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J Atten Disord. 2006 Nov;10(2):212-6.

Manual transmission enhances attention and driving performance of ADHD adolescent males: pilot study.

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  • 1University of Virginia Health System, Charlottesville, VA 22908, USA.



Inattention is a major contributor to driving mishaps and is especially problematic among adolescent drivers with ADHD, possibly contributing to their 2 to 4 times higher incidence of collisions. Manual transmission has been demonstrated to be associated with greater arousal. This study tests the hypotheses that manual transmission, compared to automatic transmission, would be associated with better attention and performance on a driving simulator.


Ten adolescent drivers with ADHD practice driving on the simulator in the manual and automatic mode. Employing a single-blind, cross-over design, participants drive the simulator at 19:30 and 22:30 hr for 30 min in both transmissions and rate their attention to driving.


Subjectively, participants report being more attentive while driving in manual transmission mode. Objectively, participants drive safer in the manual transmission mode.


Although in need of replication, this pilot study suggests a behavioral intervention to improve driving performance among ADHD adolescents.

[PubMed - indexed for MEDLINE]
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