Driving after Concussion: Examination of the Adolescent Brain and Behaviors

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Summary The population of adolescents with Congenital Heart Disease (CHD) has increased by nearly 65% since 2010. Like their healthy peers, adolescents with CHD may seek independence from their parents. Many pursue graduated drivers licensing (GDL) and experience newfound freedoms of independent driving. Driving is a complex task that relies on cognitive control and a high level of executive function. Motor vehicle crashes are common among adolescent first-year drivers. Crashes may be due in part to immature executive functioning. This immature function may be more profound among adolescents with CHD because they often have disease-related neurocognitive and neurobehavioral deficits. This presents a constellation of deficits similar to concussed adolescents. Therefore, risk for MVCs and related morbidity and mortality may be higher among concussed adolescents and adolescents with CHD. However, little is known about the association between complications of CHDs during adolescence and initial driving habits. This Administrative Supplement for R01NR018425 integrates a qualitative exploration of barriers and facilitators to safe independent driving from the perspective of adolescents with CHDs and parents (Aim 1) to address a critical gap in research and clinical practice. Aim 2 includes mentored training embedded in the Parent Grant that will help catalyze research training to set the stage for independent funding in the adolescent CHD population for the postdoctoral candidate. This Administrative Supplement is innovative because Aim 1 addresses a gap in scientific literature specific to initial driving experiences and builds upon the small body of literature that examines risk-taking behaviors among adolescents with CHD. Aim 2 provides an opportunity for the postdoctoral candidate to pursue conceptual and technical training in fNIRs during driving simulation, on-road data collection and ecological momentary assessment among concussed adolescents, as well as an opportunity to consider feasibility among adolescents with CHD in future research. This Administrative Supplement for R01NR018425 advances the field of pediatric cardiac research by identifying the types of driving behaviors and risks that adolescents with CHDs engage in and can be used as an example to describe similarities and differences when compared to adolescents without chronic cardiac disease. This mentored postdoctoral fellowship establishes an innovative foundation for future research initiatives that address the impact of risk-taking behavior on physiologic well-being in adolescents with CHD.