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.

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.

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.

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.

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.

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.

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.

Time-to-Collision Estimations in Young Drivers with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder.

Individuals with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) may exhibit driving difficulties due to cognitive impairments such as time perception difficulties, a construct related to the perception of time-to-collision (TTC). This study examined the timing abilities of drivers with ASD and ADHD. Sixty participants (nADHD = 20, nASD = 20, nTD = 20) completed a time reproduction task and a TTC estimation task in a driving simulator. Results indicated drivers with ASD were less precise in time reproduction across all time intervals and over-reproduced time at shorter intervals. Drivers with ASD produced larger TTC estimates when driving at a faster speed compared to typically developing drivers. Drivers with ASD, but not ADHD, appear to present difficulties in time estimation abilities.

The effect of prior night sleep on simulated driving performance in medical residents.

OBJECTIVE: Indications of driving performance negatively affected by poor sleep often occur early in simulated driving experiments and are measured to progress over relatively large epochs of time. How driving performance changes over smaller increments of time as a function of not only sleep quantity but also sleep quality is largely unknown. The overall objective of this work in progress is to examine the trajectory of driving performance in medical residents as a function of the prior night's sleep quality using a high-fidelity driving simulator. METHOD: Thirty-two medical residents were enrolled and wore sleep tracking devices for up to 2 weeks. The residents drove a 16-min scenario in a high-fidelity driving simulator. A mixed effects model was used to estimate baseline intercept and slope of simulated driving performance over the course of the drive. The slope of driving performance over the drive and actigraphy-estimated sleep variables from the prior 24 h served as predictors. RESULTS: Preliminary descriptive findings indicate a wide range of sleep quality metrics in the sample. CONCLUSIONS: This study is among the first to focus on the trajectory of driving performance over small continuous epochs of time when simulated driving performance may first begin to degrade. Further, objective estimates of sleep using actigraphy as predictors of the next day's driving will enhance our understanding of the potential "dose-response" between low sleep quality and crash risk in the following 24 hours.

Interactive Effects of Neighborhood Safety and Screen Time on Adolescent Internalizing Symptoms.

OBJECTIVE: Perceptions of less neighborhood safety and higher levels of screen time are independently linked to adolescent anxiety and depression. Furthermore, residing in a neighborhood perceived as less safe is associated with engaging in higher levels of screen time. Screen time may act as a potential mechanism by which the effects of neighborhood safety on internalizing symptoms differ. Yet, research has not investigated whether the relationship between neighborhood safety and psychosocial adjustment varies at high and low levels of screen time. Therefore, this study examined the interaction between perceived neighborhood safety and screen time on adolescent internalizing symptoms (i.e., anxiety and depressive symptoms). METHOD: A total of 184 adolescents (53% female; mean age = 17.09, SD = 1.07) were recruited from an ongoing longitudinal study of adolescent drivers. Participants reported their perceptions of neighborhood safety, screen use, anxiety and depressive symptoms, and demographic characteristics. The independent and interactive contributions of neighborhood safety and screen time predicting anxiety and depressive symptoms in adolescents were tested with hierarchical linear regressions. RESULTS: Perceptions of less neighborhood safety and higher levels of screen time each uniquely predicted adolescent anxiety and depressive symptoms. The relationship between living in a neighborhood perceived as less safe and anxiety symptoms was stronger for youth with high levels of screen time. CONCLUSION: The findings suggest that youth residing in less safe neighborhoods may have higher levels of anxiety symptoms, and this anxiety symptomology is higher at high levels of screen time.

Validation of the attention-related driving errors scale in novice adolescent drivers.

INTRODUCTION: Motor vehicle collisions (MVCs) are a leading cause of death among adolescents. Identifying factors that contribute to adolescent MVCs is a pressing public health need. Exogenous (cell phones, passengers, music) and endogenous (stress, worry, mind-wandering) forms of driver inattention account for approximately 78% of all MVCs in the United States. Though both exogenous and endogenous distraction contribute to crash risk, prior work investigating adolescent crash risk has largely focused on exogenous distractors. The Attention-Related Driving Errors Scale (ARDES) is a promising measure assessing individual differences in endogenous driver inattention that has been validated in adult drivers. Its validation in an adolescent sample may prove useful in tailoring future interventions to decrease MVC risk in young drivers. METHODS: This study sought to validate the ARDES in novice adolescent drivers by investigating its underlying factor structure and its relations with self-reported measures of daily inattention, performance-based attention assessments, and a self-report measure of driving behavior. RESULTS: Replicating earlier work in adults, results suggested ARDES items can be classified according to their operational level of the driving. The ARDES had good internal reliability and construct validity, suggesting it is a valid self-report measure of the propensity for adolescents' attentional errors while driving. DISCUSSION: The ARDES provides a useful tool for researchers to identify adolescents at greater risk of attentional errors while driving. Future research should use the ARDES to better understand the role of driver inattention in adolescent crash risk.

