Conscience in Childhood: Past, Present, and Future

We ask three questions: What are the components of young children’s conscience? How are they organized? How does early conscience develop? We discuss the changing perspectives on each of those questions. We describe the shift from a focus on a single component of conscience (moral emotions, conduct, cognition) to a growing emphasis on their integration; from a view of conscience as loosely organized to a view of a coherent system of causally related components; from a focus on older children and adolescents to young toddlers and preschoolers; and from a top-down view of parental discipline immediately following child misbehavior to a focus on mutual processes between the parent and the child that occur in multiple socialization contexts and are shaped by the history of the parent-child relationship and the child’s individuality. We conclude by outlining new directions for research on early conscience

Conscience in Childhood: Past, Present, and Future

We ask three questions: What are the components of young children’s conscience? How are they organized? How does early conscience develop? We discuss the changing perspectives on each of those questions. We describe the shift from a focus on a single component of conscience (moral emotions, conduct, cognition) to a growing emphasis on their integration; from a view of conscience as loosely organized to a view of a coherent system of causally related components; from a focus on older children and adolescents to young toddlers and preschoolers; and from a top-down view of parental discipline immediately following child misbehavior to a focus on mutual processes between the parent and the child that occur in multiple socialization contexts and are shaped by the history of the parent-child relationship and the child’s individuality. We conclude by outlining new directions for research on early conscience

Driving Performance and Driver State in Obstructive Sleep Apnea: What Changes with Positive Airway Pressure?

We evaluated naturalistic driving in 65 drivers with obstructive sleep apnea (OSA) before and after positive airway pressure (PAP) therapy and in 43 comparison drivers. Driving performance metrics included speed (mean, variability), and lateral, and longitudinal acceleration (g’s). Driver state measures included sleepiness and attention to the driving task based on sampled trigger and baseline video clips. OSA drivers showed less variability in speed and lateral g’s compared to control drivers before and after PAP treatment when vehicle speed wa

Effects of Fatigue on Real-World Driving in Diseased and Control Participants

This study evaluated real world driver errors and sleepiness in 66 drivers with Obstructive Sleep Apnea (OSA) and 34 matched controls (24 younger and 22 older). Driving errors and driver state were derived from analyses of video data from “black-box” event recorders. Sleep fragmentation data in OSA was derived from actigraphy for 15 days prior to beginning standard treatment (positive airway pressure, PAP) and 15 days after beginning PAP treatment. Prior to starting PAP, OSAs appeared sleepier than controls in general and particularly at intersections, while making safety errors following nights with high levels of fragmented sleep compared to matched controls. Adverse effects of sleep fragmentation during the pre-PAP phase were reduced post-PAP. Greater hours of PAP-use were associated with lower sleepiness and errors on the road. PAP-use was associated with a decrease in high sleep fragmented nights. Findings suggest reduction in acute sleepiness is unlikely to be the only mediating factor that explains the driving safety benefits of PAP in OSA

Effects of Environmental Factors on Naturalistic Driving in Obstructive Sleep Apnea

Reduced visibility and other environmental factors can impair driver ability to respond to roadway hazards. We examined the effects of reduced visibility on naturalistic driving in 66 drivers, including 45 at-risk drivers with obstructive sleep apnea (OSA) and 21 controls. We analyzed three months of electronic data using “black box” recorder technology and assessed the extent to which driver speed, longitudinal acceleration, and lateral acceleration metrics depend on ambient visibility from web-based environmental data archives. We calculated summary driving metrics within 10-second intervals, and reduced these to within-subject means and tested for associations of interest. OSA drivers did not differ from controls with respect to electronic measures or visibility conditions in which they drove. On average, drivers drove slower when visibility was reduced. After controlling for speed, variations in lateral and longitudinal acceleration were positively associated with high-visibility conditions. These findings suggest that drivers exert greater vehicular control when visibility is limited, and that this association is not just due to slower speeds. Weaker relationships between visibility and driving measures in OSA suggest reduced adaptive strategies. Our methods provide a framework for analyzing the effects of other environmental factors on driving, and we provide an additional example using wind speed

Can Intermittent Video Sampling Capture Individual Differences in Naturalistic Driving?

