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Motor vehicle crashes are the leading cause of death for 16- to 20-year-olds, accounting for about 5,500 fatalities annually and injuring thousands more. A variety of legislative measures—graduated driver licensing (GDL), minimum drinking-age and drunk-driving laws, and improved seat belt laws—are saving teens' lives, but much work remains to be done, particularly in improving the way parents handle the issue of teen driving. Parents are too often unaware of their teens' risky driving habits and while parents do place restrictions on their teens' driving, they are often not the restrictions with proven safety benefits such as prohibitions on nighttime driving and limits on the number of teen passengers.
Pediatricians can be valuable partners in helping families address this important health topic. Pediatricians can educate parents and teens about the dangers of teen driving and ways to enhance safety, facilitate communication between the parent and teen about driving, and help parents establish useful restrictions and logical consequences as their teens begin to drive.
The Parent-Teen Driving Agreement is a useful tool for pediatricians to use in practice as part of their counseling on teen driving. Although there is not yet sufficient evidence that such an agreement improves driver safety or decreases violations and crashes, it may result in better communication, more restrictions, and safer parent and teen attitudes.
Use these tools as part of your counseling. Explain that while your state has a GDL law, parents still have a crucial role to play in keeping their teens safe on the road.
Help parents understand that while it is important to know where their teens are going and when they will be home, the most important restrictions they can set are on nighttime driving and the number of teen passengers.
Remind parents that wearing a seat belt is the best defense against injury or death in a crash. Teens should never drive or ride in a car unbuckled, and parents need to set a positive example by always buckling up themselves.
Because the majority of night crashes occur before midnight, the night curfew should initially be set at 9:00 pm.
Teens who have attention-deficit/hyperactivity disorder (ADHD) are known to be safer drivers when they are taking medication. Discuss this issue with teens in your practice who have ADHD and their parents, and consider the use of long-acting medications or an afternoon or evening dose for teens who drive late in the day.
Because the highest risk of a crash is in the first 6 months of unsupervised driving, teens should not have passengers until they have had extensive on-road driving experience. You may want to mention that 1 passenger increases the risk of a crash by 40%, 2 passengers doubles the risk, and 3 passengers quadruples the risk.
Talk with parents about the dangers of expecting their newly licensed teen drivers to give rides to younger siblings.
Talk with parents about their important role in supervising their teens' driving practice. Mention that many parents view this as a rare chance to spend time alone with their teens. Explain that extensive supervised practice is critically important. Some states now require as much as 50 hours of on-road practice (5–10 hours at night) before a teen can get a provisional license.
Use this as an opportunity to help parents and teens negotiate their changing relationship and develop new communication strategies that allow teens to grow more independent while parents appropriately supervise and monitor their teens' activities to keep them safe. If parents are concerned about their teens' maturity and ability to handle the responsibilities of driving, you can advise that states allow parents to prevent teens from getting a permit or license.
Discuss the agreement and teens' driving with families several months before teens are eligible for a learner's permit. The agreement is not a static document. As teens gain more experience and prove themselves to be responsible, safe drivers, restrictions should gradually be relaxed (but should always, at a minimum, follow the GDL requirements for the state). Families should revisit the agreement frequently as part of ongoing communication about teen driving.
Help parents and teens understand that certain restrictions are nonnegotiable (eg, no driving without a seat belt, no drinking and driving), while other restrictions can be relaxed over time (eg, nighttime driving, teen passengers). Help parents and teens agree to consequences that are commensurate with the severity of the violation.
Suggest that parents discuss the teens' responsibility to help with some of the costs of driving (eg, insurance, gas, maintenance).
See A Message to Parents of Teen Drivers