Persistence of ADHD into adulthood is an important predictor of car crash risk

August 18, 2020

Washington, DC, August 18, 2020 -A new study reports that the risk of being involved in car crashes increases for those diagnosed with attention-deficit/hyperactivity disorder (ADHD). The study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, looked specifically at the rate of car crashes by adulthood, which was 1.45 times higher in those with a childhood history of ADHD compared to adults with no ADHD.

The authors also found that children whose ADHD symptoms have decreased by adulthood have no increased risk for car crashes.

Lead author Arunima Roy, MBBS, PhD, and research fellow at the Royal's Institute of Mental Health Research, University of Ottawa said: "ADHD is a common neurodevelopmental disorder. Between 5 percent and 75 percent of children with ADHD can continue to have the disorder into adulthood. Extant research shows that ADHD is associated with more traffic violations, speeding violations, license suspensions, and risky driving behaviors.

"The likelihood of risky driving behavior increases with persistence of childhood ADHD symptoms into adulthood. Prior research from our group as well as by others also shows that, aside from driving behaviors, a persistence of ADHD into adulthood can impair functioning in other domains. These domains can include occupational performance, educational attainment, emotional functioning, substance use, and justice involvement."

The findings, based on the Multimodal Treatment Study of ADHD, a multisite study with six centers in the United States and one in Canada. The MTA is one of the largest studies on treatment strategies for ADHD and include a follow-up arm spanning 16 years.

A cohort of 441 children with ADHD and 231 age- and sex-matched comparison children without ADHD from the same classrooms were studied between the ages of 7 and 25 years.

The researchers tracked data on ADHD symptoms, driving outcomes as well as a number of comorbid conditions, such as oppositional defiant disorder, conduct disorder, antisocial personality disorder, and substance use during childhood and into adulthood.

The researchers found that rates of licensure and ages at licensure were comparable between adults with and without a history of ADHD. However, the two groups differed in rates of car crash involvement by adulthood. Importantly, adults with continuing ADHD symptoms had the highest rate of car crash involvement compared to adults with no history of ADHD (1.81 times higher). Finally, rates of car crashes did not differ between adults whose ADHD symptoms remitted and adults who never had any ADHD.

"Clinicians must keep in mind the long-term effects of childhood ADHD on quality of life while attending to patients and take a holistic approach to treatment and management," Dr. Roy concluded.
Notes for editors

The article is "Effects of Childhood and Adult Persistent Attention-Deficit/Hyperactivity Disorder on Risk of Motor Vehicle Crashes: Results From the Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder," by Arunima Roy, MBBS, PhD, Annie A. Garner, PhD, Jeffery N. Epstein, PhD, Betsy Hoza, PhD, J. Quyen Nichols, BA, Brooke S.G. Molina, PhD, James M. Swanson, PhD, L. Eugene Arnold, MD, and Lily Hechtman, MD ( It currently appears on the JAACAPArticles In Press page and will appear in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 59, issue 8; (August 2020), published by Elsevier.

Dr. Lily Hechtman, MD, FRCP, is the Director of Research, Division of Child Psychiatry, McGill University Health Center and a tenured professor in the Departments of Psychiatry and Pediatrics, at McGill University. Her pioneering research in the area of ADHD, based on controlled progressive follow-up studies, helped establish the continuity of the condition into adulthood as well as the validity of the adult ADHD diagnosis.

Copies of this paper are available to credentialed journalists upon request, please contact the JAACAP Editorial Office at"> or +1 202 587 9674. Journalists wishing to interview the authors may contact Lily Hechtman, MD, Professor of Psychiatry and Pediatrics, Division of Child and Adolescent Psychiatry, McGill University, Montreal Children's Hospital, at">


Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The Journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

About Elsevier

Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge. Today, we're committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, 39,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers.

Media contact

JAACAP Editorial Office
+1 202 587 9674


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