Accident risk and driving performance in traffic among individuals with ADHD. A rapid review

To evaluate the impact of attention-deficit/hyperactivity disorder (ADHD) and other neurodevelopmental diagnoses on traffic accidents and driving performance.

Systematic searches were conducted in the international databases Medline and PsycInfo (latest search January 2025). The identified articles were assessed for bias, and only data with low or moderate risk of bias was included. The results are reported narratively.

Eight studies were included: five non-randomised studies in simulator and three observational studies conducted in real traffic, published 2007-2021. No studies on autism spectrum disorder or other comparable conditions were identified.The five studies in simulator report contradictory results regarding both accident risk and driving performance (including lane position deviation, risky driving behavior, dual-task performance, and speed adaptation). Further, it remains unclear to what extent simulator-based findings reflect real-world driving. Two of the observational studies reported that individuals with ADHD have a higher risk for accidents compared with individuals without an ADHD diagnosis. However, the data in one study (USA) contained some uncertainty about the diagnosis, while data in the other study (Sweden) did not differ between drivers, passengers, cyclists or pedestrians. In the third cohort study (Finland), no differences were found between the groups regarding number of traffic accidents or driving performance. These findings should therefore be interpreted with caution.

Based on the current state of research, no firm conclusions can be drawn regarding accident risk or driving performance among individuals with an ADHD diagnosis compared to individuals without an ADHD diagnosis.