Improving ADHD Teen Driving
Condition: Attention Deficit Disorder; Attention Deficit Disorder With Hyperactivity
MeSH terms: Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      Teens with Attention-Deficit/Hyperactivity Disorder (ADHD) have high rates of negative
      driving outcomes, including motor vehicle crashes, which may be caused by visual inattention
      (i.e., looking away from the roadway to perform secondary tasks). A driving intervention that
      trains teens to reduce instances of looking away from the roadway will be tested in teens
      with ADHD.
    

Detailed description: 
      Operating a motor vehicle requires a complex set of skills, the most important of which is
      the ability to continuously visually attend to the roadway. Glances away from the roadway
      significantly increase one's risk for a motor vehicle crash (MVC). Teen drivers evidence far
      more extended glances away from the roadway than experienced drivers. Further, teens with a
      diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) emit 3-times more extended
      glances away from the roadway than typical teens. There is a clear need for interventions,
      particularly one that targets extended glances away from the roadway, to address the driving
      deficits of teens with ADHD. The proposed research will test the efficacy of the FOcused
      Concentration and Attention Learning (FOCAL) intervention, which targets reducing the number
      of extended glances away from the roadway, among teens with ADHD. The PC-based FOCAL training
      provides teens with an operational understanding of the dangers of extended glances away from
      the roadway and trains them on limiting the length of the teens' glances. The investigators
      have enhanced the FOCAL intervention (now termed FOCAL+) to include multiple training
      sessions and to integrate practice on a driving simulator with immediate feedback regarding
      extended glance behavior. In this randomized trial, teens with ADHD will be randomly assigned
      to receive either FOCAL+ or a sham placebo group. Immediately after 1 month of training
      sessions and 6-months post-training, teens' driving skills will be assessed using a driving
      simulator. In addition, teens will have cameras installed in their cars for 12-months which
      record driver behavior and road conditions during irregular events (e.g., hard-braking,
      swerving). Using data from driving simulation, cameras installed in the teen's car, and teen
      driving records, the investigators will examine the short- and long-term efficacy of the
      FOCAL+ intervention on 1) decreasing rates of extended glances away from the roadway among
      teens with ADHD, and 2) improving driving performance among teens with ADHD.
    

Intervention name(s): FOCAL+; Rules of The road
Intervention type(s): Behavioral; Other
Intervention description(s): Weekly for 5 weeks, teens complete a computer training program designed to train teens to limit the length of glances away from the roadway. On a computer, the top portion of the screen plays a simulated video drive while the bottom half of the screen contains a map. Teens complete tasks that require switching between the 2 halves of the screen. While doing so, they receive feedback regarding how long they are looking away from the driving portion of the screen. After each session of computerized FOCAL training, teens will complete two 5-minute simulated drives. During the drives, teens will be cued to a complete a visual search task which will require them to divert their gaze from the road. Eye tracking goggles will monitor eye glances and provide real time auditory feedback when a visual glance away from the roadway exceeds 2 secs.; Weekly for 5 weeks, teens will perform computer-based training regarding traffic codes, laws, and rules of the road. After each computerized training, teens will complete two 5-minute drives. This time in the driving simulator will be contextualized as a time for them to practice the rules of the road they learned during training. Importantly, teens in the sham intervention group will complete the same distraction tasks but will NOT receive any feedback regarding their eye gaze during simulated driving.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Visual Attention; Automobile Driving