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Trial of Training to Reduce Driver Inattention in Teens with ADHD.
Epstein, Jeffery N; Garner, Annie A; Kiefer, Adam W; Peugh, James; Tamm, Leanne; MacPherson, Ryan P; Simon, John O; Fisher, Donald L.
Afiliación
  • Epstein JN; From the Department of Pediatrics, Cincinnati Children's Hospital Medical Center (J.N.E., J.P., L.T., J.O.S.), and the University of Cincinnati College of Medicine (J.N.E., J.P., L.T.) - both in Cincinnati; the Department of Psychology, Saint Louis University, St. Louis (A.A.G.); the Department of E
  • Garner AA; From the Department of Pediatrics, Cincinnati Children's Hospital Medical Center (J.N.E., J.P., L.T., J.O.S.), and the University of Cincinnati College of Medicine (J.N.E., J.P., L.T.) - both in Cincinnati; the Department of Psychology, Saint Louis University, St. Louis (A.A.G.); the Department of E
  • Kiefer AW; From the Department of Pediatrics, Cincinnati Children's Hospital Medical Center (J.N.E., J.P., L.T., J.O.S.), and the University of Cincinnati College of Medicine (J.N.E., J.P., L.T.) - both in Cincinnati; the Department of Psychology, Saint Louis University, St. Louis (A.A.G.); the Department of E
  • Peugh J; From the Department of Pediatrics, Cincinnati Children's Hospital Medical Center (J.N.E., J.P., L.T., J.O.S.), and the University of Cincinnati College of Medicine (J.N.E., J.P., L.T.) - both in Cincinnati; the Department of Psychology, Saint Louis University, St. Louis (A.A.G.); the Department of E
  • Tamm L; From the Department of Pediatrics, Cincinnati Children's Hospital Medical Center (J.N.E., J.P., L.T., J.O.S.), and the University of Cincinnati College of Medicine (J.N.E., J.P., L.T.) - both in Cincinnati; the Department of Psychology, Saint Louis University, St. Louis (A.A.G.); the Department of E
  • MacPherson RP; From the Department of Pediatrics, Cincinnati Children's Hospital Medical Center (J.N.E., J.P., L.T., J.O.S.), and the University of Cincinnati College of Medicine (J.N.E., J.P., L.T.) - both in Cincinnati; the Department of Psychology, Saint Louis University, St. Louis (A.A.G.); the Department of E
  • Simon JO; From the Department of Pediatrics, Cincinnati Children's Hospital Medical Center (J.N.E., J.P., L.T., J.O.S.), and the University of Cincinnati College of Medicine (J.N.E., J.P., L.T.) - both in Cincinnati; the Department of Psychology, Saint Louis University, St. Louis (A.A.G.); the Department of E
  • Fisher DL; From the Department of Pediatrics, Cincinnati Children's Hospital Medical Center (J.N.E., J.P., L.T., J.O.S.), and the University of Cincinnati College of Medicine (J.N.E., J.P., L.T.) - both in Cincinnati; the Department of Psychology, Saint Louis University, St. Louis (A.A.G.); the Department of E
N Engl J Med ; 387(22): 2056-2066, 2022 12 01.
Article en En | MEDLINE | ID: mdl-36449421
ABSTRACT

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 11 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.).
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trastorno por Déficit de Atención con Hiperactividad / Conducción de Automóvil / Simulación por Computador / Accidentes de Tránsito / Conducción Distraída Tipo de estudio: Clinical_trials / Etiology_studies Límite: Adolescent / Adult / Humans País/Región como asunto: America do norte Idioma: En Revista: N Engl J Med Año: 2022 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trastorno por Déficit de Atención con Hiperactividad / Conducción de Automóvil / Simulación por Computador / Accidentes de Tránsito / Conducción Distraída Tipo de estudio: Clinical_trials / Etiology_studies Límite: Adolescent / Adult / Humans País/Región como asunto: America do norte Idioma: En Revista: N Engl J Med Año: 2022 Tipo del documento: Article