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Abstract
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Introduction
Youth with Attention Deficit Hyperactivity Disorder (ADHD) face challenges with road safety. While executive functions are developing in all young drivers, those diagnosed with ADHD have deficits in executive functions that are known to be important in driving. The aims of this study were to compare the executive functions and driving skills of adolescents identified with and without ADHD, and to evaluate whether a computerized cognitive training program is associated with improvement in executive functions (i.e., attention, working memory, inhibition) and driving skills. The hypotheses were: a) compared to a group of adolescents without ADHD, executive functions and driving skills of adolescents with ADHD will be poorer at pre-training; and b) while both groups will improve their executive function and driving skills after receiving the computerized cognitive training, the improvement will be greater in the ADHD group.
Method
This study used a quasi-experimental pre- and post-training control group design. Thirty adolescents aged 16 to 18 years with no prior driving experience participated in the study. Half (50 %) were diagnosed with ADHD and groups were matched by age. The Integrated Visual and Auditory (IVA-2) functional test was administered to insure proper inclusion in both groups. Twelve 45-minute sessions aimed at improving executive functioning were provided to both groups with the Captain's Log cognitive training software. Executive functioning was measured with cognitive tasks: attention with the Continuous Performance Task (CPT), working memory with the N-Back task, and inhibition with a Go/No Go task. Driving skills were appraised with a virtual reality driving task measuring speed management (mean, variability, percentage over the speed limit) and stopping (deceleration, and frequency of stopping at red traffic lights and pedestrian crosswalks). Executive functioning and driving skills were measured at pre- and post-training. Two repeated measures MANOVA were used to test the research hypotheses.
Results
Results from the IVA-2 confirmed group membership. At pre-training, the analyses showed that the ADHD group performed more poorly than the non-ADHD group on the CPT, N-Back, Go/No Go, and driving task (higher average driving speed, higher speed standard deviation and stopping less at red lights and crosswalks). At post-training, there was a significant improvement in executive functions and driving skills in both groups. Compared to the non-ADHD group, the cognitive training program was associated with stronger improvement in executive functions for the ADHD group. However, improvement in driving skills did not differ between groups.
Conclusion
Results confirmed previous findings that computerized cognitive training is associated with greater improvement in executive functioning in adolescents diagnosed with ADHD than in non-ADHD individuals.
RESULTS also suggest that the training may have some potential to improve driving skills of both adolescents with and without ADHD in the pre-driving stage. Future research is recommended to examine computerized cognitive training aiming more directly to improve on-road driving performance of young ADHD individuals. |