We examined the utility and validity of intermittent video samples from black box devices for capturing individual difference variability in realworld driving performance in an ongoing study of obstructive sleep apnea (OSA) and community controls. Three types of video clips were coded for several dimensions of interest to driving research including safety, exposure, and driver state. The preliminary findings indicated that clip types successfully captured variability along targeted dimensions such as highway vs. city driving, driver state such as distraction and sleepiness, and safety. Sleepiness metrics were meaningfully associated with adherence to PAP (positive airway pressure) therapy. OSA patients who were PAP adherent showed less sleepiness and less non-driving related gaze movements than nonadherent patients. Simple differences in sleepiness did not readily translate to improvements in driver safety, consistent with epidemiologic evidence to date

Effects of Familiarity and Age on Driver Safety Errors During Wayfinding

Wayfinding is a critical skill that enables drivers to navigate from one location to another. Wayfinding abilities decline as individuals age, which may increase older driver reliance on directional cues (e.g. signs) and divert cognitive resources at the expense of vehicle control and safety. Familiarity with an environment can facilitate wayfinding due to previous knowledge of the route. This study examines the role of familiarity in driving safety errors committed during a wayfinding task. Results suggest that age-related driving difficulties can be lessened by familiarity with the environment. The results underscore the need to consider geographical license restrictions in administrative policies aimed at improving older driver safety

Contextualizing Naturalistic Driving Data in a Rural State Among Drivers With and Without Obstructive Sleep Apnea

In naturalistic studies, Global Positioning System (GPS) data and date/time stamps can link driver exposure to specific environments (e.g., road types, speed limits, night driving, etc.), providing valuable context for analyzing critical events, such as crashes, near crashes, and breaches of accelerometer limits. In previous work, we showed how to automate this contextualization, using GPS data obtained at 1 Hz and merging this with Geographic Information Systems (GIS) databases maintained by the Iowa Department of Transportation (DOT). Here we further demonstrate our methods by analyzing data from 80 drivers with obstructive sleep apnea (OSA) and 48 controls, and comparing the two groups with respect to several factors of interest. The majority of comparisons found no difference between groups, suggesting similar patterns of exposures to driving environments in OSA and control drivers. However, OSA drivers appeared to spend slightly more time on roads with annual traffic counts of 500-10,000 and less time driving on wider highways, during twilight, and on roads with 10,000-25,000 annual traffic counts

Feedback from Naturalistic Driving Improves Treatment Compliance in Drivers with Obstructive Sleep Apnea

As part of a study in drivers with obstructive sleep apnea (OSA), we conducted a randomized clinical trial to assess whether individualized feedback can increase compliance with continuous positive airway pressure (CPAP) therapy. After completing 3.5 months of naturalistic driving monitoring, OSA drivers were randomized either to receive an intervention, which was feedback regarding their own naturalistic driving record and CPAP compliance, or to receive no such intervention. In the week immediately after the intervention date, drivers receiving feedback (n=30) improved their CPAP usage by an average of 35.8 minutes per night (p=0.008; 95% CI=9.6, 62.0) to a mean level of 296 minutes. By contrast, CPAP usage in the non-feedback group (n=36) decreased an average of 27.5 minutes per night (p=0.022; 95% CI=4.0, 51.0) to a mean level of 236 minutes. The mean group-specific changes were higher (better) in the feedback group than in the non-feedback group during the first, second, and third weeks of follow-up (p0.25 in all cases). Our study suggests that CPAP compliance can be increased using individualized feedback, but that follow-up feedback sessions or reminders may be necessary for sustained improvement

Effectiveness of a Heads-Up Adaptive Lane Deviation Warning System for Middle-Aged and Older Adults

46 participants (24 younger and 22 older) completed at least one out of four simulated drives designed to test the effectiveness of an Adaptive Lane Deviation Warning (LDW) system, and they drove through both a warnings-on and warnings-off version of each drive. Findings showed that LDW was effective in reducing reaction time for lane deviation corrections for both older (by 1.2 seconds) and younger drivers (by 1.6 seconds). The older and younger drivers did not differ in correction RTs when the warnings were turned off. But older drivers showed slower correction RTs than younger drivers in the warning-on drives. The data indicate that these benefits were specific to LDW rather than general improvement in driving performance. Cognitive processing speed emerged as a particularly robust predictor of benefits from the LDW compared to other domains of cognitive function