Risk factors affecting Driving Behaviour during Adolescence

1
Risk factors affecting Driving Behaviour during
Adolescence

• John Brennan, Director Child Adolescent Mental
  Health Service Sydney Childrens Hospital
• Associate Professor (UNSW Conjoint)

2
Driving Performance Traffic Accidents (Barkley
et al, 2004)

• Human factors are considered to be the most
  common cause of automobile accidents
• Driving is a complex multidimensional behaviour
  that can be conceptualised on three hierarchical
  levels of competency
• Strategic
• Tactical
• Operational
• Deficits in lower levels especially at the
  operational, can have a profound effect on higher
  levels of competency.

3
Operational Competency

• Comprises elementary mental functions
• Attention and concentration
• Reaction time
• Visual scanning
• Spatial perception and orientation
• Visual motor integration
• Speed of cognitive processing
• Motor co-ordination

4
Driving Performance Traffic Accidents

• Inattention and distraction from within the
  vehicle (eg mobile phone, playing with radio/CD
  iPod, talking to other passengers) is among the
  most common contributors to traffic accidents.

5
TACTICAL COMPETENCY

• Skills and decision making to deal with different
  driving conditions
• Eg - dense traffic
• - rain
• - intersections
• - traffic lights
• - changing speed limits
• - passing other vehicles
• - country roads
• - rough roads
• - navigating unfamiliar areas

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STRATEGIC COMPETENCY

• Decisions about whether to drive and when
• eg - weather conditions
• - time of day and impact of fatigue
• - time needed to complete journey
• - route to take
• - rest stops
• - vehicle safety (ie. roadworthy)

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Association of driving with the 3 hierarchical
levels of competency operational, tactical, and
strategic.Russell A. Barkley , Daniel
CoxJournal of Safety Research 38 (2007) 113128
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PATTERNS OF RISK FOR ADOLESCENT DRIVERS

• In assessing risk age matters
• 16-19yrs when grouped lose important information
  about age as a risk factor
• Similar issues when considering older drivers
  65, 75, 85
• Distance travelled allows comparison of crash
  risk relative to exposure
• License data per person rates
• Population data overall risk for age group
• (slides refer to US date aggregated across 50
  states)

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TEENAGE DRIVERS RISK FACTORS (AF WILLIAMS (2003)

• Teenage driving risks can be considered under 3
  headings.
• (a) Situations where risk is elevated for all
  drivers
• (b) Situations where risk is elevated for teenage
  drivers relative to older drivers
• (c) situations where risk is unique to teenagers

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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
15

• The following slides-indicate that younger and
  older drivers have the highest rates
• Younger gt older crash rates
• Males gt females
• Women gt males, per mile driven
• Fatal crash rates per distance travelled 16yr
  olds greatest
• Older drivers greater fatality rate/mile as
  they are more fragile
• Note mileage based rates exaggerates risks for
  younger and older drivers. They are driving
  shorter distances on more congested roads/younger
  drivers more night time exposure.

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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
15
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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
15
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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
15Crashes / licence holder

• Youngest 16-19 (greatest for all crashes,
  greatest for fatal crashes)
• Young males slightly greater crash rate
• Per capita rates
• - youngest least likely to have a licence so
• 16yr olds lowest/capita
• - fatal crashes/16yr olds, and 20-24yr have
  highest per capita

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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
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15
Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
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Times of highest risk

• Learner period low risk as parents are
  supervising
• Permit period Nova Scotia data Clear
  increased risk immediately following Licensing
• Night time driving risk greatest risk
  especially in younger drivers.
• Night time greater risk for fatal crashes
  (drivers 20-24 even greater relative increase
  than in daytime
• Alcohol plays a greater role in older adolescents
  and young adults.
• Time of day fatal crashes two peaks before
  and after school day for 16/17yr old drivers.
• Per trip students are 44 times more likely to be
  killed in a vehicle with a teen driver than
  whilst riding a school bus.

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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
15
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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
15
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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
15
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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
15
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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
15
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Teenage Drivers

• Alcohol
• Low in teenage drivers compared to older drivers
• When young drivers do drink however, their
• relative increase in risk is greater than older
• drivers
• Alcohol related fatalities have fallen
• substantially due to changes in law.

24
Socio-cultural risk Factors

• Driving is a rite of passage and a developmental
  milestone for most adolescents
• Driving can be crucial for many young persons
  employment and education
• Driving contributes to normal social development,
  self confidence and esteem with peers
• Adolescents value driving as an opportunity for
  getting together with other adolescents without
  being supervised and scrutinized by adults
• Music, distracting talk, joking around together,
  are considered to be important pleasurable
  aspects of teenage driving experience but can
  encourage risk taking

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Crash Risks Unique to Adolescence

• Having passengers in the vehicle
• - creates a social situation affecting driving
  behaviour
• - associated with increased risk
• It is a very high-risk situation for teenage
  drivers
• to have multiple passengers when they are also
• teenagers.
• More than 50 of all deaths in crashes of 16-17
  year old drivers occur when passengers younger
  than 20 years old are present and there is not
  adult in the vehicle.

