Rachel K Myers1, Meghan E Carey2, Janice M Bonsu3, Benjamin E Yerys4, Cynthia J Mollen5, Allison E Curry6. 1. Rachel K. Myers, PhD, MS, is Research Scientist, Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, and Research Assistant Professor, Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia; myersr@chop.edu. 2. Meghan E. Carey, MS, is Doctoral Student, Dornsife School of Public Health, Drexel University, Philadelphia, PA. At the time this work was conducted, Carey was Research Coordinator, Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA. 3. Janice M. Bonsu, MPH, is Medical Student, Ohio State University College of Medicine, Columbus. At the time this work was conducted, Bonsu was Research Assistant, Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA. 4. Benjamin E. Yerys, PhD, is Scientist, Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, and Assistant Professor, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia. 5. Cynthia J. Mollen, MD, MSCE, is Professor and Chief, Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, and Faculty, PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA. 6. Allison E. Curry, PhD, MPH, is Senior Scientist and Director of Epidemiology, Center for Injury Research and Prevention, Children's Hospital of Philadelphia, and Assistant Professor, Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Abstract
IMPORTANCE: In the transition to adulthood, driving supports independence. For autistic adolescents, training provided by specialized driving instructors, including occupational therapists, may establish fitness to drive and continued independence. OBJECTIVE: To examine specialized driving instructors' experiences providing behind-the-wheel instruction to autistic adolescents. DESIGN: We recruited participants through purposive and snowball sampling of members of ADED, the Association for Driver Rehabilitation Specialists. Interviews investigated experiences providing instruction, autistic students' strengths and challenges, strategies used, and recommendations to improve the learning-to-drive process. We coded transcripts using a directed content analysis approach. SETTING: Telephone interviews. PARTICIPANTS: Specialized driving instructors (N = 17) trained as occupational therapists, driver rehabilitation specialists, or licensed driving instructors with recent experience providing behind-the-wheel training for autistic adolescents participated. RESULTS: Behind-the-wheel challenges included mental inflexibility, distractibility, and difficulties with social cues and motor coordination. Instructors acknowledged students' strengths, including adherence to rules of the road, limited risk taking, and careful observations. Instructors scaffolded learning to help students develop skills. Although licensure and driving outcomes were sometimes unknown to instructors, students who became licensed frequently drove with supervision or restrictions. CONCLUSIONS AND RELEVANCE: Licensure is possible for autistic adolescents, although developing fitness to drive requires individualization and rigorous specialized instruction, which may culminate in delayed or restricted driving. What This Article Adds: This article highlights challenges and strengths encountered by specialized driving instructors teaching autistic adolescents. Despite requiring prolonged training, autistic adolescents can achieve licensure when supported by specialized instruction that is individualized to their needs and strengths.
IMPORTANCE: In the transition to adulthood, driving supports independence. For autistic adolescents, training provided by specialized driving instructors, including occupational therapists, may establish fitness to drive and continued independence. OBJECTIVE: To examine specialized driving instructors' experiences providing behind-the-wheel instruction to autistic adolescents. DESIGN: We recruited participants through purposive and snowball sampling of members of ADED, the Association for Driver Rehabilitation Specialists. Interviews investigated experiences providing instruction, autistic students' strengths and challenges, strategies used, and recommendations to improve the learning-to-drive process. We coded transcripts using a directed content analysis approach. SETTING: Telephone interviews. PARTICIPANTS: Specialized driving instructors (N = 17) trained as occupational therapists, driver rehabilitation specialists, or licensed driving instructors with recent experience providing behind-the-wheel training for autistic adolescents participated. RESULTS: Behind-the-wheel challenges included mental inflexibility, distractibility, and difficulties with social cues and motor coordination. Instructors acknowledged students' strengths, including adherence to rules of the road, limited risk taking, and careful observations. Instructors scaffolded learning to help students develop skills. Although licensure and driving outcomes were sometimes unknown to instructors, students who became licensed frequently drove with supervision or restrictions. CONCLUSIONS AND RELEVANCE: Licensure is possible for autistic adolescents, although developing fitness to drive requires individualization and rigorous specialized instruction, which may culminate in delayed or restricted driving. What This Article Adds: This article highlights challenges and strengths encountered by specialized driving instructors teaching autistic adolescents. Despite requiring prolonged training, autistic adolescents can achieve licensure when supported by specialized instruction that is individualized to their needs and strengths.
Authors: Katherine Gotham; Alison R Marvin; Julie Lounds Taylor; Zachary Warren; Connie M Anderson; Paul A Law; Jessica K Law; Paul H Lipkin Journal: Autism Date: 2015-05-11
Authors: Stephany M Cox; Daniel J Cox; Michael J Kofler; Matthew A Moncrief; Ronald J Johnson; Ann E Lambert; Sarah A Cain; Ronald E Reeve Journal: J Autism Dev Disord Date: 2016-04
Authors: Rachel K Myers; Janice M Bonsu; Meghan E Carey; Benjamin E Yerys; Cynthia J Mollen; Allison E Curry Journal: Autism Adulthood Date: 2019-09-11