Curriculum What the Research Says

How an Attention-Training Program Can Make Teens Better Drivers

By Sarah D. Sparks — January 18, 2023 6 min read
Driver Training Simulator
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The moment a driver looks away from the road, the countdown to a potential accident begins.

After just 1.7 seconds, the risk of crashing skyrockets with every millisecond of inattention. And young drivers with attention deficits typically have their eyes off the road more than twice as long and twice as often as other adolescents.

That’s why a new program in Cincinnati aims to improve driver’s education by helping young drivers with attention deficit disorders learn to focus.

“These students [with attention deficits] were looking away for four or five seconds at a time, so we said, hey, if we can get them down to two seconds, we are going to save lives,” said Jeffery Epstein, a pediatric psychologist at Cincinnati Children’s Hospital. He led a study on the use of the Forward Concentration and Attention Learning program, (or FOCAL) in a driving simulation geared to help adolescent drivers with attention deficits.
Results so far look promising. A study in the New England Journal of Medicine finds older teenagers who participated in FOCAL had more than 40 percent fewer long glances per trip after a month and nearly 42 percent fewer long glances per trip after six months, compared to similar young drivers who did not take part in the training. A year after the training, FOCAL participants also were less likely to get into a crash than those who had not participated, with an accident rate of 3.4 percent versus 5.6 percent for non-participants.

While the FOCAL program targeted drivers with attention deficit hyperactivity disorder, experts argue skills-based simulations like this may help boost the effectiveness of driver’s education programs more generally. That’s needed, they say, because statistics show that driver’s education programs often don’t actually reduce young drivers’ crashes in their first few years on the road.

“We know the first year of independently licensed driving is the riskiest time for negative outcomes in a teen’s whole lifetime,” said Gregory Fabiano, a psychology professor and driver’s education researcher at Florida International University, who was not part of the Cincinnati study.

“These ADHD behaviors [such as distraction] are ones that all drivers do have to some extent,” Fabiano said. “I think we need to be more thoughtful about how to attenuate problems with attention or impulsive decision-making with drivers—either through more practice or monitoring and contingency management.”

Nearly all states require adolescents to get a learner’s permit, including at least some adult-supervised driving time, but their rules vary widely, according to the Insurance Institute for Highway Safety, a nonprofit group that studies crash data. Eight states do not require students to take a driver’s education course to get their license, and 19 states allow students to take online driver’s education courses. The hours of required practice driving range from none in Arkansas to 50 hours in Colorado and California—10 of which must be at night in those states.

But after graduating to full driver’s licenses, prior studies have found that new drivers are eight times more likely to crash or have a close call in the first three months after getting a license than during the last three months on a learner’s permit. In particular, adolescents who have just traded a learner’s permit for a full license are more likely to slam their brakes abruptly, swerve, and make hard turns. Even teenagers who have to wait until they are 17 or 18 to get a full driver’s license show a spike in crashes when they first start driving on their own.

“Everybody assumes that the reason teens are bad drivers is because they’re inexperienced,” Epstein said. “But it’s funny, when you look at teens driving during that learner’s permit period where they have to have somebody in the car, they aren’t getting in wrecks. They’re actually pretty good drivers during that learning permit period. But as soon as they get that independent driver’s license, their risk goes through the roof.”

Epstein’s and other research suggests this jump in crashes may be because many traditional driver’s education curriculums, both in and out of schools, focus on teaching students road rules and laws and basic driving moves—such as turns or parallel parking—but not the attention and control skills young people need to safely drive during long stretches of traffic or rural roads at night.

“We do know that brain development in the frontal lobes—where executive functioning occurs—is one of the later things to develop throughout the teens and young adulthood,” Epstein said. “So some of those executive functioning skills that you need when you’re driving, whether it’s planning or shifting attention or any of those higher-order cognitive skills that are really critical to driving, are still coming on board.”

Simulating Driving Skills

The FOCAL program initially targeted 16- to 19-year-olds with attention deficit hyperactivity disorder, those old enough to receive full driver’s licenses even in states with graduated driving laws that limit driving access for younger teenagers. Students in the program first trained in five 1.5-hour sessions in a simulator which required them to drive in a realistic setting while also occasionally doing a visual task in a center console.

“We’re always doing secondary tasks when we’re driving. Some of those are driving-related—looking at the speedometer or looking in the rear-view mirror—and some of them are non-driving secondary tasks like looking at a billboard or looking at our phone,” Epstein said.

“We learn through experience that long glances away from the roadway are a bad thing and we shouldn’t do them, but an inexperienced driver doesn’t have those miles under their belt, so to speak, to really have learned that skill,” he said.

Afterward, researchers installed cameras and sensors in the students’ real cars to track how often they looked away from the road for longer periods and how often they crashed or slammed on their brakes.

Epstein and his colleagues are now studying how young drivers focus differently in social situations. The researchers have also made the software for the FOCAL program freely available to schools that want to add attention training to their driver’s education curriculums, though adding the full simulator and eye-tracking equipment could cost hundreds of dollars. The researchers are working now to recreate the intervention using a virtual reality program and glasses, which are more commonly available.

The difference the program made in young drivers’ behavior was “meaningful,” Fabiano said.

Even without a simulation, Fabiano recommended schools work to integrate more attention practice into students’ formal driver’s education curriculum, as well as provide models for parents to help students practice at home.

“Driver’s education has been embedded in schools for a long time, and we know that parents are very concerned about their teens’ transition to driving,” he said. “So schools could think about this as an opportune time to engage with parents and create opportunities [for parents] to build upon or reinforce what the driving instructor has been talking about or doing with the teen in the driver’s education class.”


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