Teen Driving and Adolescent Health - New Strategies for Prevention
American Journal of Preventive Medicine
Volume 35, Issue 3, Supplement 1 - September 2008
Adolescent Drivers: A Developmental Perspective on Risk, Proficiency, and
Safety
Despite considerable improvement in the rates of crashes, injuries, and fatalities
among adolescent drivers, attributable in part to effective interventions such as
graduated driver licensing, these rates and their associated health risks remain
unacceptably high. To understand the sources of risky driving among teens, as well as to
identify potential avenues for further advances in prevention, this article presents a
review of the relevant features of contemporary research on adolescent development.
Current research offers significant advances in the understanding of the sources
of safe driving, proficient driving, and risky driving among adolescents. This multifaceted
perspective—as opposed to simple categorization of good versus bad driving—provides
new opportunities for using insights on adolescent development to enhance prevention.
Drawing on recent work on adolescent physical, neural, and cognitive development, we
argue for approaches to prevention that recognize both the strengths and the limitations
of adolescent drivers, with particular attention to the acquisition of expertise, regulatory
competence, and self-regulation in the context of perceived risk. This understanding of
adolescent development spotlights the provision of appropriate and effective
scaffolding, utilizing the contexts of importance to adolescents—parents, peers, and the
broader culture of driving—to support safe driving and to manage the inherent risks in
learning to do so.
Biological, Developmental, and Neurobehavioral Factors Relevant to
Adolescent Driving Risks
This article reviews emerging knowledge about key aspects of neurobehavioral
development, with an emphasis on the development of self-regulation over behavior
and emotions and its relevance to driving risks among youth. It begins with a brief
overview of recent advances in understanding adolescent brain maturation and
presents a heuristic model focusing on brain–behavior–social-context interactions during
adolescent development. The article considers the relatively slow neurobehavioral
maturation of cognitive control and emphasizes the importance of affective influences
on decision making. It points to several questions about programs and policies that may
help to protect high-risk youth during this important maturational period. The heuristic
model is then used to examine a specific neuroregulatory system during adolescence—
the regulation of sleep and arousal. This focus on sleep illustrates key points about brain–
behavior–social-context interactions by looking at both biological and social influences
on sleep in teens. Moreover, sleep has direct relevance to understanding a specific
dimension of driving risk in youth. Sleep deprivation is rampant among adolescents, and
the consequences of insufficient sleep (sleepiness, lapses in attention, susceptibility to
aggression, and negative synergy with alcohol) appear to contribute significantly to
driving risks in teens.
Adolescents, Peers, and Motor Vehicles: The Perfect Storm?
Motor-vehicle crashes are a leading cause of death among teenagers and in
many instances appear linked to negative peer influences on adolescent driving
behavior. This article examines a range of developmental and structural factors that
potentially increase the risks associated with adolescent driving. Developmental risk
factors for adolescents include a propensity toward engaging in deviant and risky
behavior, a desire to please peers, and the potential cost to an adolescent of alienating
peers with his or her behavior while driving. Structural features of the driving situation that
create risks for negative peer influences on driving behavior include the inability of
adolescents to look at peers who may be pressuring them, divided attention, the need
to behave in a conventional manner among peers who may not value conventional
behavior, and the lack of accountability by peers for the effects of any risky driving they
promote. A range of potential peer influences are considered, including passive and
active distraction and direct disruption of driving, as well as more positive influences,
such as peer modeling of good driving behavior and positive reinforcement of good
driving. Although the range of risk factors created by peers is large, this range presents a
number of promising targets for intervention to improve teen driving safety.
Parenting and the Young Driver Problem
Crash rates increase sharply at the age at which teenagers begin to drive and
remain elevated relative to adult levels until drivers are well into their twenties. Parents
have important roles to play in managing the risk for teenage drivers before and after
licensure. Parents can be involved in their teenagers' driving, allowing them to test for
permit and licensure, supervising practice driving, providing access to a vehicle, and
setting and enforcing limits on driving privileges after licensure. However, the
management practices of many parents may not be sufficient to provide safety effects.
The literature indicates that the two most important decisions parents can make to
reduce teenagers' driving risk are to delay licensure and impose limits on high-risk driving
conditions (such as driving at night and with teenage passengers) during the first year of
licensure. Two intervention programs have been shown to increase parental limit setting
as a means of reducing risky driving behaviors and improving driving performance
among novice teenage drivers. This article describes the contexts of and opportunities
for parental involvement in teenage driving and the effectiveness of interventions to
increase and improve parental management of young drivers.