School Travel Safety

Our last blog looked at issues relating to early school start times and the new California law that prohibits start times for middle school students before 8 a.m. and for high school students before 8:30 a.m. But no matter what time your child begins his or her school day, being safe on the way to and from school is an important issue to everyone to keep in mind.

Safety concerns start on the way out the door in the morning and continue until students arrive at their homes at the end of the day, which for some students with after-school sports or activities can be as late as 6 or 7 pm. Our colleagues at The American Academy of Pediatrics cite research from The National Research Council  Transportation Research Board, Committee on School Transportation Safety that broke down the ways that students travel to and from school during the regular school day. These modes of travel included passenger vehicle with adult driver, 45%; school buses, 25%, other buses, 2%; passenger vehicle with teen driver, 14%; bicycle, 2%; and walking, 12%. Not included in these figures are transportation after regular school hours or for extracurricular activities. These after hours trips are often done after dark and can involve longer distances (to sporting events or tournaments outside of the home district); they have a disproportionately high occurrence of crashes.

 

What can parents do to make travel to and from school safer?

• Make sure young children are accompanied by a parent, caretaker, or responsible older sibling while walking to or from school or the bus stop
• Remind children that the bus stop is not a playground and that running around, which can often end up in the adjacent road, can be dangerous
• Dawn and dusk are the most difficult times of day for motorists to see pedestrians. As the days shorten, make sure your child is wearing at least some reflective clothing so he or she is highly visible
• Work with your PTA or other group to make sure your school has implemented appropriate safety measures -- crossing guards, dismissal and arrival procedures, and safety training as part of the curriculum -- to provide children age-appropriate safe travel
• Support graduated driving licences for teens. Teenage drivers should pass not just the State road test, but Mom or Dad's road test as well. That may mean that driving privileges are delayed until a teen demonstrates sufficient maturity and judgment to understand that the consequences of distracted driving can be deadly. 
• Model good driving practices yourself; never text or use your phone or otherwise drive with distractions and always wear seat belts. We've written before about steps to safer teen driving. Speed, having passengers in the car, and failure to wear seat belts are some of the driving practices that pose the most risk to teens.

Teen Driver Safety Week

It sometimes seems like there are "weeks" or "days" for all sorts of things, most of them them the creation of some marketing mind trying to get attention for a product or event. But this week's commemoration of Teen Driver Safety Week is one event that no parent should ignore. 

According to the Centers for Disease Control and Prevention, motor vehicle crashes are the leading cause of death for U.S. teens. To put the issue in context, the CDC provides the following statistics: In 2014, 2,270 teens in the United States ages 16–19 were killed and 221,313 were treated in emergency departments for injuries suffered in motor vehicle crashes; six teens ages 16–19 died every day from motor vehicle injuries.

In 2013, young people ages 15-19 represented only 7% of the U.S. population. However, they accounted for 11% ($10 billion) of the total costs of motor vehicle injuries.

The National Highway Traffic Safety Administration focuses on five most significant risks when teens are at the wheel, and has created a "5 to Drive" campaign to address these: 

• alcohol use
• not wearing seat belts
• distracted driving
• speeding 
• extra passengers, especially other teens

There are a number of steps parents can take to reduce the risks when their teens drive. Our colleagues at the American Academy of Pediatrics (AAP) have looked at the risk factors noted above and add a few of their own: nighttime driving, driving older vehicles, driving by teens who do not have a license, and unmedicated ADHD. They propose solutions which involve both parents and teens, including graduated driving laws, restrictions on nighttime driving and carrying passengers, and zero tolerance for alcohol use by teen drivers. 

Both the AAP and the American Automobile Association urge parents of teen drivers to consider entering into a contract with their children, first discussing the many factors that impact safe driving and then coming to an agreement about how and when their child should be operating a motor vehicle and what the consequences will be for any infractions. The AAP also offers links to information for parents about their role in safe teen driving and to clear, colorful charts (good for sharing with your teen) showing how different risk factors can affect teen driving safety.

Lag in Putting Sleep Research into Practice

A recent editorial in The Brown University Child and Adolescent Behavior Letter expresses frustration with the lengthy time gap between important scientific discoveries and the implementation of these discoveries in everyday practice.

