of driving variables to report when assessing driving behavior in simulated driving scenarios. To facilitate comparisons across studies, researchers need consistency in how driving simulator variables combine to assess driving behavior. With inter-study consistency, driving simulator research could support stronger conclusions about safe driving behaviors and more reliably identify future driver training goals. The purpose of the current study was to derive empirically and theoretically meaningful composite scores from driving behaviors of young people in a driving simulator, utilizing driving data from across a variety of driving environments and from within the individual driving environments. Method: One hundred ninety adolescent participants aged 16 years or 18 years at enrollment provided demographic data and drove in a high-fidelity driving simulator. The simulated scenario included 4 distinct environments: Urban, Freeway, Residential, and a Car Following Task (CFT). A Principal Components Analysis (PCA) was conducted on the variable output from the driving simulator to select optimal factor solutions and loadings both across the multi-environmental drive and within the four individual driving environments. Results: The PCA suggested two components from the multi-environmental simulated drive: vehicle control and speed. The individual driving environments also indicated two components: vehicle control and tactical judgment. Conclusion: These findings are among the first steps for identifying composite driving simulator variables to quantify theoretical conceptualizations of driving behavior. Currently, driving behavior and performance measured by driving simulators lack "gold standards" via driving scores or benchmarks. The composites derived in this analysis may be studied for further use where driving behavior standards are increasingly sought by clinicians and practitioners for a variety of populations, as well as by parents concerned about the readiness of their novice driving teen.

Behind the Wheel: Unraveling the Impact of Experience Over Age Over the First 18 Months of Licensure.

OBJECTIVE: This study examined how driving attention develops with age and driving. METHODS: In this observational longitudinal study, 190 adolescents (53% female, 73% Black) were enrolled across four groups: 16- and 18-year olds with and without driving experience. They underwent driving simulation with eye-tracking technology seven times over 18 months. By using a combination of factorial and longitudinal designs, the study examined the individual and combined effects of age and driving experience on driving attention over time. RESULTS: Licensed participants had higher odds of glancing at safety-critical events initially (OR = 15.01, 95% CI: 1.36-165.53), but these odds decreased at higher driving speeds (b = -0.17, p<.01). Average glance length decreased over time (b = -0.26, p=.01), but less so in licensed participants (b=0.14, p=.01). Several visual behaviors were influenced by environmental and driving factors. CONCLUSIONS: Motor vehicle crashes (MVCs) are burdensome and costly to society. This study focused on the role of inattention in MVCs, particularly during the risky period of adolescence. Findings indicated that driving experience, as determined by licensure, had a considerable impact on visual behavior in both the short term (within two weeks of obtaining a license) and over the first 18 months of independent driving. Overall, these findings suggest that licensed adolescents are more likely to identify potential hazards on the road and navigate safely. To ensure effective guidance, pediatric psychologists and other professionals should consider the unique circumstances, needs, and concerns of individual patients.

Severity and correlates of brain fog in people with traumatic brain injury.

Brain fog is one symptom that has been underexplored in traumatic brain injury (TBI). We explored the cognitive and affective correlates of brain fog in people with symptomatic mild TBI (n = 15), moderate-to-severe TBI (n = 15), and a healthy control group (n = 16). Measures across the studies assessed "brain fog" (Mental Clutter Scale), objective cognition (Useful Field of View® and Cogstate Brief Battery®), post-concussive symptoms (Post-Concussion Symptom Scale), and depressive symptoms (Profile of Moods Scale). Brain fog was higher in symptomatic mild TBI and moderate-to-severe TBI compared with healthy controls. Greater brain fog corresponded to greater depressive symptoms in symptomatic mild TBI. Greater brain fog corresponded to poorer episodic memory and working memory in moderate-to-severe TBI. Brain fog appears to reflect challenges in recovery, including depressive symptoms and worse cognitive function. Screening for brain fog might be worthwhile in people with brain injuries.

COVID-19 effects on diet, sleep, and physical activity among mid- to late-adolescents residing in the deep south in the United States.

