How autism can affect driving, and training that can help

Most of us without a neurological development diagnosis like autism spectrum disorder (ASD) have little trouble learning to drive—we’re able to attend driver education courses, easily recognize signals and road signs, and react safely in typical driving scenarios.

But the widely varying symptoms of ASD can present unique challenges to drivers with that diagnosis, and typical drivers’ training programs aren’t always equipped to help.

That’s why the Ohio State Wexner Medical Center’s Driver Rehabilitation Program includes occupational therapy not just for drivers with physical challenges, but also for clients who interpret the world differently.

How ASD can make driving challenging

Common ASD symptoms are motor coordination challenges, delayed decision-making skills and problems with executive functioning (those higher-level thinking skills, like multi-tasking). Associated conditions, such as a sleep disorder or ADHD, can make driving challenging, too.

In other words, ASD can affect many of the skills we need while driving.

Those with ASD also can have difficulty communicating with others (verbally and nonverbally) or take instructions extremely literally. If a sign uses an idiom to communicate what a driver should do or look for, the message may not be obvious to someone with ASD. And if they’re stopped at a four-way stop and one driver waves another ahead, someone with ASD may not correctly interpret that nonverbal cue.

At Ohio State’s Driver Rehabilitation Program, we commonly see clients with ASD having trouble making the visual or physical steps for a lane change. They may also have a hard time recognizing or reacting to aggressive drivers, or they react too slowly to traffic lights or unexpected hazards.

In general, many clients with ASD know the rules of driving extremely well but, because they interpret instructions literally, it’s difficult for them to know when it makes “safety sense” to break a rule. For example, if you’re approaching an intersection at full speed and are already committed to crossing when the light turns yellow, it’s safer to continue. But someone with ASD may be more likely to slam on their brakes before crossing, risking being rear-ended.

Occupational therapy strategies for drivers with ASD

At Ohio State, the occupational therapists (OTs) in our Driver Rehabilitation Program are dually credentialed certified driving instructors.

The program’s staff incorporate typical driving instruction with individualized strategies to help those with unique diagnoses. They know to avoid sarcasm, slang or figurative language for clients with ASD, and they’re trained to give clear, step-by-step instructions.

Social and hazard perception

We run through simulations of common driving scenarios, breaking them down into smaller steps to reduce frustration. If there are particular routes that clients want or need to drive, we practice driving those routes over and over to build skills and confidence.

Running commentary

To introduce new routes or to help clients develop observation and recognition skills, OTs might hop behind the wheel while a client sits in the passenger seat and notes aloud the signs, traffic lights, pedestrians and other crucial observations needed to drive safely.

Emergency preparedness

What should you do if you feel anxious or panicky? What if you’re in a wreck or other emergency situation? What about when you’re being pulled over?

We review calming strategies, when to call parents or other members of a support system, and the specific steps to pulling over for law enforcement.

In Ohio, law enforcement has access to a registry that tells them when someone has a communication disability. When law enforcement officers run someone’s license plate or driver’s license, they can see the name on that registry, and they’re trained to interact in a way that accommodates that person’s needs.

Can someone with ASD become a completely independent driver?

Each ASD diagnosis is unique, so the potential for independent driving will vary. For some, medical symptoms are just too profound to become a safe driver. We can work with these clients to help them navigate public transportation.

Some of our clients have particular routes they want to be able to drive on their own and only ever drive to and from those destinations independently. When they have a new route to learn, they come back to the Driver Rehabilitation Program to practice with our OTs again.

For other drivers with ASD, they’re able to drive independently within a certain radius of their home. Still others need just a little help fine-tuning their skills, and after some training, they’re able to drive anywhere on their own with confidence. But each client gets an in-clinic evaluation and an individualized plan of care.

Almost everyone can become a better, safer driver with help from occupational therapy. And driving skills help many of our clients find employment, be more social and enjoy a fuller life.

Meredith Sweeney is a registered/licensed occupational therapist, licensed driver training school instructor and certified driver rehabilitation specialist at The Ohio State University Wexner Medical Center, where she’s the clinical team leader for its Driver Rehabilitation Program in Assistive Technology Services.