Doctors’ Notes


Teen Driving

Most teenagers are excited about driving, and can’t wait to get their learner’s permit and get behind the wheel! However, it’s easy for them and their parents to forget that this an important milestone that comes with great responsibility.

A teenager may be (chronologically) “old enough,” but not (psychologically) “mature enough” to master the complex task of driving. The stats are very scary indeed.

The most common cause of death in the US for kids between ages 16 and 20 is MOTOR VEHICLE ACCIDENTS. Pennsylvania is one of the only states in which teenaged applicants for a non-commercial learner’s permit must receive medical certification, to ensure they don’t have a condition that seriously impairs their ability to drive. We recommend that all pediatricians incorporate a routine “readiness to drive” assessment for their teen patients who are age-eligible and expressing interest in driving. Just as we place a great deal of focus on sports participation to identify fitness to safely engage in team sports, we should apply the same vigilance when it comes to driving, which can be a matter of life and death.

Dr. Huang and Dr. Flaura Winston of The Children’s Hospital Of Pennsylvania recommend the following questions to consider in assessing driving readiness:

  • Do you feel your teen consistently demonstrates good judgment and maturity at school around peers, and at home, and is receptive to constructive criticism and instruction? Is he/she ready to accept responsibility for his/her safety and that of those around him/her?
  • Is your teen demonstrating knowledge of the rules of the road and other proficiencies based on lessons learned in driver education classes? If not , is your teen not ready to drive or is in need of specialized instructions?
  • Is your teen agreeable to practicing driving (for at least 65 hours required in Pennsylvania as of December 2011) with a skilled adult prior to driving independently; is there an adult who is willing/ able to serve in this important role?
  • Are there any medical and physical issues (untreated seizures, significant uncorrected visual impairment, uncontrolled diabetes, amputation, concussion) that may prevent him/her from driving safely?
  • Are there any behavioral or neuropsychiatric issues (drug dependence, depression, ADHD, intellectual disability) that may prevent him/her from driving safely?
  • Are there medical interventions that may be needed to ensure safe driving behaviors, such as stimulant medication for treatment of ADHD?

Teens who have conditions that impair their physical, developmental, visual/fine motor and cognitive skills are at risk for unsafe driving behaviors. For instance, teens with ADHD may be at much greater risk, as they tend to be more impulsive, have impaired reaction times, and have difficulty when it comes to planning, strategizing, and attending to detail during complex tasks.Teens with autism spectrum disorders may have difficulty recognizing the cues of other drivers on the road.

But the good news is that appropriate treatment with medication has been shown to improve the driving performance of adolescents with ADHD — both in virtual-reality driving simulators (in which drivers are exposed to high risk driving demands) and routine on-road driving in their own vehicles. Stimulant medication, when prescribed (and optimally dosed and carefully controlled) must be taken 7 days a week, without fail. Some teens think they don’t need to take their medication on weekends, but that is when they are more likely to drive!

Finally, here are some Keys to Being a Safe Driver:

  • Always wear a seat belt.
  • Never drink and drive.
  • Never drive while sleepy.
  • No cell-phone use while driving.
  • No eating, drinking, or smoking while driving.
  • No teenage passengers for the first 6 months of driving.
  • Select a radio station or CD before driving.
  • Know directions to your destination before driving.
  • No speeding.
  • No running stop signs or red lights.
  • Minimize night-time driving.
  • Inform parents of your destination and return time.
  • No tailgating.
  • Do not use “cruise control” — this takes your mind off driving.

Dr. K.G. Pai is the founding father of the Kids Plus practice family.