Manual Transmission Enhances Attention and Driving Performance of ADHD Adolescent Males

Abstract

Objective: Inattention is a major contributor to driving mishaps and is especially problematic among adolescent drivers with ADHD, possibly contributing to their 2 to 4 times higher incidence of collisions. Manual transmission has been demonstrated to be associated with greater arousal. This study tests the hypotheses that manual transmission, compared to automatic transmission, would be associated with better attention and performance on a driving simulator.

Method: Ten adolescent drivers with ADHD practice driving on the simulator in the manual and automatic mode. Employing a single-blind, cross-over design, participants drive the simulator at 19:30 and 22:30 hr for 30 min in both transmissions and rate their attention to driving.

Results: Subjectively, participants report being more attentive while driving in manual transmission mode. Objectively, participants drive safer in the manual transmission mode.

Conclusion: Although in need of replication, this pilot study suggests a behavioral intervention to improve driving performance among ADHD adolescents.

Keywords

ADHD adolescents driving safety behavioral interventions manual transmission automatic transmission inattention

Get full access to this article

View all access options for this article.

References

American Psychiatric Association . (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Barkley R. A. (1998). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (2nd ed.). New York: Guilford.

Barkley, R. A. , Guevremont, D. C. , Anastopoulos, A. D. , DuPaul, G. J. , & Shelton, T. L. (1993). Driving-related risks and outcomes of attention deficit hyperactivity disorder in adolescents and young adults: A 3- to 5-year follow-up survey. Pediatrics, 92(2), 212-218.

Barkley, R. A. , Murphy, K. R. , & Kwasnik, D. (1996). Motor vehicle driving competencies and risks in teens and young adults with attention deficit hyperactivity disorder. Pediatrics, 98(6 Pt 1), 1089-1095.

Barkley, R. A. , Murphy, K. R. , O’Connell, T. , & Connor, D. F. (2005). Effects of two doses of methylphenidate on simulator driving performance in adults with attention deficit hyperactivity disorder. Journal of Safety Research, 36(2), 121-131.

Cox, D. J. , Broshshek, D. K. , Kiernam, B. P. , Kovatchev, B. P. , Guerrier, J. , Giulano, A. , et al. (2002). Specific driving impairments with progressive age. Advances in Medical Psychotherapy and Psychodiagnosis, 11, 107-122.

Cox, D. J. , Gonder-Frederick, L. , & Clarke, W. (1993). Driving decrements in type I diabetes during moderate hypoglycemia. Diabetes, 42(2), 239-243.

Cox, D. J. , Gonder-Frederick, L. A. , Kovatchev, B. P. , & Clarke, W. L. (2002). The metabolic demands of driving for drivers with type 1 diabetes mellitus. Diabetes/Metabolism Research and Reviews, 18(5), 381-385.

Cox, D. J. , Gonder-Frederick, L. A. , Kovatchev, B. P. , Julian, D. M. , & Clarke, W. L. (2000). Progressing hypoglycemia’s impact on driving simulation performance, occurrence, awareness and correction. Diabetes Care, 23(2), 163-170.

10.

Cox, D. J. , Humphrey, J. W. , Merkel, R. L. , Penberthy, J. K. , & Kovatchev, B. (2004). OROS methylphenidate improves attention during on-road driving by adolescents with attention-deficit/hyperactivity disorder. Journal of the American Board of Family Practice, 17(4), 235-239.

11.

Cox, D. J. , Kovatchev, B. P. , Gonder-Frederick, L. A. , & Clarke, W. L. (2003). Physiological and performance differences between drivers with type 1 diabetes with and without a recent history of driving mishaps: An exploratory study. Canadian Journal of Diabetes, 27(1), 23-28.

12.

Cox, D. J. , Merkel, R. L. , Kovatchev, B. , & Seward, R. (2000). Effect of stimulant medication on driving performance of young adults with attention-deficit hyperactivity disorder: A preliminary double-blind placebo controlled trial. Journal of Nervous and Mental Disease, 188(4), 230-234.