PURPOSE: This study investigated the differential impact of COVID-19 on United States (US) adolescents' physical health as a function of sociodemographic factors over 18 months. It was hypothesized that the impact of COVID-19 and its mitigation efforts on physical health factors would vary by sociodemographic factors. DESIGN AND METHODS: Data were drawn from a longitudinal study in which participants (ages 16 or 18) self-reported sleep, diet, and physical activity over 18months. Participants were enrolled between 2018 and 2022. Participants (n = 190, 73% Black/African American, 53% female) provided 1330 reports over 194 weeks (93 weeks before and 101 weeks after COVID-19 restrictions implementation). RESULTS: Physical health outcomes moderated by demographic factors were measured and assessed over 18 months. Multilevel models and general estimated equations estimated the impact of COVID-19 restrictions on participants' health outcomes. Sleep and physical activity worsened after COVID-19 regardless of moderating factors, but some specific outcomes varied across subgroups. CONCLUSIONS: This study diversifies the literature on the impact of COVID-19 and its mitigation measures on adolescents' social health. Further, it is based in the US's Deep South, largely populated by those identifying as Black/African American or of low socioeconomic status. Both subgroups are underrepresented in US-based health outcomes research. COVID-19 directly and indirectly impacted adolescents' physical health. PRACTICE IMPLICATIONS: Understanding if and how COVID-19 impacted adolescents' health will inform nursing practice to adapt to and overcome adverse sequelae to promote positive patient health outcomes.

Transportation Barriers and Health-Related Quality of Life in a Sample of Middle-Aged and Older Adults Living with HIV in the Deep South.

Access to reliable transportation is a social determinant of health imperative for disease management for those aging with HIV/AIDS. To what degree transportation barriers are associated with health-related quality of life (HRQOL) in middle-aged and older people living with HIV (PWH) in the Deep South region of the United States is presently unknown. PWH (n = 261, age range = 39 to 73 years old, 80.1% African American, 64.4% male) were recruited from an academic medical center in the Deep South. Variables included sociodemographics, HIV characteristics, depressive symptoms, HRQOL, and perceived transportation barriers. Spearman rho correlations and linear regressions accounting for covariates were conducted. After accounting for covariates, greater perceived transportation barriers were associated with worse health perceptions, pain, social functioning, health distress, and health transitions. Access to reliable transportation is a key factor in improving health for PWH. Considerations for healthcare and traffic safety are discussed.

Executive Function Brain Network Activation Predicts Driving Hazard Detection in ADHD.

Drivers with neurodevelopmental disorders (NDDs), such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are at increased risk of experiencing driving difficulties. An important aspect of driving safety and skill involves hazard detection. This functional magnetic resonance imaging study examined the neural responses associated with driving hazard detection in drivers with ASD, ADHD, and typically developing (TD) drivers. Forty participants (12 ASD, 15 ADHD, 13 TD) ages 16-30 years completed a driving simulator task in which they encountered social and nonsocial hazards; reaction time (RT) for responding to hazards was measured. Participants then completed a similar hazard detection task in the MRI scanner so that neural response to hazards could be measured. Activation of regions of interest considered part of the executive function (EF) and theory of mind (ToM) networks were examined and related to driving simulator behavior. Results showed that stronger activation of the EF network during social hazard processing, including the bilateral dorsolateral prefrontal cortex and posterior parietal cortex, was associated with faster RT to social hazards among drivers with ADHD, but not among drivers with ASD. This provides the first evidence of a relationship between EF network brain activation and driving skills in ADHD and suggests that alterations in this network may underlie driving behavior. In comparison, the current study did not observe a relationship between ToM network activation and RT to social hazards in any group. This study lays the groundwork for relating neural activation to driving behavior among individuals with NDDs.

Gender moderates the relationship between media use and sleep quality.

With high screen time and poor sleep commonly reported in adolescents, it is important to more fully understand how screen time impacts sleep. Despite similar overall screen times, male and female media preferences and usages differ, making it critical to determine if different domains of screen time differentially affect sleep quality. The present study examined whether differing amounts and domains of screen-based media vary in impact on sleep quality of 16-year-old male and female adolescents over a 3-month period. A total of 98 adolescents (mean [SD] age 16.27 [0.29] years; 51% female) completed two online surveys spaced 3 months apart and comprised of well-validated self-reported measures of sleep quality, media usage, and depressive symptoms. The various domains of media were categorised into screen-based media with little-to-no peer-to-peer interaction involved (video-only) and screen-based media with interaction a predominant component to the usage (peer-to-peer interaction-involved). Self-reported sleep quality decreased across the 3-month study period. Gender moderated the effect of interactive screen time on sleep quality 3 months later, with interactive screen time associated with better sleep quality in males, but remaining poorer in females. Screen time competes with sleep time and may do so differentially depending on the media domain. Compared to females, interactive components of screen time may lessen worsening sleep quality over time in males. Understanding the relationships among screen time, its content, age, and gender may inform guidelines for educators, parents, and adolescents to help improve sleep quality of adolescents.

