Ready for a Learner's Permit? Clinical Neuropsychological Off-road Tests and Driving Behaviors in a Simulator among Adolescents with ADHD and ASD

A simulator driving test (SDT) and two neuropsychological tests, the Useful Field of View (UFOV) test and the Test of Variables of Attention (TOVA) were evaluated with regard to validity for fitness to drive on 51 young clients diagnosed with attention deficit hyperactivity disorder (ADHD), 33 of whom also had autism spectrum disorder (ASD), and 38 adolescents without a neurodevelopmental diagnosis. The results show generally much greater variability and significantly poorer performance in the SDT and the TOVA for clients with ADHD/ASD compared with the control group. The SDT results were strongly intratest correlated, but had no interest correlation with either the UFOV test or the TOVA. The greater variability among clients with ADHD/ASD suggests greater effort and susceptibility to motivational issues and decline in sustained attention over several tests. In conclusion, the SDT is sensitive and has good face validity, and the TOVA is sensitive to neuropsychological aspects of safe driving. The SDT and the TOVA thus complement each other, and discrepancy between test scores calls for special consideration.

The effect of attention-deficit/hyperactivity disorder (ADHD) on driving behavior and risk perception

OBJECTIVE

To examine the effect of attention-deficit/hyperactivity disorder (ADHD) on differences in driving behavior and risk perception, in experienced drivers.

METHODS

A total of 147 experienced drivers participated in the study. Drivers with ADHD (n = 91) were compared to an age-matched control group of drivers (n = 56) with no neuropsychiatric diagnoses. A simulator driving test (SDT) was used in the study and included a driving scenario with various traffic environments to examine any differences in number of collisions, number of speedings, risk index (based on 12 risky situations), speed adaptation (based on 19 road sections), mean speed, and preferred speed, between the two groups. The participants also completed a questionnaire about their driving behavior.

RESULTS

No differences in the simulator driving test were found between the ADHD group and the control group. No adverse effects of ADHD were found for any of the measures, i.e., collisions, number of speeding, risk index, speed adaptation, mean speed and preferred speed. The only significant group difference was that drivers with ADHD rated themselves lower on concentration.

CONCLUSIONS

Participants with ADHD and the control group drove remarkably similarly in the simulator driving test and rated themselves similarly regarding how they drive. The results contribute to state that ADHD drivers are less deviant than asserted by previous research.

Speech-reading of synthetic and natural faces: effects of contextual cueing and mode of presentation

A natural and a synthetic face were compared with regard to speech-reading performance, with a visual and an audio-visual condition, and with three levels of contextual cueing in an experiment with 90 normal-hearing subjects. Auditory presentation (speech in noise) served as a control condition. The results showed main effects for type of face, presentation mode and contextual cueing, and also an interaction between presentation mode and type of face, such that performance was superior for the natural compared with the synthetic face, and especially in the audio-visual mode. Audio-visual speech-reading was more accurate than visual and auditory presentation and contextual cueing improved performance overall. It is suggested that a synthetic face can be a valuable and useful support if proper cueing and an auditory signal are provided, but it is outperformed by a natural face with regard to complementarity to an underspecified auditory speech signal.

Speech-reading: cognitive predictors and displayed emotion

The present study had three aims: to examine the effects of displayed emotion and message length on speech-reading performance, and how measures of working memory (cf. Baddeley 1986) and verbal information processing speed relate to speech-reading performance. Words and sentences with either positive or negative meaning were used in a word decoding and a sentence-based speech-reading test. A total of 48 normal-hearing subjects participated. The results revealed general effects of displayed emotion, message meaning and message length and no effect of displayed emotion vs message length. Furthermore, working memory but not verbal information processing speed nor accuracy predicted speech-reading performance. The results were discussed with respect to a model of face-processing (Bruce & Young 1986) and with respect to clinical implications.

Facial expressions and speechreading performance

In the present study, the role of facial expressions in visual speechreading (lipreading) was examined. Speechreading was assessed by three different tests: sentence-based speechreading, word-decoding, and word discrimination. Twenty-seven individuals participated as subjects in the study. The results revealed that no general improvement as a function of expression was obtained across all tests. Nevertheless, skilled speechreaders could significantly improve their performance as a function of emotional expression in the word-decoding and word-discrimination conditions. Furthermore, a correlational analysis indicated that there was a significant relationship between the subjects' rating of confidence regarding their responses to each test-item and performance on speechreading tests where lexical analysis is a necessary task-demand. The results are discussed with respect to how information from facial expressions is integrated with the information given by the lip movements in visual speechreading, and also with respect to general models of face-processing (i.e., Bruce & Young, 1986; Young & Bruce, 1991).