Driving After Pediatric Traumatic Brain Injury: Impact of Distraction and Executive Functioning

Objective: The objective of the current study was to examine the driving performance of young drivers with a history of moderate to severe traumatic brain injury (TBI) compared with an uninjured control group. The impact of cell phone related distraction (conversation and texting) and executive functioning (EF) were also explored. Method: Individuals aged 16-25 years with (n = 19) and without (n = 19) a history of TBI engaged in a simulated drive under 3 distraction conditions (no distraction, cell phone conversation, and texting). Mean speed, maximum speed, standard deviation of speed, standard deviation of lane position, and crash rates were used as outcomes. The Global Executive Composite (GEC) from the Behavior Rating Inventory of Executive Functioning (BRIEF) was used to measure EF. Results: Significant Injury x Distraction x GEC interaction effects were noted on max speed and speed variability, with a trending Distraction x GEC interaction noted for lane position variability. The effect of distraction was most notable among individuals with greater GEC scores, across both injury groups. Conclusions: A history of pediatric TBI did not specifically impact driving performance independent of EF, with EF playing a central role in functioning across domains of driving performance. Consistent effect of EF suggests that deficits in driving performance may he associated with EF specifically, with individuals with EF difficulties following TBI at greater risk for poor driving performance.