Dr. Gregory Fritz notes that the lag between research findings and changes in practice and behavior is often cited to be 17 years on the average, but that the disconnect is particularly egregious when it comes to what researchers know about the importance of sleep for adolescents and the actual amount of sleep that teenagers get. He refers to a 2014 Policy Statement from the American Academy of Pediatrics as evidence that the need for sleep is well-accepted in the pediatric community. The AAP Policy Statement and Dr. Fritz both point to early school start times as a major factor in sleep deprivation. We have written about this issue many times; in fact so often that it is impossible to include links to all relevant posts. Searching "sleep" in the list of blog topics will enable readers to locate all our posts on this subject.

Research has demonstrated that the tendency for teens to stay up later is part of the changes in the level of the hormone melatonin that occur during puberty and continue through adolescence. When teens are able to compensate for this change by sleeping later in the morning, things tend to balance out. But, when teens have an early start time at school and they must get up before they have had the full amount of sleep needed for maximum functioning, their daytime function is impaired. Dr. Fritz notes that, "sleep-deprived adolescents tend to get lower grades and report higher rates of depressive symptoms," compared to those who get the optimal amount of sleep - close to nine hours. Particularly concerning is that there is a correlation between sleep deprived teens and auto accidents. When you consider that teens are inexperienced drivers, and you add in the impairment caused by drowsy driving, this is frightening.

Dr. Fritz laments the failure of adults to take the available data seriously and to take steps to change the start times of school for teens. It may take some logistical maneuvering, but failure to make this a national priority is creating a generation of drowsy, inattentive- and possibly endangered - teens.

photo credit :D Sharon Pruitt @ flickrcc

ADHD Medications and Teenage Drivers

We are frequently asked whether it is really necessary to take attention medications every day. Some students feel that they only need their meds when they have a major project, important test, or heavy workload. Many parents like to give their children a “break” over the weekend or during vacations. I believe that deciding whether and how to take medications is a personal decision best made in consultation with the prescribing physician. But making a wise decision requires the best information so each of us can weigh the potential benefits and risks in the context of our own lives. With that in mind, I think it is important to share interesting research that was published in the April 2012 edition of the Journal of Clinical Psychopharmacology in a study called "Long-Acting Methylphenidate Reduces Collision Rates of Young Adult Drivers With Attention-Deficit/Hyperactivity Disorder" (by Cox, Daniel J. PhD; Davis, Margaret BA; Mikami, Amori Yee PhD; Singh, Harsimran PhD; Merkel, Richard L. MD, PhD; and Burket, Roger MD). 
    
The investigators studied adolescents diagnosed with ADHD who had previously responded to medication, were not routinely taking medication, and were active drivers with more than one collision or citation in the past two years. Half of the participants received long-acting stimulants; the other half did not. Their driving was monitored for three months with in-car video cameras. (You are probably wondering how you can get a hold of one for your own adolescent driver). Compared to the untreated group, the group receiving medications had fewer video-documented collisions and “problematic driving events.” So, when making decisions about risks and benefits of attention medications, bear in mind that academic performance may not be the highest priority.

Photo by Dominic Alves via Flickr/Creative Commons

Teens and Driving

There is no easy way to discuss this topic. Auto accidents are the leading cause of death of American teenagers, killing nearly 6,000 each year. Anything that can reduce this number, and the anguish it represents, is welcome news for parents.

The American Automobile Association (AAA) has long been concerned with the dangers posed by new drivers, who often lack both  judgment and experience. Making things even more difficult is the social aspect of driving, which prompts teens to want to drive with friends in the car, sometimes with music blasting and with other distractions that add to the inherent dangers of operating an almost two ton machine on a road with other vehicles. The AAA has recently launched a new website to provide information to parents to help their children through every step of the driving process, from pre-permit education, through getting a learner's permit, to becoming ready to drive solo. The website is state specific; when you go to the web address it will provide the specific information on the state you are searching from and let you look at information from other states as well. This is particularly useful, because states have taken many steps to make teen driving safer, including graduated licensing and restrictions on when and with whom teens may drive. Of course, state laws are only a minimum standard. Parents can always impose their own rules and restrictions. We know parents who won't give their teens the car keys until they pass Mom's (or Dad's) Road Test, a far tougher test than any state examiner will provide.

By using interactive features and including sections for both parents (on teaching teens to drive) and young people (with lots of bells and whistles to keep the information on driving safely interesting), the website is one more tool in  helping to keep our children safe.