Adolescent Development Adolescent Drivers A Developmental Perspective on Risk, Proficiency, and Safety Daniel P. Keating, PhD, Bonnie L. Halpern-Felsher, PhD Abstract: Despite considerable improvement in the rates of crashes, injuries, and fatalities among adolescent drivers, attributable in part to effective interventions such as graduated driver licensing, these rates and their associated health risks remain unacceptably high. To understand the sources of risky driving among teens, as well as to identify potential avenues for further advances in prevention, this article presents a review of the relevant features of contemporary research on adolescent development. Current research offers significant advances in the understanding of the sources of safe driving, proficient driving, and risky driving among adolescents. This multifaceted perspective—as opposed to simple categorization of good versus bad driving—provides new opportunities for using insights on adolescent development to enhance prevention. Drawing on recent work on adolescent physical, neural, and cognitive development, we argue for approaches to prevention that recognize both the strengths and the limitations of adolescent drivers, with particular attention to the acquisition of expertise, regulatory competence, and self- regulation in the context of perceived risk. This understanding of adolescent development spotlights the provision of appropriate and effective scaffolding, utilizing the contexts of importance to adolescents—parents, peers, and the broader culture of driving—to support safe driving and to manage the inherent risks in learning to do so. (Am J Prev Med 2008;35(3S):S272–S277) © 2008 American Journal of Preventive Medicine Introduction D riving requires a set of complex, interrelated, and simultaneous competencies, including psy- chomotor, cognitive, and perceptual proficiency. Although teens are generally successful at acquiring necessary driving skills, translating these skills into safe driving requires complex strategies, expertise, and con- centration, with errors in execution often resulting in serious, even fatal, consequences. However, on average, adolescents are not cognitively mature enough to fully execute safe driving skills, with particular risks arising from regulatory challenges that occur in complex and distracting contexts. Given the ongoing development of adolescents’ bodies and minds, seen in the context of social influences that occur during adolescence, it is not surprising that adolescent drivers are at such great risk. Reducing risky adolescent driving necessarily re- quires an understanding of these multiple and often competing demands of development and environment, suggesting that interventions and policies need to re- spond to these complex systems. The emerging knowledge of adolescent develop- ment has important applications to adolescent driv- ing, providing strong support for the most successful and most promising approaches to enhancing teen driving safety, such as those related to graduated driver licensing (GDL). As discussed later in this article, further understanding of adolescent develop- ment should continue the momentum necessary to implement and expand policies that have been shown to be effective. Legislative change requires continuous effort, especially when safety has to com- pete with custom and convenience, as it so often does. 1 Restrictions on teen driving, for example, may on average decrease driving risk, but they also extend the period during which parents need to provide transportation for their adolescent. Further, under- standing the underlying mechanisms of adolescent development could provide an impetus for closer study of approaches that have not been systematically tested, as well as some guidance on how such ap- proaches might be more precisely focused. Adolescent Development: Implications for Teen Driving Adolescence marks a period of time when rapid and extreme physical, cognitive, and psychosocial changes are occurring. These sets of developmental change are From the Center for Human Growth and Development, University of Michigan (Keating), Ann Arbor, Michigan; Division of Adolescent Medicine, Department of Pediatrics, University of California (Halpern- Felsher), San Francisco, California Address correspondence and reprint requests to: Daniel P. Keat- ing, PhD, Center for Human Growth and Development, 300 N. Ingalls Street, University of Michigan, Ann Arbor MI 48109. E-mail: keatingd@mail.umich.edu. S272 Am J Prev Med 2008;35(3S) 0749-3797/08/$–see front matter © 2008 American Journal of Preventive Medicine • Published by Elsevier Inc. doi:10.1016/j.amepre.2008.06.026