Skip to Main Content
Skip Nav Destination

Policy describes research, interventions to help teens curb risky driving :

September 24, 2018

Obtaining a driver’s license is a milestone for many teenagers. Unfortunately, motor vehicle crashes are the leading cause of death and injury for adolescents in developed countries, with drivers ages 15-19 years having the highest rate of motor vehicle crashes in the U.S.

The updated AAP policy statement The Teen Driver, from the Committee on Adolescence and Council on Injury, Violence and Poison Prevention, highlights new research describing the unique risks teen drivers and their passengers face. It also offers promising interventions to decrease morbidity and mortality, and considerations for teen drivers who have certain health challenges.

The policy discusses parents’ role in fostering the development of their children into safe and competent drivers, and examines the roles of schools, community organizations and governments in supporting and creating policies and programs to mitigate the risks adolescents face on the road. Recommendations are provided for pediatricians in counseling teen drivers, potential drivers and their families.

The policy is available at and will be published in the October issue of Pediatrics.

Multiple distractions, risk factors

A number of risk factors unique to the teen driver increase the likelihood of crashes.

Teens lack experience, may drive at unsafe speeds and maintain shorter following distances, especially with friends aboard. They can be distracted visually (eyes off the road), manually (removing one’s hands from controls) and cognitively (attention diverted from driving). Electronic devices, such as cellphones, can create all three distractions, a major threat to driver safety. Having friends as passengers also creates distraction.

Use of alcohol, marijuana, illicit substances and certain medications can impair driving. Although alcohol remains the most common ingested substance resulting in crashes and fatalities for teens, drug-impaired driving is a growing concern, with cannabinoids the most commonly detected substance.

Sleep deprivation also is an emerging factor in motor vehicle crashes, as most U.S. teens do not get enough sleep. The statement discusses the impact of adolescent brain development and its effect on teen drivers.

There also is information about how certain medical challenges such as attention-deficit/hyperactivity disorder, concussions, epilepsy or sleep apnea can affect driving. The idea of a standard prelicensing medical evaluation is explored, as a few states require a health assessment prior to obtaining a driver’s license.

Positive influences, interventions

Parents influence teen driving behaviors as role models and as monitors. Parents can set a positive example not only by the way they drive but also by discussing expectations and enforcing them during supervised driving and beyond. Parental monitoring and guidance are associated with reduction in traffic violations and crash rates. The policy details other types of active parent engagement, such as in-vehicle data recording and feedback.

Surprisingly, studies have shown that there is no safety effect associated with traditional driver education, probably due to its focus on  rules of the road and basic vehicle handling. On the other hand, graduated driver’s licensing has been an important advance in teen driver safety over the past 25 years, and its effectiveness has been well-studied.

In general, laws around driving have been proven to decrease fatalities and crashes. Seat belt laws, as well as raising the minimum drinking age, have been effective. With a number of states legalizing cannabis for medicinal and recreational use, states are moving toward standards and laws related to cannabis use and driving.

Laws governing technology that causes electronic distraction while driving are not always clear and not uniformly enforced. Conversely, promising technological interventions that have contributed to safer driving, such as rear-view cameras and automatic braking, exist or are being developed.  

Recommendations for pediatricians 

  • Remind parents that they are powerful role models and can shape their child’s ultimate driving behavior. Encourage parents to practice driving with their teens for more than the state-required minimum number of hours. Assist parents in identifying teens with acute or chronic medical or behavioral risk factors for high-risk driving.
  • Counsel teen drivers about safe driving. Discuss distracted driving, particularly related to technology and friends in the car, and the impact of impaired driving due to alcohol, illicit drugs, medications or lack of sleep.
  • Consult the policy for guidance on community and legislative advocacy on teen driver safety. Recommendations include exploration of a standardized prelicensure medical visit and studying the effect of concussions on teen driving to create guidelines for safe return to driving.

Dr. Alderman, a lead author of the policy, is a member of the AAP Committee on Adolescence and a former chair of the Section on Adolescent Health Executive Committee.

Close Modal

or Create an Account

Close Modal
Close Modal