Autism & the Driver License Test: The Great Debate

A few days ago, I was at a red light that turned green, but a group of motorcycles were traveling together. In order to stay together, approximately 15 motorcycles ran the red light after signaling their intent to do so with hand motions (i.e., waving) and having another member block traffic. Would someone driving with with an autism diagnosis have been able to recognize their intent and maintained safety in this situation?

Lissa Robins Kapust, of the DriveWise program at Beth Deaconess Medical Center in Boston, says that “driving in traffic is like reading a person’s face,” often due to gestures, motions, and signals that take place routinely in traffic. “The driving scene may be friendly, it may be frenetic, it may be angry,” she says. She also states that “Driving is so busy on the inside and outside of the car- it’s the most complex thing we do.”

Dr. Jamie Dow, the medical adviser for safety issues in Quebec’s auto insurance and licensing agency, concurs, “Driving is a social act. It involves obeying rules and cooperating with other drivers.” When considering challenges of driving for those with an ASD diagnosis, such tasks would be anticipated to be challenging. Such challenges may explain why one survey found that only 24% of individuals with an Autism Spectrum Disorder identified themselves as independent drivers, compared with 75% of the general population (Cecilia Feeley, Center for Advanced Infrastructure and Transportation at Rutgers University). Concerns are clearly numerous; however, some identify positive traits of a driver with a diagnosis of Asperger syndrome that may benefit other drivers. For example, Dr. Patty Huang of the Children’s Hospital of Philadelphia considers it a positive that teenagers with Asperger syndrome are rule-driven saying, “They’re less likely to be reckless.”

Concerns

Many states require only 40-50 hours of road practice before a driver is eligible to tast, with the majority of researchers supporting additional practice for any teen. Dr. Simons-Morton states that delaying driving lessons may be a positive decision, “If I were the parent of an A.D.H.D or other special-needs kid, my goal would be to delay licensing. They mature, they accommodate to their deficits and they’re more likely to take medication.” Although medication is often prescribed for individuals with A.D.H.D, some medications may aid those with autism spectrum disorders as well.

Recommendations

DriveWise has made a video, sponsored by Autism Speaks, that considers the benefits of driving, as well as the safety issues, for those with Asperger syndrome. Some recommendations have been presented for those who decide driving is in their future. An article in the Science Times recommends making sure the child can ride a bike safely prior to driving. This may be a significant barrier, as riding a bicycle is often a difficult task for those with gross motor or proprioceptive challenges.

“Narrating” while a parent drives is another recommendation, as it can demonstrate the ability to use executive function skills and provide safe practice. Science Times also stresses that narrating raises awareness of the components of driving, and identifying areas that will be challenging.

A doctor’s exam is important and awareness of sensory issues can also be important for driving success. Is a visual processing issue present? Will the individual be able to focus on the road if a car alarm is accidentally set off in a nearby parking lot? Kathleen Ryan, an instructor at Driving MBA, feels that it is important to not set timelines, but to “think about the opportunity” to drive. She also recommends slowing tasks down to target one piece of instruction at a time and allowing time to role-play situations such as being pulled over by a police officer, being caught in traffic, or other stressful scenarios. DriveWise also offers a comprehensive driver examination prior to considering a driver license test that evaluates multiple domains.

Another consideration is installing a passenger-side brake to allow safety during driving practice. Science Times states that “a temporary passenger-side break can cost less than repairing a significant dent.”

Conclusion

Both parents and members of the general population are often concerned about safety and the challenges with executive functioning, including multi-tasking, often seen in those with an ASD diagnosis. Whether or not to provide an individual with the opportunity to test for a drivers license is often debated in schools, homes, and community settings. The independence and self-reliance afforded by a license are tempered by safety concerns of responding to stressful driving situations. As with most decisions, the costs and benefits must be carefully weighed and determined in light of the individual. In many circumstances, the opportunity to take a driver license exam should be considered carefully for anyone- adult or teenager- regardless of diagnosis or lack thereof.

What other considerations do you think should factor into granting a drivers license?

Category(s): Independence, Sensory

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