Related Experiment Video
Updated: Aug 6, 2026
Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects
Published on: September 18, 2012
Early neurodevelopment predicts driving experience in early adulthood in a congenital heart disease cohort
Keith S Baxelbaum1, Nancy Burnham2, Lyla Hampton3
1Department of Biomedical and Health Informatics, Data Science and Biostatistics Unit, Children's Hospital of Philadelphia, Philadelphia, PA, USA. baxelbaumk@chop.edu.
Background:
Survivors of CHD are at elevated risk for neurodevelopmental impairments and functional implications at the transition to adulthood. This study examined whether early neurodevelopmental indicators predict attainment of a driver's license in early adulthood-a real-world milestone for independence-among CHD survivors.
Methods:
This prospective longitudinal cohort study followed children who had surgical treatment for CHD into adulthood. Standardized neurodevelopmental assessments were conducted at age 4 years, including measures of executive function, attention, processing speed and visuomotor function. Participants were followed into young adulthood (ages 18-21), at which time they self-reported whether they had obtained a driver's license or learner's permit. Multivariable logistic regression models were used to examine associations between early cognitive measures and licensure outcome, adjusting for demographic and clinical covariates.
Results:
Analysis included 119 participants who completed both the age-four assessment and follow-up survey in young adulthood. In adjusted models, better inhibition and visuo-motor skills at age four were significantly associated with higher likelihood of driving later: inhibition odds ratio [OR] = 1.38, 95% CI, 1.12-1.78, p < 0.01; visuo-motor OR = 1.06, 95% CI, 1.01-1.11, p < 0.05.
Conclusion:
High-level executive and motor control capacities in early childhood were a meaningful predictor of driving in young adulthood among CHD survivors.
Impact:
High level cognitive and motor control-specifically inhibition and visuo-motor skills-at age four were significantly associated with higher likelihood of driving measured at the transition to adulthood. Early identification of children at elevated risk for neurodevelopmental impairment-particularly those with visuo-motor or inhibition challenges-may allow for timely and targeted support towards improving later life functional outcomes.