Trajectories of self-regulatory driving practices: Role of learner phase practice.

INTRODUCTION: Previous research suggests that driving practice in diverse contexts may contribute to earlier licensure and improve driving skills among teen drivers. However, few studies have examined the role of practice diversity in driving outcomes post-licensure. Specifically, examining self-regulatory driving practices post-licensure may provide insight into the extent to which teens choose to avoid driving various environments. The current study examined the relationship between learner phase driving practice diversity and teen self-regulatory driving practices over the first six months of licensure. METHODS: Fifty-six newly licensed 16-year-olds reported pre-licensure practice diversity, driving exposure and, self-regulatory driving practices at three timepoints (within 2 weeks of licensure and at 3 and 6 months post-licensure). RESULTS: Multi-level models revealed self-regulatory driving practices significantly decreased over the first six months of independent driving. Practice in complex environments (e.g., on a commercial road, on a highway, etc.) was associated with fewer self-regulatory driving practices at baseline. Practice in simple environments (e.g., in a residential area, in a parking lot) was associated with more self-regulatory driving practices at baseline. Practice driving at night and in bad weather conditions predicted greater post-licensure self-regulation of driving in those specific environments. CONCLUSION: This study reinforces the importance of practice diversity for teens before independent driving, as early practice can have implications for self-regulatory driving practices immediately upon licensure. Future research examining this topic may inform parent-based interventions to maximize teen driver safety during the critical post-licensure period.

Developmental trajectories of driving attention in adolescents: Preliminary findings from REACT.

OBJECTIVE: To characterize the trajectory of driving attention as a function of age and driving experience. Hypotheses. The rate of change in driving attention will be greater for 16- compared to 18-year-olds and those acquiring driving experience (vs. non-drivers). Age and driving experience will interact, with the effect of driving experience being stronger among 16- compared to 18-year-olds. METHODS: In this longitudinal study, 190 adolescents were enrolled into 4 groups: (1) 16-year-olds and (2) 18-year-olds recruited within 2 weeks of obtaining a full driver's license; (3) 16-year-olds and (4) 18-year-olds with no driving experience (no permit/license, no intention to obtain either over study period). At seven time points over 18 months, participants drove in a high-fidelity driving simulator integrated with eye tracking. Participants completed three experimental drives with three safety critical events and varying cognitive load conditions. Driving attention was measured by vertical and horizontal eye movements, number of glances, and glance length. A multilevel model using SAS PROC MIXED (SAS 9.4) will estimate the baseline intercept and slope of driving attention over time, with baseline age, driving experience, and their interaction serving as predictors of intercept and slope. RESULTS: Preliminary analyses suggest driving attention changes over time as a function of age, driving experience, and across cognitive load conditions. CONCLUSIONS: Inattention is the primary contributor to motor vehicle crashes. It is critical to gain a clear understanding of how driving attention changes during adolescence, the riskiest developmental period for drivers. Results will reveal how driving impacts attention development through practice, providing a target for intervention.

Demographic, driving experience, and psychosocial predictors of adolescent distracted driving beliefs.

PURPOSE: The current study had three aims: 1) describe distracted driving beliefs among adolescents by various distraction types (i.e., talking on a hands-free/hands-held cell phone, texting or emailing, taking "selfies," and updating/checking social media); 2) examine the factor structure of distracted driving beliefs; and 3) test whether individual difference factors, shown in prior work to be related to distracted driving behavior, significantly predicted factors of distracted driving beliefs. METHODS: Three hundred seventy-nine high school students enrolled in non-mandatory Driver's Education courses completed surveys of distracted driving beliefs, sensation seeking, and demographics. RESULTS: A factor analysis revealed four factors of distracted driving beliefs: 1) self-acceptance of interacting with a cell phone while driving; 2) perceived peer acceptance of interacting with a cell phone while driving; 3) perceived threat of distracted driving to personal safety; and 4) self- and peer- acceptance of talking on a cell phone while driving. Adolescents perceived a greater threat to safety and less self- and peer-acceptance of interacting with cell phones while driving (i.e., texting/emailing, updating/posting to social media, taking selfies) than talking on a cell phone while driving. In general, men, those with more driving experience, higher in sensation seeking, and those placing more importance on checking notifications on a phone had riskier beliefs about distracted driving. CONCLUSION: Findings suggest adolescent distracted driving beliefs are influenced by individual difference factors, providing some knowledge about the motivations for distracted driving. Future work should consider novel strategies for intervening to reduce this common yet extremely dangerous behavior among adolescents.

