Driving on the spectrum

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Determining whether a young person with autism is ready to drive can be tricky for their health care providers.

That's the upshot of a new survey that included 78 pediatric physicians, psychologists and other providers in Pennsylvania and New Jersey.

Half of the respondents said they routinely talk to teen patients about their transportation needs with an eye to encouraging mobility and independence, but only 1 in 5 had had such discussions with patients with autism.

While 33% said they believed they could assess if patients without autism were ready to drive, only 8% believed they could do so for those with autism.

“It was also surprising to learn that only 1 in 4 providers refer their patients, autistic or not, to other providers for driving-related issues,” said study lead author Emma Sartin, a postdoctoral fellow at the Center for Injury Research and Prevention at Children’s Hospital of Philadelphia (CHOP).

Previous research from CHOP found that two-thirds of 15- to 18-year-olds with autism but not an intellectual disability either drive or plan to drive. One-third get licensed by age 21.

Other recent research showed that newly licensed drivers with autism have similar to lower crash rates than those without autism. That suggests those with autism who get a license are generally safe drivers.

Also, young drivers with autism are much less likely to receive a traffic violation or license suspension, other CHOP research found.

“I know that saying that learning I’m neurodivergent helped my driving is a bit of an odd claim,” said Saira K. Zuberi, “but it is true in that it made me examine the issues that I have as a driver/decision-maker, and in the way I move, how my body and brain connect, or how I communicate non-verbally.”

Getting a licence is a rite of passage for many, but for neurodiverse people the experience of driving comes with unique, heightened challenges. Information overload, ADHD and anxiety can make driving more difficult.

“You experience the world very differently because all your senses are very heightened,” said Anita Lesko, 62.

Lesko is a registered nurse anesthetist who was diagnosed at age 50 with Asperger’s. She has since written extensively about driving with autism, contributing pieces for organizations such as the International Board of Credentialing and Continuing Education Standards.

“I call it living in Dolby Surround Sound, because all your senses are greatly intensified.

Anne Woods, diagnosed as autistic at age 40, finds getting behind the wheel therapeutic.

“Driving for me is a brilliant way to center and focus and forget everything else,” she said. “It’s a good combination of physical and mental activities that require me to use both hemispheres of my brain.”

Zuberi, 47, who was diagnosed as neurodivergent in the spring, said, “It took me years to teach my nervous system that missing a turn is not cause for panic or a tantrum, because you literally just take the next turn.

Winnipegger Adam Schwartz started driving at age 18.

“I got my driver’s licence late because I was afraid of driving,” he said. “It got to the point where it was awkward being the only one of my friends who didn’t have a licence. It was awkward always asking people for a ride.”

He’s now been driving for 18 years and said his fear of getting lost or missing his destination still “terrifies” him, but has been partially solved by technology.

“I feel nervous about going to a new place. Even when I have GPS I worry about missing the location. It is scary, especially highway driving, because I end up focusing so much on finding the place but GPS is a lot easier to use than a map.”

Sensory overload is another issue. Sometimes described as a “traffic jam in your head,” it happens when the senses become overwhelmed by any number of triggers, including noise, bright lights and movement.

“I am a good driver,” said Sarah Richardson. “I am a confident driver. My main issue is sensory with the noise my kids generate in the back seat. It is worse due to being in a confined space with them. Aside from driving a convertible I’m not sure what else could be done!”

Veronica Rodriguez said her 16-year-old autistic son is an excellent driver.

“He takes the rules of the road very seriously. He is meticulous with car care. He says his only concern while driving is getting distracted by others in the car, so now he does not allow passengers in his car.
Kirk Carson, 35, an autistic person who has been driving commercial trucks since 2006, said he has always been obsessed with cars. He applied for his licence the days after he turned 16 because his father marked down the wrong day on the calendar. Waiting that extra day, he said, was “excruciating. I never let him forget it.”

Like Zuberi, Carson said autism has helped him in the job.

“I’ve always been very good at route planning and time management,” he said. “It’s not really a hyperfocus, but I feel that being able to remember routes and shipper locations is just a lot easier for me than some of my some of the coworkers I’ve had in the past.”

“The independence is definitely a big factor. There’s not a whole lot of face-to-face interaction with people, which can be uncomfortable. You know, figuring out how to load a truck is like a puzzle and there’s a lot of spatial awareness involved so I can just kind of rely on myself to get things done.”