Driving Safety among Adolescents with Health Conditions: An Integrative Review

Obtaining a driver's license enhances independence and quality of life but can be challenging for adolescents with health conditions. Health conditions may impact driving behavior and not always require driving restrictions. Strategies that promote safe independent driving for adolescents with various health conditions are not well described.

The goal of this integrative review was to summarize the body of literature about safe driving behaviors and strategies to promote positive driving experiences among adolescents (15-24 years old) with at least one of the following health conditions: attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), disruptive behavior/conduct disorder, type 1 diabetes (TID), congenital heart disease (CHD), epilepsy/seizure disorder, neurological/neurobehavioral conditions, obstructive sleep apnea (OSA), restless leg syndrome (RLS), narcolepsy, and mental health conditions.

Sixty-eight studies published between 2007 and 2024 were included in the review. Over 70% of the included studies focused on ADHD and/or ASD. Driving attitudes, driving behavior/performance, licensure processes, driving interventions and other driving-related factors emerged as key outcome themes. Older age at licensure was common among the included sample. Evidence consistently showed that adolescents with ADHD, ASD, traumatic brain injury, developmental coordination disorders, and mood disorders experienced more unsafe driving compared to their age-matched peers. Blood glucose management was a common concern in studies examining driving behaviors among adolescents with T1D. Studies among adolescents with ADHD and ASD using well-developed interventions may serve as a model for future research examining the impact of other health conditions on driving behaviors.

Our findings substantiate the body of research devoted to understanding safe independent driving among adolescents with ADHD and ASD and reveal opportunities for more research among adolescents with disruptive behavior/conduct disorder, T1D, CHD, epilepsy/seizure disorder, neurological/neurobehavioral conditions, OSA, RLS, narcolepsy and mental health conditions to inform health policies and clinical practice.