Gaze Control During Simulator Driving in Adolescents With and Without Attention Deficit Hyperactivity Disorder

IMPORTANCE: Attention deficit hyperactivity disorder (ADHD) is associated with driving deficits. Visual standards for driving define minimum qualifications for safe driving, including acuity and field of vision, but they do not consider the ability to explore the environment efficiently by shifting the gaze, which is a critical element of safe driving. OBJECTIVE: To examine visual exploration during simulated driving in adolescents with and without ADHD. DESIGN: Adolescents with and without ADHD drove a driving simulator for approximately 10 min while their gaze was monitored. They then completed a battery of questionnaires. SETTING: University lab. PARTICIPANTS: Participants with (n = 16) and without (n = 15) ADHD were included. Participants had a history of neurological disorders other than ADHD and normal or corrected-to-normal vision. Control participants reported not having a diagnosis of ADHD. Participants with ADHD had been previously diagnosed by a qualified professional. OUTCOMES AND MEASURES: We compared the following measures between ADHD and non-ADHD groups: dashboard dwell times, fixation variance, entropy, and fixation duration. RESULTS: Findings showed that participants with ADHD were more restricted in their patterns of exploration than control group participants. They spent considerably more time gazing at the dashboard and had longer periods of fixation with lower variability and randomness. CONCLUSIONS AND RELEVANCE: The results support the hypothesis that adolescents with ADHD engage in less active exploration during simulated driving. WHAT THIS ARTICLE ADDS: This study raises concerns regarding the driving competence of people with ADHD and opens up new directions for potential training programs that focus on exploratory gaze control.