Longitudinal study of driver licensing rates among adolescents and young adults with autism spectrum disorder

Abstract

Driving may increase mobility and independence for adolescents with autism without intellectual disability (autism spectrum disorder); however, little is known about rates of licensure. To compare the proportion of adolescents with and without autism spectrum disorder who acquire a learner's permit and driver's license, as well as the rate at which they progress through the licensing system, we conducted a retrospective cohort study of 52,172 New Jersey residents born in the years 1987-1995 who were patients of the Children's Hospital of Philadelphia healthcare network ⩾12 years of age; 609 (1.2%) had an autism spectrum disorder diagnosis. Electronic health records were linked to New Jersey's driver licensing database (2004-2012). Kaplan-Meier curves and log-binomial regression models were used to determine the age at and rate of licensure, and estimate adjusted risk ratios. One in three adolescents with autism spectrum disorder acquired a driver's license versus 83.5% for other adolescents and at a median of 9.2 months later. The vast majority (89.7%) of those with autism spectrum disorder who acquired a permit and were fully eligible to get licensed acquired a license within 2 years. Results indicated that a substantial proportion of adolescents with autism spectrum disorder do get licensed and that license-related decisions are primarily made prior to acquisition of a permit instead of during the learning-to-drive process.

Process of learning to drive by young persons with autism: experiences of the young persons themselves, parents, and driving instructors

“…When specific methodologies and procedures are in place to support young persons with ASD, this could also enhance the number of positive decisions concerning the pursuit of a driving licence. At present, research suggests that there may be an important discrepancy between a strong interest in driving and relatively lower licensure rates among adolescents with ASD (Curry et al, 2017).…”

“…At this point, intervention by a trained instructor is required in order to stop driving and refocus on the task through appropriate methods (Tyler, 2013). In summary, pupils with ASD will generally take longer to complete driving training (also observed by Curry et al, 2017) because they need to learn coping strategies and develop social communication skills on top of driving skills. It is necessary to teach pupils with ASD all the road regulations, gestures and courtesies in driving; even the ones not listed in the books, which neurotypical drivers may understand more easily.…”

“…However, a recent retrospective cohort study including the US Children's Hospital of Philadelphia healthcare network patients, with 609 patients with ASD indicated that by the age of 21,one in three adolescents with ASD acquired a driving license, in contrast to 83.5% of neurotypical adolescents. In addition, they obtained their licence at a later point in time (i.e., 9.2 months according to the median) (Curry, Yerys, Huang, & Metzger, 2017). Driving is a complex and goal-directed activity, which consists of different parallel subtasks that have to be alternated smoothly (e.g., changing gears, steering, lane changing, and giving way).…”

The Potential for Autonomous Vehicle Technologies to Address Barriers to Driving for Individuals with Autism

“…25 A recent study that linked 52,000 electronic health records of children born from 1987 to 1995 and New Jersey driver licensing data found that about one-third of people with autism were able to obtain a driver's license. 26 Another study, which surveyed adults (online convenience sample of 703) with autism through various autism-related organizations in New Jersey (or 2016 New Jersey survey), found that 9.3% of respondents had a driver's license. 27 An earlier study by Feeley (or 2010 Feeley et al survey), which surveyed adults with autism or their parent or caretakers (an online convenience sample of 1,077 with recruitment focused in New Jersey) reported that 24.3% of respondents, many of whom identified as higher-functioning, said that they primarily drove themselves to activities.…”

A Pilot Study Assessing Performance and Visual Attention of Teenagers with ASD in a Novel Adaptive Driving Simulator

“…Recent estimates suggest that roughly one third of individuals with ASD currently drive (Curry et al 2017), although Cox et al (2012) found that 48% of surveyed parents of a child with ASD reported that their child had successfully attained a driver’s license. Huang et al (2012) found that 30% of age-eligible individuals with ASD do drive, and another 34% plan to do so.…”