Teenagers are notoriously reckless. They engage in risky sexual behaviors, binge drink alcohol, and abuse tobacco and other drugs.

Behind the wheel of a car, teenagers are most dangerous, to themselves and others. Motor vehicle crashes are the leading cause of death for U.S. teens, and the risk of crashing is higher among 16 to 19 year olds than any other age group.

Catherine McDonald, an assistant professor in the School of Nursing and a principal investigator in the Center for Injury Research and Prevention (CIRP) at the Children’s Hospital of Philadelphia, says teens are at their highest risk for a crash during their first year of driving—particularly within the first six to 12 months—and the risk can persist for two to three years thereafter.

McDonald, also an assistant professor in the Department of Pediatrics at the Perelman School of Medicine, says there are a multitude of factors that lead teens to drive dangerously, such as inattention to the road, texting and driving, peer passengers, and poor performance.

“It’s related to both skill and risk,” she says. “Some [teen] drivers just lack appropriate skills to be competent drivers.”

McDonald is involved in a number of research projects studying teen driver behavior.

One project employed a simulated driving assessment McDonald developed with Flaura Winston, a professor of pediatrics at Penn Medicine and scientific director at CIRP.

In a study published in June in Injury Prevention, McDonald and Winston had teens complete an assessment in a driving simulator.

Parked in a suite at the CIRP offices at 3535 Market St., the simulator, a Pontiac, contains the seat of a car, a seatbelt, dashboard, gearshift, radio, rearview and side-view mirrors, a 180-degree field of view, and the noises one would hear while operating a vehicle.

In her studies, McDonald has worked with 16- or 17-year-olds who have had their driver’s license for a year or less.

After a practice drive to get a feel for the simulator, the teens complete an experimental drive to assess their behaviors.

The simulated environment includes objects and scenarios from real life, such as road signs, speed limits, restaurants, curves, turns, and unexpected distractions.

Participants in the simulator also wear an eye tracker that gives researchers an up-close view of where the teens are looking during the simulated assessment. McDonald and colleagues are able to see what the teenager sees, and when, where, and for how long he or she takes his or her eyes off the road.

“There is some strong evidence that shows that longer than two seconds of eyes off the forward roadway is highly related to crash risk,” McDonald says.

When a participant crashes, McDonald says he or she does not feel the accident but can see it occur.

Sophomore Annie Wightman, 19, an undergraduate student at Penn Nursing, has been assisting McDonald with one of her driving simulator studies. She says she took a normal driver’s education course in high school and the simulator has the added advantage of incorporating possible distractions and interventions “to really get a feel for what it’s like to be on the road.”

“That’s not really something that many teens get in normal driver’s education, so it’s definitely helpful in that respect,” she says.

Funded by the National Institutes of Health, McDonald is testing the feasibility of a web-based intervention for teen driver inattention that she developed based on the Theory of Planned Behavior, and she is using the simulator as an assessment for the intervention.

“The web-based intervention addresses teen driver attention, looking to change their behavior around cell phone use and passenger engagement,” she says. “We developed it based on focus-group data that [Penn Nursing Professor] Marilyn Sommers and I conducted.” McDonald and Sommers recently published results from their focus group study in Traffic Injury Prevention.

McDonald says they are still in the process of collecting and analyzing data from the web-based intervention study with the driving simulator. She says they are not yet sure if what happens in the simulator will translate to the road, but one of the benefits of the simulator is the ability to subject teens to the same scenarios and environments.

“We’re able to expose teens and make comparisons across groups, as well as expose teens to high-risk and dangerous scenarios in the simulator that you can’t do on the road,” she says.