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ADHD and Increased Risk of Accidents

     

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are nearly twice as likely to suffer an injury requiring a hospital visit compared to those without ADHD. Adults with ADHD are at increased risk of driving accidents. Taking additional precautions can help reduce these risks, and some research shows that the risk is reduced for those taking medication for ADHD.

ADHD is the most commonly diagnosed mental health condition in children. It is a neurodevelopmental disorder that affects the brain and causes problems relating to attention, hyperactivity and impulsivity. Depending on the severity of symptoms, ADHD can contribute to negative consequences, such as difficulties in peer, parent and teacher relationships, increased risk taking behaviors, poor self-esteem and academic difficulties.

ADHD Month

Reducing the risk of accidents

Accidents are a natural part of a child’s development—a simple scrap, fall, or bruise is normal, but having ADHD increases the risks. Kimberly Gordon, M.D., Medical Director of the Berkeley & Eleanor Mann Residential Treatment Center and School, part of the Sheppard Pratt Health System in Baltimore, notes that “If you ask kids and teens how to stay safe, most will have good strategies, but often implementation is a challenge for those with ADHD. They tend to forget what they know or not follow through. Knowledge alone is not enough to prevent injury.”

Some research has found that children with ADHD are less likely to have accidents and injury if they are taking medication for the ADHD, yet many families struggle with whether to use medication for their child with ADHD. Medication can have unwanted side-effects, such as sleep problems and loss of appetite. Gordon suggests undertaking a careful assessment of risks and benefits. “When defining risk, concentrate on the larger picture. Don’t just focus on potential risks of medication. Also consider the potential short and long-term implications of inattention, impulsiveness, and hyperactivity over a lifetime—on school and academic achievement, self-esteem and satisfaction, family and social relationships, job performance and accidents and automobile crashes.”

Many children with ADHD do well without medication. Other treatments, including behavioral counseling, can be used alone or in combination with medication. Talk with your child’s health care provider about your child’s specific circumstances.

In considering the potential risks for accidents among teens with ADHD, the advocacy organization CHADD reminds parents that “these are only risks, they are not prophecies.” CHADD suggests that “continued awareness and treatment is crucial in parenting teens who have ADHD and helping them avoid these risks and fulfill their potential.” CHADD offers many resources for families including a free Ask the Expert Webinar Series.

Driving risks

For some children ADHD symptoms improve as they grow into adulthood, but many others will continue to experience symptoms into adulthood. Several studies, including a 2014 meta-analysis, have found that adults with ADHD have a significant increased risk of driving accidents and more speeding violations. A large study in Sweden found among men with ADHD the risk for car accidents was reduced by almost 30 percent for those on ADHD medication. The same was not true for women – they found no reduction in accident risk for women using ADHD medication.

What else can you do to reduce driving risks?* Leave enough time that you aren’t tempted to speed and avoid heavy traffic if possible. For adolescents, consider delaying getting a drivers’ license, increasing practice time or having additional instruction over the minimum required. Much of what you can to do to improve driving safety involves minimizing distractions:

  • Make sure you know where you are going. Know your route ahead of time and use a navigation system that "speaks" the directions instead of requiring you to look at a display.
  • Try to minimize distractions from passengers. If others in the car are watching a video or listening to something distracting, ask them to keep the volume low or to wear headphones. Let someone else handle the kids carpool if possible, a car full of noisy kids can be dangerous.
  • Set your music/radio and leave it alone. While listening to music may help some people with ADHD to focus better, changing stations or hunting for particular audio can be distracting.
  • Skip the cell phone while driving. A good rule for all drivers and the law in many places.

(*Adapted from “Road Safety: Overcoming Driving Distractions” by Patricia Quinn, M.D. in ADDitude magazine)

References

  • Singh, A, et al. Overview of Attention Deficit Hyperactivity Disorder in Young Children. Health Psychology Research. 2015, Vol. 3, No. 2.
  • Zheng, C. et al. Serious transport accidents in adults with ADHD, and the effect of medication: A population based study. JAMA Psychiatry. 2014, 71(3): 319–325. www.ncbi.nlm.nih.gov/pmc/articles/PMC3949159/

     

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