Research In Action

As they become young adults, teens often have discussions with their healthcare providers about a myriad of topics, including health, education, vocational training, and independent living. Driving or independently using other transportation options facilitates independence, which affects quality of life outcomes in adulthood.

This effect of independent mobility on outcomes in adulthood is especially robust for individuals with neurodevelopmental differences, like autism. Yet, according to our recently published research in the Journal of Autism and Developmental Disorders, only 20% of pediatric healthcare and behavioral service providers report discussing transportation topics with their autistic patients. Further, only 8% say they feel prepared to assess whether their autistic patients are ready to drive.

This is concerning, since prior research conducted at the Center for Injury Research and Prevention in collaboration with the Center for Autism Research at Children’s Hospital of Philadelphia, shows that many autistic teens are not only interested in driving, but also doing so safely. Two-thirds of 15- to 18-year-old autistic adolescents without intellectual disability are currently driving or planning to drive, and 1 in 3 autistic individuals without intellectual disability are getting licensed by age 21. We also know that autistic teens who do drive have similar to lower crash rates as their non-autistic peers, as well as a lower likelihood of having their license suspended or receiving a traffic violation.

Many families, including those with non-autistic teens, say they seek the guidance of their healthcare and behavioral service providers when making decisions about driving. Our study sought to understand if and how often these conversations occurred.

Few Talk About Driving with Autistic Youth 

In our survey study of 78 providers in Pennsylvania and New Jersey (the majority were pediatricians and pediatric psychologists) who care for autistic and non-autistic patients:

• Half reported they had general transportation-related discussions with their non-autistic patients, while only 1 in 5 had these conversations with their autistic patients.
• A third of providers believed they could assess if their non-autistic patients were ready to drive, while only 8% believed they could do so for their autistic patients.

These findings suggest the vast majority of pediatric and behavioral service providers would benefit from resources and education to prepare them in supporting all of their patients around transportation-related planning or needs. One key takeaway is that it may be helpful for providers to initiate these conversations with autistic teens and their families before they reach high school age.

Start the Discussions Early

Earlier discussions may encourage families to consider additional skills and goals related to driving or transportation in general to be added to their teen’s individualized educational program (IEP) at school (transition to adulthood goals can be formally added to a teen’s school IEP at age 14). Families may also benefit from additional time to access services outside of the healthcare system, such as individualized instruction from a driving rehabilitation specialist.

If any specific areas of challenge are identified, and even potentially addressed through interventions such as medication (e.g., medication to help support symptoms related to an associated Attention Deficit/Hyperactivity Disorder), earlier discussions between healthcare providers and families allow more time to optimize these interventions.

Many autistic teens are interested in driving and can do so safely. They and their families look to providers to help guide them through this transition. Research to educate and support providers in facilitating these discussions continues to be a priority for our team as part of an overall effort to understand and support the transportation needs of autistic youth.

Resources for families to help their autistic teens transition to adulthood are available at the Center for Autism Research and Teen Driver Source.