Pediatric Reflections: Offering Guidance to Families of Autistic Youth Who Want to Drive

Contributed by: Allison E. Curry, PhD, MPH Although prior driving simulator studies suggested that young autistic drivers may be at heightened risk for motor vehicle crashes, a recent CHOP study published in the Journal of the American Academy of Child & Adolescent Psychiatry found that newly licensed drivers on the autism spectrum have similar—or even lower—per-driver rates of crash involvement than their non-autistic peers. They also have substantially lower rates of moving violations and license suspensions than other young drivers. Among those involved in a crash, young autistic drivers were half as likely to crash due to speeding but more likely to crash while making left- or U-turns and failing to yield.

While future research still needs to be conducted to determine whether the crash patterns are attributable to different driving patterns, a greater affinity to follow the rules of the road, or an active effort by families to balance independence and driving risk, our findings suggest that young autistic drivers may establish driving patterns that balance independent mobility and risk; thus, bringing their likelihood of crashing in line with their non-autistic peers.

What we do know is that young autistic drivers may need rigorous, tailored instruction and other support to develop the range of skills needed to acquire licensure, particularly in more challenging traffic scenarios. But, once they do, they’re on their way to becoming safe, independent drivers.

Families rely on clinicians like you to provide guidance for their adolescents with autism who may be interested in driving. You can encourage these families to:

• Seek the advice of an occupational therapist who specializes in driving or a driver rehabilitation specialist who has training in working with individuals with special needs. Visit the Association for Driver Rehabilitation Specialists website for a list of members.
• Add driving goals to their child’s individualized education plan (IEA) and follow up with school personnel. Our research has found that those with driving goals are more likely to be licensed.
• Early in adolescence, begin preparing for adulthood by identifying and promoting the acquisition of independent life skills in diverse domains, including: personal hygiene, health, food preparation, housekeeping, and transportation.
• Consider treatment for ADHD symptoms, including impulsivity and inattention, if needed.
• Provide plenty of caregiver-supervised driving instruction in partnership with professional driving instruction. The TeenDrivingPlan Practice Guide offers online evidence-based instruction in six driving environments, at night, and in inclement weather.

Access transportation mobility resources from TeenDriverSource.org and the Center for Autism Research at CHOP.

References and Further Reading

Curry AE, Metzger KB, Carey ME, Sartin EB, Huang P, Yerys BE. Comparison of Motor Vehicle Crashes, Traffic Violations, and License Suspensions Between Autistic and Non-autistic Adolescent and Young Adult Drivers. [Published online ahead of print January 13, 2021.] Journal of the American Academy of Child & Adolescent Psychiatry.

Allison E. Curry, PhD, MPH, is an assistant professor of Pediatrics in the Division of Emergency Medicine and a senior scientist in the department of Epidemiology and Biostatistics at the Center for Injury Research and Prevention.