Longitudinal associations between internalizing symptoms and driving avoidance in newly licensed adolescents.

BACKGROUND: Extensive literature assesses risky adolescent driving, but nothing examines what makes teens avoid driving. Many assume teenagers are eager to drive, but evidence suggests internalizing symptoms lead some to avoid driving. AIMS: This study tested whether depressive and anxious symptomology predicted longitudinal driving avoidance in novice teen drivers. MATERIALS AND METHODS: N = 56 16-year-olds (52% female; 48% Black/African American) completed three observations over 6 months. At Time 1, participants reported depressive (Center for Epidemiological Studies Depression 10-item Scale) and anxious (Generalized Anxiety Disorder 7-item Scale) symptomologies, and driving avoidance (Driving Habits Questionnaire [DHQ]), repeating DHQ at Times 2 and 3. Multiple linear regression tested whether symptomologies predicted avoidance at licensure. Linear mixed models tested associations between symptomologies and avoidance over time. RESULTS: High anxiety predicted greater avoidance at baseline and over 6 months. Depressive symptoms did not predict avoidance. DISCUSSION: Findings warrant an assessment of anxious adolescents' barriers to driving and avoidance impacts on crash risk.

Differences in Postinjury Psychological Symptoms Between Collegiate Athletes With Concussions and Orthopedic Injuries.

OBJECTIVE: To describe the differences in postinjury psychological symptoms among Division I collegiate student athletes who sustained concussions versus orthopedic injures and to examine the effects of injury type on postinjury psychological symptoms during the course of recovery. DESIGN: A prospective cohort study with repeated measures. SETTING: Two Big 10 Conference universities. PARTICIPANTS: Student athletes who were at least 18 years old and participated in one of 9 National Collegiate Athletic Association (NCAA) Division I-sponsored sports during the 2007 to 2011 seasons. MAIN OUTCOME MEASURES: Baseline depressive symptoms and anxiety were measured at enrollment. On identification of an eligible injury, follow-up surveys were conducted among injured athletes at multiple intervals until the injured athlete returned to play. Depressive symptoms, anxiety, fear of return-to-play, and fear of reinjury were measured at the postinjury follow-ups. RESULTS: The concussion group had significantly lower scores of fear of return-to-play (B = -0.94, P = 0.0278) and fear of reinjury (B = -1.11, P = 0.0152) compared with the orthopedic injury group. The concussion group scored higher on depressive symptoms than the orthopedic injury group at 1 month after injury (P = 0.0264), although both groups scored similarly at baseline (P = 0.9729) and at 1 week after injury (P = 0.1475). CONCLUSIONS: Patterns of psychological disturbance differ after concussions and orthopedic injures. Further research is warranted to identify the factors contributing to these differences and to develop effective intervention programs to prevent these symptoms.

Personality determinants of subjective executive function in older adults.

Objectives: Problems in subjective executive function, the perceived cognitive control of mental processes for goal-directed behavior, may indicate cognitive impairment in older adulthood. Although, previous studies highlight the importance of personality on objective cognitive performance, no studies clarify their role with subjective executive function. To inform methods of early identification of cognitive impairment, this study explored how temperament and personality traits account for problems in subjective executive function.Method: The current project examined the associations between temperament and personality on subjective executive function across two samples of community-dwelling older adults (65+ years, n1 = 25, n2 = 50). Both studies measured subjective executive function (Behavioral Rating Inventory of Executive Function-Adult) and separately administered scales on temperament (Adult Temperament Questionnaire) and personality (Big Five Inventory).Results: Concerning temperament, older adults higher in negative affect endorsed greater difficulty in subjective executive function. Regarding personality traits, older adults with higher neuroticism and lower conscientiousness reported higher difficulty in subjective executive function.Conclusion: Findings enhance our understanding of subtle cognitive changes and may aid in early detection. In particular, distressful inclinations were associated with more reported problems in executive function whereas problem-solving tendencies were inversely related. Future work should examine if enhanced negativity coupled with analytical disengagement predicts problems in subjective executive function over time.

Distracted Walking, Bicycling, and Driving: Systematic Review and Meta-Analysis of Mobile Technology and Youth Crash Risk.

This article examined the impact of mobile technology on young pedestrians, bicyclists, and drivers. A systematic search yielded 41 articles meeting inclusion criteria: peer-reviewed, published before February 1, 2016, behavioral outcome related to pedestrian, bicycling, or driving in the presence of mobile technology use, youth sample. Eleven studies were meta-analyzed to evaluate increased risk for crash/near-crash while distracted. Risk of bias and quality of research were assessed. Across methodologies, developmental stages, and type of distracting task, mobile technology use impairs youth safety on the road. Quality of evidence was low (pedestrian) to moderate (driving). Findings are discussed from the perspective of cognitive and visual distractions. Policy and behavioral efforts should continue to reduce mobile technology use in transportation settings.

Return to Driving After Hip Arthroscopy.

OBJECTIVE: The objective of this study was to evaluate patients' braking performance using a modern driving simulator after undergoing a right hip arthroscopy. DESIGN: This prospective study included 5 total driving sessions at which measurements were taken. SETTING: The study was conducted at an academic medical center. PATIENTS: A total of 14 patients scheduled to undergo a right hip arthroscopy were enrolled and compared with a control group of 17 participants to account for a potential learning phenomenon. INTERVENTIONS: Patients drove in the simulator preoperatively to establish a baseline, and then drove again at 2, 4, 6, and 8 weeks postoperatively. The control group did not undergo any type of surgical procedure. The main independent variable was time from surgery. MAIN OUTCOME MEASURES: A modern driving simulator was used to measure initial reaction time (IRT), throttle release time (TRT), foot movement time (FMT), and brake travel time (BTT). The braking reaction time (BRT) was calculated as the sum of IRT + TRT + FMT, and the total braking time (TBT) was calculated as the sum of BRT + BTT. RESULTS: The experimental group showed no significant changes in BTT (P = 0.11, (Equation is included in full-text article.)= 0.04) nor TBT (P = 0.20, (Equation is included in full-text article.)= 0.03) over the duration of 8 weeks. Although the experimental group did exhibit significant improvements in IRT (P = 0.002), TRT (P < 0.0001), FMT (P < 0.0001), and BRT (P = 0.0002) between preoperative and 2 weeks postoperative driving sessions, there were no significant changes thereafter. The mean preoperative TBT and 2 weeks postoperative TBT for the experimental group were 3.07 seconds (SD = 0.50) and 2.97 seconds (SD = 0.57), respectively. No learning phenomenon was observed in the control group. CONCLUSIONS: This study's findings suggest that patients may return to driving 2 weeks postoperatively from a right-sided hip arthroscopy procedure.

Visual Behavior Differences in Drivers Across the Lifespan: A Digital Billboard Simulator Study.

Driver distraction is implicated in a significant portion of motor vehicle collisions; evidence has suggested that billboards can contribute to such distraction, but many knowledge gaps remain. The purpose of this study was to evaluate the effects of various types of billboards (static, 250-foot digital transition, 500-foot digital transition, and a control [no billboard] condition) and age group (teen, middle, and older) on visual behavior through the use of a driving simulator. To address gaps in the existing literature, the effects of age group and billboard type on the following visual attention variables were considered: percent of time participants looked at billboards, average glance length, number of glances, and glance pattern activity. Significant main effects of age group were found, suggesting that teen drivers exhibited significantly different visual behavior as compared to drivers in the other age groups. An Age Group x Billboard Type interaction for one outcome provided some evidence that percent of time spent looking at billboards significantly increased as billboard transition time increased for drivers, except for older adults, who spent more time looking at static billboards. This study helps lay the groundwork for future studies that may consider how young drivers' differential scanning patterns impact driving safety.

Distracted Driving in Teens With and Without Attention-Deficit/Hyperactivity Disorder.

OBJECTIVE: This study is among the first to examine the effect of talking on a cell phone or text messaging while driving in teens with and without attention deficit/hyperactivity disorder (ADHD). METHOD: Teens (average age 17years) with a diagnosis of ADHD (N=16) were matched with typically developing controls (N=18). All participants operated a driving simulator while (1) conversing on a cell phone, (2) text messaging, and (3) with no distraction during a baseline condition. Six indicators of driving performance were recorded: (a) time to complete the drive; (b) lane deviations; (c) variability in lane position (i.e., root mean square [RMS]); (d) reaction time; (e) motor vehicle collisions; and, (f) speed fluctuation. RESULTS: Significantly greater variation in lane position occurred in the texting task compared to no task and the cell phone task. While texting, in particular, teens with ADHD took significantly less time to complete the scenario. No significant main effects of group were found. CONCLUSIONS: Generally, those with ADHD did not differ in regard to driving performance, when compared to controls, with the exception of one outcome: time to complete scenario. These findings suggest that distracted driving impairs driving performance of teen drivers, regardless of ADHD status. Texting while driving had the greatest negative impact on driving performance, particularly with regard to variability in lane position (i.e., RMS). This study sheds light on key issues regarding injury prevention, with the intent of providing pediatric care providers with the knowledge to inform teen drivers of risks associated with distracted driving which will ultimately result in reduced rates of motor vehicle crashes and concomitant injuries.

Risky driving behavior among individuals with Autism, ADHD, and typically developing persons.

INTRODUCTION: Many individuals with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) often experience difficulty with driving, including difficulty with obtaining a driver's license as well as driving safely and efficiently. Such difficulties negatively impact their ability to function independently and participate in daily activities that require driving. ASD and ADHD commonly occur co-morbidly and share many overlapping clinical features. Few studies have directly compared the nature of difficulties in driving safety outcomes between ASD and ADHD. The overarching goal of the current study was to characterize and compare self-reported driving behavior among young autistic drivers, ADHD drivers, and typically developing (TD) drivers. METHOD: Fifty-four participants (14 ASD, 20 ADHD, 20 TD); ages 16-30) completed the Autism Spectrum Quotient and ADHD Adult Rating scale as a method of screening of symptoms. All three groups then completed the Driving Behavior Questionnaire (DBQ), which measured self-reported driving violations, driving errors, and overall risky driving behavior. The three groups of ASD, ADHD, and TD individuals were then compared regarding symptomology and driving behavior differences. RESULTS: One-way ANOVAs indicated group differences in DBQ total scores and DBQ errors. Drivers with ADHD reported significantly greater overall risky driving behaviors and driving errors compared to ASD and TD drivers. There were no significant differences between ASD and TD drivers in reported risky driving behaviors and errors. Linear regressions indicated that among all drivers, self-reported ADHD symptoms were significantly associated with higher levels of self-reported overall risky driving and driving errors, regardless of diagnostic group. DISCUSSION: Risky driving and driving errors may be more closely related to symptoms that are characteristic of ADHD. This has implications for individuals with ADHD and autistic individuals who often show or report higher rates of ADHD symptoms. Future studies should compare driving skills of ASD and ADHD drivers using objective measures of driving performance, such as driving simulators or on-road tests.

Moderate-to-Vigorous Physical Activity and Response Inhibition Predict Balance in Adults with Attention Deficit/Hyperactivity Disorder.

Background: Some evidence indicates that adults with attention deficit hyperactivity disorder (ADHD) may have balance impairments. This study examined the associations between moderate-to-vigorous physical activity (MVPA), response inhibition (RI), and static balance in this population while off and on psychostimulant medication (PS). Methods: Participants (n = 40; 30 females; M age = 29.0; SD = 6.3 years) wore an ActiGraph GT9X-link around their waist to estimate MVPA levels (minutes/day). To assess RI, participants completed the Delis-Kaplan Executive Function System (D-KEFS) subtests Trail-Making Test (TMT) and Color-Word Interference Test (CWIT). To evaluate static balance, participants completed postural sway area (cm2) assessments in four conditions: feet-apart eyes-open (FAEO), feet-apart eyes-closed (FAEC), feet-together eyes-open (FTEO), and feet-together eyes-closed (FTEC). Participants also completed the single-leg standing tests (seconds) with eyes open (SLEO) and with eyes closed (SLEC). Results: When off medication, MVPA significantly predicted SLEC (ß = 0.30; p = 0.017). MVPA and TMT significantly predicted FTEO, explaining ~19% of the variance in FTEO; both MVPA and TMT were significant predictors (ß = -0.33, p = 0.027 and ß = -0.31, p = 0.039, respectively). When on medication, TMT significantly predicted FAEC (ß = 0.17; p = 0.047). Conclusions: MVPA and RI may be effective parameters in predicting static balance in adults with ADHD when off medication only.

R2DRV: study protocol for longitudinal assessment of driving after mild TBI in young drivers.

BACKGROUND: Mild traumatic brain injury (mTBI) and traffic-related injuries are two major public health problems disproportionately affecting young people. Young drivers, whose driving skills are still developing, are particularly vulnerable to impaired driving due to brain injuries. Despite this, there is a paucity of research on how mTBI impacts driving and when it is safe to return to drive after an mTBI. This paper describes the protocol of the study, R2DRV, Longitudinal Assessment of Driving After Mild TBI in Young Drivers, which examines the trajectory of simulated driving performance and self-reported driving behaviors from acutely post-injury to symptom resolution among young drivers with mTBI compared to matched healthy drivers. Additionally, this study investigates the associations of acute post-injury neurocognitive function and cognitive load with driving among young drivers with and without mTBI. METHODS: A total of 200 young drivers (ages 16 to 24) are enrolled from two study sites, including 100 (50 per site) with a physician-confirmed isolated mTBI, along with 100 (50 per site) healthy drivers without a history of TBI matched 1:1 for age, sex, driving experience, and athlete status. The study assesses primary driving outcomes using two approaches: (1) high-fidelity driving simulators to evaluate driving performance across four experimental study conditions at multiple time points (within 96 h of injury and weekly until symptom resolution or 8 weeks post-injury); (2) daily self-report surveys on real-world driving behaviors completed by all participants. DISCUSSION: This study will fill critical knowledge gaps by longitudinally assessing driving performance and behaviors in young drivers with mTBI, as compared to matched healthy drivers, from acutely post-injury to symptom resolution. The research strategy enables evaluating how increased cognitive load may exacerbate the effects of mTBI on driving, and how post-mTBI neurocognitive deficits may impact the driving ability of young drivers. Findings will be shared through scientific conferences, peer-reviewed journals, and media outreach to care providers and the public.

Predictors of health-related quality-of-life following traumatic brain injury.

PRIMARY OBJECTIVE: To examine the predictive associations of family satisfaction, functional impairment, pain, and depression on health-related quality-of-life (HRQoL) among persons with traumatic brain injury (TBI) through structural equation modelling (SEM). RESEARCH DESIGN: Participants were part of a larger longitudinal study of adjustment following TBI. Direct and indirect effects of predictor variables on HRQoL were analyzed through SEM. METHODS AND PROCEDURES: The sample included 131 participants with TBI (89 men, 42 women) who had been discharged from an acute care hospital. The Sickness Impact Profile was administered to measure HRQoL at or beyond 24 months post-discharge. Predictor variable measures included the Functional Independence Measure, Family Satisfaction Scale and single items assessing the presence of pain and depression. MAIN OUTCOMES AND RESULTS: SEM revealed direct effects of functional impairment (p < 0.001), family satisfaction (p < 0.01), depression (p < 0.05) and pain (p < 0.01) on HRQoL. Indirect effects from functional impairment (p < 0.05) and pain (p < 0.05) to HRQoL through depression were also present. CONCLUSIONS: The presence of pain and depression, greater functional impairment and lower family satisfaction were predictively associated with lower HRQoL. Depression further mediated the effects of pain and functional impairment on HRQoL. The present study advances understanding of the ways in which pain, depression and functional impairment predict HRQoL.

Driving performance acutely after mTBI among young drivers.

OBJECTIVE: Mild traumatic brain injury (mTBI) can impair executive function, learning, and memory, which can negatively impact driving ability. However, little is known how the driving performance of young drivers may be impacted acutely after mTBI. This study aimed to evaluate simulated driving within 96 h of mTBI among young drivers as compared to matched healthy controls, and assess the effects of increased cognitive load on driving performance. METHODS: Injured young drivers ages 16 to 24 with physician-confirmed mTBI were enrolled from two sites (University of Alabama at Birmingham and Ohio State University) and completed the assessment on a high-fidelity driving simulator within 96 h of injury. Matched healthy controls were young drivers without mTBIs matched with an index mTBI by age, sex, athlete status, and driving experience. Participants drove four scenarios in a 2x2 design: with/without cognitive load and with/without critical events. Linear mixed models were used to compare the driving outcomes between mTBI drivers and healthy controls. RESULTS: A total of 38 participants were included, with 25 cases and 13 controls. Standard deviation of lateral position, following distance and reaction time were analyzed. The preliminary findings indicated that mTBI drivers tended to maintain more distance to the car in front of them than healthy controls. High cognitive load was associated with slower reaction time regardless of TBI status. CONCLUSIONS: This study is the first to assess simulated driving performance among young drivers with mTBI acutely post-injury. The findings will have important clinical implications on when young drivers may return to driver post-mTBI and at what conditions. Additional research is warranted to confirm these results.