Study finds few pediatric providers discuss transportation with their autistic patients

A collaborative study from the Center for Injury Research and Prevention (CIRP) and the Center for Autism Research (CAR) at Children's Hospital of Philadelphia (CHOP) found that only 8% of pediatric healthcare and behavioral service providers feel prepared to assess whether their autistic patients are ready to drive. These findings, recently published in the Journal of Autism and Developmental Disorders, suggest a critical need to develop resources that prepare providers and others who work with autistic youth to effectively facilitate independence and mobility as their patients become adults.

This study is part of a body of research that aims to understand the transportation needs of autistic adolescents. Prior studies have examined how individualized training, parental support, and driving patterns contribute to safe driving. Other studies have found that, whether autistic adolescents decide to drive or not, being able to get where they want to go on their own improves psychosocial, health and employment outcomes. While making decisions about transportation, families of both autistic and non-autistic youth seek guidance from their child's pediatric healthcare and behavioral service providers. However, little is known about these conversations or how providers approach these topics with patients.

The researchers surveyed a total of 78 providers who care for both autistic and non-autistic patients in March and April of 2019. Most providers were attending pediatric physicians and psychologists located in Pennsylvania and New Jersey. 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. When discussing driving, 33% 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.

"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," says Emma Sartin, Ph.D., MPH, lead author and a postdoctoral fellow at CIRP. "Our next steps will be to start developing resources and tools so that families, and the professionals who support them, are not left largely on their own to make or guide important decisions about driving."

A lack of guidance for families on how to navigate transportation decisions could be critical, as previous CHOP research found that 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 get licensed by age 21. Other recent research conducted at CHOP found that newly licensed young autistic drivers have similar to lower crash rates than their non-autistic peers, suggesting those who do become licensed are generally safe drivers. Additionally, young autistic drivers are much less likely to have their license suspended or to receive a traffic violation than their non-autistic peers.

"One important way that providers can help autistic teens and their families is to start talking about driving and transportation before they get to high school," says Benjamin E. Yerys, Ph.D., study author and a clinical psychologist at CAR. "We know this seems early, but it provides more time for them to benefit from supports, including those services that come from outside of healthcare, including tailored instruction from a driving rehabilitation specialist."