Teenage drivers diagnosed with attention-deficit/hyperactivity disorder (ADHD) are at significant risk for negative driving outcomes related to morbidity and mortality. However, there are few viable psychosocial treatments for teens with ADHD and none focus on the key functional area of driving. The Supporting the Effective Entry to the Roadway (STEER) program was evaluated in a clinical trial to investigate whether it improved family functioning as a proximal outcome and driving behavior as a distal outcome. One hundred seventy-two teenagers with ADHD, combined type, were randomly assigned to STEER or a driver education driver practice program (DEDP). Relative to parents in the DEDP condition, parents in STEER were observed to be less negative at post-treatment and 6-month follow-up but not at 12-month follow-up, and there were no significant differences for observed positive parenting. Relative to teens in the DEDP condition, teens in STEER reported lower levels of risky driving behaviors at post-treatment and 6-month follow-up, but not at 12-month follow-up. Groups did not differ on objective observations of risky driving or citations/accidents. Conclusions: The STEER program for novice drivers with ADHD was effective in reducing observations of negative parenting behavior and teen self-reports of risky driving relative to DEDP; groups did not significantly differ on observations of positive parenting or driving behaviors. Families with a teenager with ADHD may benefit from engaging in behavioral parent training around the transition to independent driving, especially via reductions in negative parenting. Teenagers with ADHD self-reported fewer risky driving behaviors within the family-focused intervention, but these findings were not replicated on objective observations of driving.