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Teenage Passenger Crash Rates

• Many teens die as passengers in motor vehicles.
• - 40 of deaths in 16-19 yr olds travelling in
  passenger vehicles were passengers.
• - for 16yr olds it is 50 of fatalities
• - often travelling with teenage drivers

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Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
15
28
Teenage drivers patterns of riskAllan F.
WilliamsJournal of Safety Research 34 (2003) 5
15
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Crash Risks Unique to Adolescence

• Crash rates by driver age and number of passenger
  present per 10,000 trips.
• With increasing numbers of passengers the risk
  for older driver falls
• For teenagers the rate increases exponentially
  with 1-3 plus passengers
• The risk increases for male and female drivers
  with night time rates being higher
• The highest risk for male and female teenager
  drivers is with male passengers
• The risk for teenage males falls with female
  passengers.
• The presence of one male passenger doubles the
  fatality rate the presence of two male
  passengers doubles the fatality rate again ( for
  male and female teenage drivers)
• Driving behaviour is affected, increased speed,
  increased risks
• But when carrying female passengers teenagers
  drive more safely

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Factors related to seat belt use among fatally
injured teenage drivers Anne T. McCartt , and
Veronika Shabanova Northrup

• Seat belt use was examined for teenage (1619
  years) drivers who were fatally injured in
  traffic crashes occurring in the United States
  during the years 19952000.
• Results During 19952000, mean belt use was 36
  among fatally injured teenage drivers
• and 23 among fatally injured teenage passengers.
  
• Lower belt use among fatally injured teenage
  drivers was associated with
• increasing age
• Male drivers
• Drivers of SUVs, vans, or pickup trucks rather
  than cars older vehicles
• crashes occurring late at night
• crashes occurring on rural roadways single
  vehicle crashes
• and drivers with BACs of 0.10 or higher.
• Teenage driver belt use declined as the number of
  teenage passengers increased,
• but increased in the presence of at least one
  passenger 30 years or older.

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Passenger effects on teenage driving and
opportunities for reducing the risks of such
travel llan F. Williamsa, , , Susan A.
Fergusonb and Anne T. McCarttcbFerguson
International LLC, 1328 Lancia Drive, McLean, VA
22102, USA 2007

• Despite passenger restrictions in the majority of
  states,
• 42 of 16- and 17-year-old drivers in fatal
  crashes in 2005 were transporting teenagers with
  no adults in the vehicle
• 61 of teenage passenger deaths (1,222 in 2005)
  occurred in vehicles driven by other teenagers.
• Wider application of passenger restrictions is
  indicated.
• Ways to make passenger restrictions more
  effective are needed, and other techniques for
  reducing this major problem need development and
  testing.

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Teenage drivers with ADHD A review of driving
risks and impairments associated withADHD
Russell A. Barkley , Daniel CoxJournal of
Safety Research 38 (2007) 113128

• Inattention/distractibility key factors
  increasing risk
• Young drivers with ADHD-- key findings
• 2-4 times more risk of traffic accidents
• 3 times more risk of injuries
• 4 times more risk of being at fault
• 6-8 times more risk of license suspension
• Comorbid factors which add to risk
• Increased aggression
• Poor emotional regulation, anger
• Increased risk taking / limited insight
• If Conduct Disorder is also diagnosed even
  greater risk
• Should we mandate that they take medication when
  driving?

33
Association of driving with the 3 hierarchical
levels of competency operational, tactical, and
strategic.Russell A. Barkley , Daniel
CoxJournal of Safety Research 38 (2007) 113128
34
The effect of teenage passengers on the fatal
crash risk of teenage drivers Preusser, DF
Ferguson, SA Williams, AFAccident Analysis
Prevention Accid. Anal. Prev.. Vol. 30, no. 2,
pp. 217-222. Mar 1998.

• Fatal crash-involved drivers of passenger
  vehicles were identified in the Fatality Analysis
  Reporting System for the period 1990 through
  1995. Each driver was categorized as being alone
  in the vehicle at the time of the crash or with
  one or more passengers. Drivers at fault or
  responsible for crash occurrence were defined as
  all drivers involved in a single-vehicle crash,
  or drivers in multiple-vehicle crashes who were
  coded in the Fatality Analysis Reporting System
  as committing one or more driver errors. The
  results indicated that passenger presence was
  associated with proportionately more at-fault
  fatal crashes for drivers aged 24 and younger,
  were a neutral factor for drivers aged 25-29, and
  were associated with fewer at-fault involvements
  for drivers aged 30 and older. Relative risk of
  fatal crash involvement was particularly high for
  teenage drivers traveling, day or night, with two
  or more teenage passengers.
• Additional research is needed to determine how
  the added risk associated with teenage passengers
  riding with teenage drivers can be reduced or
  eliminated.

35
Passenger effects on teenage driving and
opportunities for reducing the risks of such
travel llan F. Williamsa, , , Susan A.
Fergusonb and Anne T. McCarttcbFerguson
International LLC, 1328 Lancia Drive, McLean, VA
22102, USA 2007

• Passenger presence increases crash risk for
  teenage drivers, especially when the passengers
  are other teenagers and especially when they are
  male.
• Teenagers are more susceptible to peer influences
  than adults.
• The combination of passenger-induced distraction
  and driving inexperience can disrupt driving
  behavior,
• teenage driver risk taking increases in vehicles
  with multiple teenagers.
• Possible ways to reduce the resulting crash
  problem include altering the in-vehicle behavior
  of teenagers or influencing their selection of
  travel partners.
• Legal restrictions on passengers with teenage
  drivers have been found effective in reducing the
  crash problem. Parental monitoring of teenage
  driving behavior,
• programs aimed at teenagers themselves, could be
  other options
• but their efficacy is unproven.
• It currently is unknown why female passengers
  have a different effect than males or if that
  might offer clues about future interventions.
• Conclusions
• Despite passenger restrictions in the majority of
  states,
• 42 of 16- and 17-year-old drivers in fatal
  crashes in 2005 were transporting teenagers with
  no adults in the vehicle
• 61 of teenage passenger deaths (1,222 in 2005)
  occurred in vehicles driven by other teenagers.
• Wider application of passenger restrictions is
  indicated.
• Ways to make passenger restrictions more
  effective are needed, and other techniques for
  reducing this major problem need development and
  testing.