Institute for Mobility, Activity and Participation, College of Public Health and Health Professions, University of Florida, Gainesville, Florida 32610, USA.
Traffic Inj Prev. 2013;14(2):188-93. doi: 10.1080/15389588.2012.700747.
We conducted an evidence-based review of intervention studies and predictor studies related to driving outcomes in teens with attention deficit-hyperactivity disorder (ADHD) or autism spectrum disorder (ASD).
Ten primary studies were classified using the American Academy of Neurology's criteria (class I-IV, I = highest level of evidence). We provided recommendations including Level A: intervention/factors are effective/predictive or not; Level B: probably effective/predictive or not; Level C: possibly effective/predictive or not; Level U: no recommendations.
For the intervention studies we identified 1 Class II and 1 Class III study; for predictor studies, we identified 7 ADHD studies consisting of 1 Class II and 6 Class III studies. Only 1 Class III ASD study was found. In synopsizing the evidence, the following recommendations are made for the intervention studies pertaining to on-road performance in teens with ADHD: a multimodal intervention is possibly effective in improving driving performance (Level C); stimulants possibly do not affect driving negatively (Level C); no recommendations can be made for hazard perception training in ADHD or ASD (Level U). Consider the following recommendations useful for simulated driving performance: Stimulants possibly improve driving performance (Level C); ADHD diagnosis and being unmedicated possibly worsen driving performance (Level C); no recommendations for driving in low-stimulus conditions (Level U). From self-/proxy report, no recommendations can be made related to gender or ADHD subtype affecting adverse driving outcomes (Level U).
Class I studies with Level A recommendations, currently lacking in the literature, are urgently needed to make clear the mechanism underlying driving performance outcomes in ADHD and ASD. Supplementary materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention for the following supplemental resource: Table: Evidence-based Synopsis of ADHD, ASD and Driving Performance: Variables, Sample, Findings & Rationale.
我们对与青少年注意力缺陷多动障碍（ADHD）或自闭症谱系障碍（ASD）相关的驾驶结果的干预研究和预测研究进行了循证综述。
使用美国神经病学学会的标准（I-IV 级，I 级为最高证据水平）对 10 项主要研究进行分类。我们提供了包括 A 级建议：干预/因素有效/预测或无效；B 级建议：可能有效/预测或无效；C 级建议：可能有效/预测或无效；U 级建议：无建议。
我们确定了 1 项 II 级和 1 项 III 级干预研究；对于预测研究，我们确定了 7 项 ADHD 研究，包括 1 项 II 级和 6 项 III 级研究。仅发现 1 项 III 级 ASD 研究。在综合证据时，我们对 ADHD 青少年道路表现的干预研究提出了以下建议：多模式干预可能有效提高驾驶表现（C 级）；兴奋剂可能不会对驾驶产生负面影响（C 级）；ADHD 或 ASD 中的危险感知训练无建议（U 级）。考虑以下建议对模拟驾驶表现有用：兴奋剂可能改善驾驶表现（C 级）；ADHD 诊断和未服药可能会恶化驾驶表现（C 级）；在低刺激条件下无驾驶建议（U 级）。从自我/代理报告来看，没有建议可以与影响不良驾驶结果的性别或 ADHD 亚型相关（U 级）。
目前文献中缺乏 I 级研究和 A 级建议，迫切需要阐明 ADHD 和 ASD 驾驶表现结果的机制。本文提供了补充材料。要获取 ADHD、ASD 和驾驶表现：变量、样本、发现和理由的循证综述的补充资源，请访问出版商的《交通伤害预防》在线版本。