13.

Cox, D. J. , Merkel, R. L. , Moore, M. , Thorndike, F. , Muller, C. , & Kovatchev, B. (2006). Relative benefits of OROS® MPH vs. se-AMPH ER in improving driving performance of ADHD adolescent drivers. Manuscript submitted for publication.

14.

Cox, D. J. , Merkel, R. L. , Penberthy, J. K. , Kovatchev, B. , & Hankin, C. S. (2004). Impact of methylphenidate delivery profiles on driving performance of adolescents with attention-deficit/hyperactivity disorder: A pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 43(3), 269-275.

15.

Cox, D. J. , Quillian, W. C. , Gressard, C. F. , Westerman, P. S. , Gonder-Frederick, L. A. , & Canterbury, R. J. (1995). The effects of blood alcohol levels on driving variables in a high risk population: Objective and subjective measures. Journal of Alcohol and Drug Education, 40(3), 84-98.

16.

Cox, D. J. , Quillian, W. C. , Thorndike, F. P. , Kovatchev, B. P. , & Hanna, G. (1998). Evaluating driving performance of outpatients with Alzheimer disease. Journal of the American Board or Family Practice, 11(4), 264-271.

17.

Cox, D. J. , Taylor, P. , & Kovatchev, B. (1999). Driving simulation performance predicts future collisions among older drivers. Journal of the American Geriatric Society, 47(3), 381-382.

18.

Dingus, T. A. , Klauer, S. G. , Neale, V. L. , Petersen, A. , Lee, S. E. , Sudweeks, J. , et al. (in press). The 100-Car Naturalistic Driving Study: Phase II - Results of the 100-Car Field Experiment (Interim Project Report for DTNH22-00-C-07007, Task Order 6; Report No. TBD). Washington, DC: National Highway Traffic Safety Administration.

19.

DuPaul, G. J. , Power, T. J. , Anastopoulos, A. D. , & Reid, R. (1998). ADHD Rating Scale-IV: Checklists, norms, and clinical interpretation. New York: Guilford.

20.

Murphy, K , & Barkley, R. A. (1996). Attention deficit hyperactivity disorder adults: Comorbidities and adaptive impairments. Comprehensive Psychiatry, 37(6), 393-401.

21.

National Center for Statistics and Analysis , National Highway Traffic Safety Administration . (2005). Fatality Analysis Reporting System (FARS) Web-based encyclopedia. Retrieved May 16, 2005, from http://www-fars.nhtsa.dot.gov/

22.

National Highway Traffic Safety Administration . (2003). Young drivers traffic safety facts 2003. Washington, DC: U.S. Department of Transportation.

23.

Quillian, W. C. , Cox, D. J. , Gonder-Frederick, L. A. , Driesen, N. R. , & Clarke, W. L. (1994). Reliability of driving performance during moderate hypoglycemia in adults with IDDM. Diabetes Care, 17(11), 1367-1368.

24.

Quillian, W. C. , Cox, D. J. , Kovatchev, B. P. , & Phillips, C. (1999). The effects of age and alcohol intoxication on simulated driving performance, awareness, and self-restraint. Age and Aging, 28(1), 59-66.

25.

Shaffer, D. , Fisher, P. , Lucas, C. P. , Dulcan, M. K. , & Schwab-Stone, M. E. (2000). NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 39(1), 28-38.

26.

Shinar, D. , Meir, M. , & Ben-Shoham, I. (1998). How automatic is manual gear shifting? Human Factors, 40(4), 647-654.

27.

Tellini, M. , & Angeletti, P. (1975). Double blind study on the effects of automobile driving with automatic and standard transmission on various physiological parameters. Quaderni Sclavo di Diagnostica Clinica e di Laboratorio, 11(4), 747-769.

28.

Zeier, H. (1979). Concurrent physiological activity of driver and passenger when driving with and without automatic transmission in heavy city traffic. Ergonomics, 22(7), 799-810.