Teens With ASD Who Want to Drive: Who Is Ready?

Hi. My name is Patty Huang, and I am a developmental and behavioral pediatrician at Children's Hospital of Philadelphia.

A group of my colleagues, led by Dr Allison Curry, recently published a study^[1] that showed that a significant proportion of teens with autism spectrum disorders (ASDs) do drive and that, for many, the decision to attain a license appears to be made before these teens do a trial run on a learner's permit.

This made me think about conversations I've had regarding readiness to drive among teens with a variety of developmental disabilities, including ASDs.

Many teens and their families view getting a license as an exciting milestone in their transition to adulthood but also approach this time with fear. Many services received as children are no longer available, and the thought of driving may be overwhelming. However, we also know that encouraging driving when appropriate and fostering independence is important for long-term physical and mental health.

Parents are appropriately concerned that their teens with ASDs may have characteristics that place them at risk for unsafe driving behaviors, like inattention or getting lost in the details of the road. On the other hand, they may also have characteristics that promote safer driving behavior, such as a vigilance to follow driving laws.

In Pennsylvania, physicians must certify that their teen patients do not have a condition that seriously impairs their ability to drive before they can receive a learner's permit. However, I recommend that all pediatricians incorporate a "readiness to drive" assessment for their teen patients who want to drive, much like the way we complete sports physicals.

Here are some questions you can ask parents regarding driving readiness for their teen with ASD or another developmental disability:

Do you feel that your teen consistently demonstrates good judgment and maturity at school, around peers, and at home?
Is your teen receptive to constructive criticism and instruction?
Does your teen demonstrate knowledge of the rules of the road and other skills taught in driver education classes? If not, does your teen need specialized instruction or a driving assessment?
Is your teen agreeable to practicing driving with a skilled adult prior to driving independently? If so, is there an adult who is willing and able to serve in this important role? Previous research showed that teens with ASD were more likely to be licensed when they had a parent who had previously taught a teen to drive.
Are there any medical or behavioral conditions (such as untreated seizures) that may prevent your teen from driving safely?
Are there medical interventions that may be needed to ensure safe driving behaviors?

If a patient with ASD is interested in driving, I recommend encouraging families to:

Add goals about driving into their teen's individualized education plan;
Seek the advice of an occupational therapist who specializes in driving or a driving educator trained to work with individuals with special needs; and
Consider treatment with ADHD medication if their teen has symptoms of ADHD.

Clearly, there is still much to learn about the driving experience of teens with ASDs—how they learn, how they drive, and how we can help them. This is such an important topic, especially as more children with ASD age into the driving years.

The Center for Autism Research at CHOP offers helpful resources to support teens with ASD transition to adulthood, including the fact sheet Driving and ASD: Determining Readiness.

Learn more about the research here.