"Improving ADHD Teen Driving"

“改善多动症青少年驾驶”

• 批准号: 9232170
• 负责人: JEFF N. EPSTEIN
• 金额: $ 57.07万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9232170
• 关键词: Address; Attention; Attention deficit hyperactivity disorder; Attenuated; Automobile Driving; Behavior; Cause of Death; Cessation of life; Complex; Data; Diagnosis; Diagnostic; Driving While Intoxicated; Educational Intervention; Environment; Exhibits; Eye; Feedback; Frequencies; Goals; Health Care Costs; Impulsivity; Individual; Injury; Intervention; Learning; Length; Mediating; Modeling; Modification; Motor Vehicles; Outcome; Patients; Performance; Placebos; Positioning Attribute; Public Health; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Records; Research; Risk; Speed; Teenagers; Testing; Time; Training; Translating; Treatment Efficacy; Vehicle crash; Visual; Visual attention; base; driving behavior; efficacy testing; experience; high risk; high risk population; improved; inattention; intervention effect; learned behavior; public health relevance; randomized trial; skills; teen driving

 DESCRIPTION (provided by applicant): Operating a motor vehicle requires a complex set of skills, the most important of which is the ability to continuously visually attend to the roadway. Glances away from the roadway, especially those longer than 2 seconds, significantly increase one's risk for a motor vehicle crash (MVC). Teen drivers evidence far more extended glances away from the roadway than experienced drivers. Further, teens with a diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) emit 3-times more extended glances away from the roadway than typical teens. Moreover, our preliminary data indicate that the substantial driving deficits observed among teen drivers with ADHD are mediated by elevations in the number of extended glances away from the roadway. Hence, there is a clear need for interventions, particularly one that targets extended glances away from the roadway, to address the driving deficits of teens with ADHD. The proposed research will test the efficacy of the FOcused Concentration and Attention Learning (FOCAL) intervention, which targets reducing the number of extended glances away from the roadway, among teens with ADHD. The PC-based FOCAL training provides teens with an operational understanding of the dangers of extended glances away from the roadway and trains them on limiting the length of their glances. Tested with typical teens, FOCAL significantly attenuates the number of extended glances away from the roadway. To date, FOCAL has not been tested in teens with ADHD. Because of the magnitude of ADHD-related driving deficits and their difficulty with generalization of skills to natural environments, we have enhanced the FOCAL intervention (now termed FOCAL+) to include multiple training sessions and to integrate practice on a driving simulator with immediate feedback regarding extended glance behavior. In the proposed randomized trial, teens with ADHD will be randomly assigned to receive either FOCAL+ or a sham placebo group. Immediately after 1 month of training sessions and 4-, 8- and 12-months post-training, teens' driving skills will be assessed using a driving simulator, a road test, and driving records. Using this data, we will examine the short- and long-term efficacy of the FOCAL+ intervention on 1) decreasing rates of extended glances away from the roadway among teens with ADHD, and 2) improving driving performance among teens with ADHD. We will also explore potential moderators of intervention efficacy. The public health impact of improving the driving behavior of teens with ADHD cannot be overstated. MVCs are the leading cause of death among teens. among teens with ADHD significantly contributes to these figures. By targeting teens with ADHD, The 2- to 3-fold increased risk of MVCs we are targeting one of the highest risk groups of drivers on the road. Were our interventions to normalize driving among teens with ADHD, the potential impact on rates of MVC injuries and deaths would be substantial.

 描述（由申请人提供）：操作机动车辆需要一套复杂的技能，其中最重要的是能够持续目视道路。离开道路的一瞥，特别是那些超过2秒的一瞥，会显着增加机动车碰撞（MVC）的风险。与有经验的司机相比，青少年司机的目光更多地远离道路。此外，诊断为注意力缺陷/多动障碍（ADHD）的青少年比典型的青少年发出3倍的延长目光远离道路。此外，我们的初步数据表明，在患有ADHD的青少年司机中观察到的大量驾驶缺陷是由远离道路的扩展扫视次数的升高介导的。因此，显然需要采取干预措施，特别是针对远离道路的扩展目光，以解决ADHD青少年的驾驶缺陷。这项拟议的研究将测试FOcused Concentration and Attention Learning（FOCAL）干预的有效性，该干预的目标是减少ADHD青少年远离道路的扩展目光的数量。基于PC的FOCAL培训为青少年提供了一个操作上的理解，从道路上延伸的目光的危险，并训练他们限制他们的目光的长度。测试与典型的青少年，焦点显着衰减的数量延长目光远离道路。迄今为止，FOCAL尚未在患有ADHD的青少年中进行测试。由于ADHD相关的驾驶缺陷的严重性及其将技能推广到自然环境的困难，我们加强了FOCAL干预（现在称为FOCAL+），以包括多个培训课程，并将驾驶模拟器上的练习与有关扩展扫视行为的即时反馈相结合。在拟议的随机试验中，患有ADHD的青少年将被随机分配到接受FOCAL+或假安慰剂组。在1个月的培训课程和4个月，8个月和12个月的培训后，青少年的驾驶技能将使用驾驶模拟器，道路测试和驾驶记录进行评估。使用这些数据，我们将检查FOCAL+干预的短期和长期疗效：1）减少ADHD青少年远离道路的扩展目光的比率，2）改善ADHD青少年的驾驶表现。我们还将探讨干预效果的潜在调节因素。改善ADHD青少年的驾驶行为对公共健康的影响不能被夸大。MVC是青少年死亡的主要原因。 在ADHD青少年中的比例对这些数字有很大的贡献。通过针对患有多动症的青少年，我们针对的是道路上风险最高的驾驶员群体之一，其风险增加了2到3倍。如果我们的干预措施能使ADHD青少年的驾驶正常化，那么对MVC受伤和死亡率的潜在影响将是巨大的。