Data Reduction Solution for Driving Simulator.

This paper describes the methods that have been developed and implemented to process research participant data generated by a high fidelity driving simulator that has been integrated with eye tracking equipment. The driving simulator is used for experimental studies to understand driving behavior. Solutions are implemented to programmatically process the output of the simulator and transform the raw data from these research experiments to an analysis ready format. The algorithm is tested across the data for numerous participants with varying scenarios within the experiments and is further curated to meet the requirements and standards of the research studies that require the use of driving simulator to generate data.

Sleep and stress before and after duty across residency years under 2017 ACGME hours.

INTRODUCTION: Residents may differentially experience high stress and poor sleep across multiple post-graduate years (PGYs), negatively affecting safety. This study characterized sleep and stress among medical and surgical residents across multiple PGYs and at specific times surrounding duty. METHOD: Thirty-two medical and surgical residents (Mage = 28.6 years; 56% male) across PGYs 1-5 participated in 3 appointments (immediately before duty, after duty, and on an off day) providing 96 data points. Sleep, stress, and occupational fatigue were measured by both self-report and objectively (actigraphy, salivary coritsol). RESULTS: Residents averaged 7 h of actigraphy-estimated sleep per night but varied ±3 h day-to-day. Residents reported clinically poor sleep quality. Life stress decreased by PGY-2. All residents averaged elevated life stress values. Poor sleep quality did not differ among PGY cohorts. DISCUSSION: Poor sleep quality is similar between early residency cohorts (PGY-1) and later residency cohorts (PGY-3+). Persistent fatigue is highest in later residency cohorts. Even the most experienced residents may struggle with persisting fatigue. Current hour policies may have shortcomings in addressing this risk.

Adolescent driving behavior before and during restrictions related to COVID-19.

INTRODUCTION: Understanding who heeds the driving-related COVID-19 restrictions is critical for assisting public health professionals improve response to this and future pandemic events. The purpose of the current study was to characterize driving behavior changes among adolescents as a function of COVID-19 restrictions. It was hypothesized that adolescent driving would be reduced by COVID-19 restrictions, especially for younger teens, non-minorities, females, non-working teens, and those with higher prosocial tendencies. METHODS: Participants were licensed drivers in "REACT," a longitudinal study of adolescent driving attention. Upon enrollment in REACT, drivers were required to be age 16 or 18, have been issued a driver's license within the last two weeks, and be fluent in written/spoken English. The current observational cohort study was of drivers reporting driving exposure between February 8 and April 22, 2020. Linear mixed-effects models estimated differences in driving changes between COVID-19 periods. RESULTS: Results indicated a decrease across pre-COVID-19 period (February 8 - March 13, 2020) in days driven per week and vehicle miles driven (VMD) was explained by the change of slope post-COVID-19 restrictions (March 14 - April 22, 2020). Post-COVID-19, driving days per week decreased by 37 % and VMD decreased by 35 %. This decrease was lower in ethnic minorities, older adolescents, and employed adolescents. Those with greater dire prosocial tendencies showed greater post-COVID-19 driving decline. DISCUSSION: Findings provide early evidence of COVID-19 restriction-related adolescent driving changes suggesting older, employed, minority teens and teens with lower prosocial tendencies are less likely to reduce driving behavior. These observations provide a foundation for more extensive studies of adolescent drivers during various driving and contact restrictions and inform future public health campaigns for social distancing.

Impact of adolescent media multitasking on cognition and driving safety.

Adolescence is a critical period in brain development particularly in regions related to attention and executive function (EF). As the use of electronics and media in daily activities increases, one essential question is how adolescent attention development and related executive and speed processes are impacted by media multitasking (MM), or the simultaneous use of media (e.g., text messaging while watching television). This review examines current literature concerning (a) the prevalence of MM during adolescence; (b) relations between MM and adolescent cognitive development, specifically attention, speed of processing, and EF; and (c) real-world implications of MM including adolescents and driver distraction. Finally, future challenges and opportunities in MM research are explored with special attention given to overcoming the limitations of current research in this area and the critical need to advance our understanding of the impact of MM on adolescent driver safety.