Individualized training is key for autistic adolescents learning to drive

(Press-News.org) Philadelphia, April 20, 2021 - A collaborative study from the Center for Injury Research and Prevention (CIRP) and the Center for Autism Research (CAR) at Children's Hospital of Philadelphia (CHOP) identified clear strengths and a series of specific challenges autistic adolescents experience while learning to drive. The findings were recently published by the American Journal of Occupational Therapy.

Researchers conducted in-depth interviews with 17 specialized driving instructors who were trained as occupational therapists, driving rehabilitation specialists, or licensed driving instructors and who had completed additional training related to teaching autistic individuals to drive. Their insights stress the importance of providing specialized, scaffolded instruction where skills are taught one at a time, allowing students to develop mastery before adding new skills. These approaches help young autistic drivers develop driving skills over time supported by plenty of caregiver-supervised practice.

Instructors described specific behind-the-wheel challenges among young autistic drivers, including being overly rule-bound, becoming easily distracted, and having difficulty integrating what other drivers are doing with their own hand-eye-foot coordination required to drive. Instructors believed many of these challenges could be overcome through careful skill-building instruction over a prolonged period of time.

Observed strengths of young autistic drivers included carefully following the rules of the road, paying close attention to their driving environment, and limiting risk-taking. Instructors believed these clear strengths help students become competent drivers.

"Through our interviews with specialized driving instructors who worked specifically with young autistic drivers, we learned about teaching strategies perceived to be effective and recommendations to improve the learning-to-drive process for these adolescents and young adults," said Rachel K. Myers, PhD, lead author of the study and a scientist at CIRP. "Rigorous, individualized training is needed for their behind-the-wheel instruction. More research is needed to standardize best practices for autistic adolescent driver instruction."

Besides breaking down driving tasks into discrete learning goals, instructors used a variety of strategies to build driving skills, including having teens sit in the passenger seat and describe what the driver is doing, and repeated practice on the same driving routes to reduce anxiety.

Instructors also stressed that young autistic drivers should be prepared for experiences they may encounter outside the vehicle, such as changing a tire or interacting with law enforcement. After getting licensed, some instructors may recommend autistic adolescents drive only with supervision or restrictions, such as only traveling on familiar routes.

"According to the specialized driving instructors we interviewed, autistic adolescents who had limited experience with other forms of transportation or vehicle use, such as bicycling, before learning to drive had a harder time learning to control the vehicle," said Benjamin E. Yerys, PhD, study author and a clinical psychologist at CAR. "This difficulty could contribute to challenges in controlling speed, maintaining lane position, and managing oncoming traffic. Caregivers should find ways to promote these life skills and hand-eye-foot coordination skills before beginning the learning-to-drive process."

Recent research conducted at CHOP found that newly licensed young autistic drivers have similar to lower crash rates than their non-autistic peers. Additionally, young autistic drivers are much less likely to have their license suspended or to receive a traffic violation than their non-autistic peers.

Driving is an important part of leading an independent life and is one option for ensuring safe mobility for autistic adolescents and young adults. Resources for families to help with the transition to adulthood are available at TeenDriverSource.org and CAR Autism Roadmap.

INFORMATION:

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health.

Myers et al, "Behind the Wheel: Specialized Driving Instructors' Experiences and Strategies for Teaching Autistic Adolescents to Drive." Am J Occup Ther, online April 12, 2021. DOI: 10.5014/ajot.2021.043406.

About Children's Hospital of Philadelphia: Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals, and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country. In addition, its unique family-centered care and public service programs have brought the 595-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu.