Do people with autism struggle behind the wheel?
A new study from researchers at UAB’s Translational Research for Injury Prevention Laboratory (TRIP Lab), offers what may be the first lab-tested answer to that question. The UAB researchers used a driving simulator to challenge 16 young adults with autism spectrum disorder (ASD) and 16 typically developing young adults in a course filled with hazards. They found no significant difference between the two groups. The results were published in the Journal of Autism and Developmental Disorders online in January 2017, and the finding drew significant interest on social media. Michelle Dawson, a member of an autism-focused research lab at the University of Montreal, tweeted a widely shared link to the UAB study, along with a quote from the paper’s findings: “Contra popular claims, autistic drivers show ‘no significant driving performance decrements,’” she wrote.
“People in the autism community were excited to hear about the results,” says Haley Johnson Bishop, a graduate student in UAB’s Lifespan Developmental Doctoral Psychology Program and first author on the study. “Driving already causes anxiety for parents and teens, and the additional challenges of developmental disabilities make it even more daunting,” she notes. “Parents say, ‘How can I know if my child is ready or able to drive?’ but unfortunately there are not a lot of resources available.”
License to thrive
Bishop aims to help alleviate that problem. Her graduate research is focused on driving behavior among people with developmental disabilities. “According to the most recent estimate, about 25 percent of people with ASD are driving, compared to 85 to 90 percent of the general population,” Bishop says. In Alabama, and much of the United States, it can be difficult to find and keep a job without a driver’s license, she points out.
The problem is growing. The number of children diagnosed with ASD in the United States has risen sharply over the past few decades, from 1 in 150 in 2000 to 1 in 68 by 2012. In 2014, a report in JAMA Pediatrics estimated the total number of people with ASD in the U.S. at more than 3.5 million. That includes two of Bishop’s family members. “These kids are growing up, becoming adolescents and young adults, but most of the research in the field is focused on children and early intervention,” says Bishop. “Early intervention is clearly very important, but we also need to figure out how to help people be successful as they grow up. And one of the major parts of that is driving and helping them be independent.”
Watch out for that taxi
The new UAB study was co-authored with TRIP Lab director Despina Stavrinos, Ph.D., an assistant professor in the UAB College of Arts and Sciences Department of Psychology, and Fred Biasini, Ph.D., an associate professor in the department. It appears to be the first research to examine hazard response among licensed drivers with autism. “Most of the literature right now is survey data, based on interviews with parents and teens and driving instructors,” Bishop says.
The UAB study took a different approach. The 32 participants each had anywhere from a few months to a few years of experience behind the wheel. They were given time to get used to driving the TRIP Lab’s simulator. Then they were confronted with eight different hazard situations. These included a truck backing out of a driveway onto the street, jaywalking pedestrians, a car pulling out from behind a stopped vehicle, and swerving bicyclists. The researchers measured how long it took each driver to react — letting off the accelerator, applying the brakes, or steering away from the danger. They also tracked driving errors: collisions, speeding, and veering off the digital roadway.
The results were similar across the two groups, but there was one significant difference, Bishop says. The researchers had classified the road hazards as either social — those involving pedestrians or cyclists — or non-social — those involving other cars. The typically developing drivers in the study reacted more quickly to the social hazards than the non-social ones. The drivers with ASD, meanwhile, showed no difference in reaction times between social and non-social hazards.
“People don’t often think of driving as a social interaction, but you are really doing a lot of interacting with people when you drive,” Bishop says. That includes judging other drivers’ intentions at a four-way stop, for example, or negotiating a lane merge on a busy highway on-ramp. If future studies confirm that drivers with ASD have difficulty reacting to social hazards, “that could certainly be addressed with training,” Bishop says. She points out that computer-based hazard response and perception training is already required for new drivers in many countries.
What about pre-drivers?
One limitation of the current study is that it only included participants who were already licensed drivers — that is, they were already skilled enough to pass a driving test. For her dissertation, Bishop is analyzing data from an expansion of the original study, made possible by a grant from the American Psychological Foundation, which enrolled a group of “pre-drivers.” These were participants who had a learner’s permit, but “had not got their license for some reason,” she says.
Although she has just begun her analysis of that data, “a lot of what we’re seeing in this group is anxiety,” Bishop says. “There is a fear that they’re going to crash or not going to be able to handle the situation.” The good news, if those observations bear out in further research, “is that there is a huge literature on anxiety treatments and therapies that could be implemented to help these kids,” she says.
Practice, practice, practice
One option may be to give pre-drivers a safe space in which to practice. In 2016, the TRIP Lab debuted a high-tech immersive driving simulator. It features floor-to-ceiling video screens surrounding around an actual Honda SUV, which rests on hydraulics that allow it to lean realistically in response to turns and braking. (It is believed to be the world’s first such SUV-based simulator.)
“If you can expose people to situations in a safe, controlled environment, you can teach them to respond appropriately,” says Bishop. “We’ve talked to many of our parents about this, and they are very interested. They are desperate for help and training — anything that can help their kids achieve the life they’ve imagined for them.”