A Simulated Driving Intervention for Young Adults with Autism Spectrum Disorder: Attention, Perceptual, and Motor Considerations

Background: Obtaining a driver’s license is an important milestone for most teenagers. In many parts of the United States, driving is critical for adults to function independently; the inability to drive can be an obstacle to education, employment, and routine errands such as grocery shopping.  Although many high-functioning individuals with autism spectrum disorder (ASD) plan to drive, research has shown that many in this population experience deficits in attention, motor, and perceptual skills that are crucial for safe driving (Miller, Chukoskie, Zinni, Townsend, & Trauner, 2014; Townsend, Keehn, & Westerfield, 2011). Prior driving simulation research suggests that these features may, in fact, impact the ability of teens with ASD to drive (Reimer et al., 2013). However, the extent of the relationship between these basic functions and driving ability in ASD remains unclear.  Furthermore, it is unknown whether teenagers on the autism spectrum may benefit from training on a driving simulator, and how individual differences in basic processing affect driving outcomes. By allowing teenagers with ASD to practice in a low-risk environment, we expect that both their overall confidence and driving proficiency will improve.

Objectives: Our goal was to assess the effectiveness of driving simulation training, and to relate basic perceptual, attention, and motor skills to driving ability in individuals with ASD.

Methods: 18 teenagers and young adults with ASD trained on a driving simulator for 45-60 minutes each week, for six weeks. Simulations included 1) simple drives, 2) divided attention drives that required responses to visually peripheral stimuli while driving, and 3) “challenge” drives that included unexpected obstacles. Divided attention and challenge drive performance was compared pre- and post-intervention. Our personalized six-week training program allowed participants to master progressively more complex driving environments at their own paces. Additional pre- and post-training assessments included a visual-motor integration task, an attention-orienting task, a general motor assessment, and a balance test. Participants’ parents also completed the Social Responsiveness Scale-2. Changes in driving, attention, and sensorimotor function over the course of the intervention were assessed, as well as the role of pre-training basic processing skills as predictors of intervention success.

Results: Overall, driving skills improved over the course of the six-week intervention. Of the 18 participants, two have since become fully-licensed drivers; follow-up of the remaining participants is pending. Analysis of supplementary tasks is under way to determine whether and how driving ability and improvement with training is related to basic attention, perceptual and motor function. 

Conclusions: Our six-week training appears to have been effective in improving performance on specific driving simulation tasks. Pending data analysis will shed light on the mechanistic involvement of perceptual, motor, and attention functions in moderating this change. These data will inform future research on the added benefit of training these general skills as part of a driving intervention;  developing the best possible training resources for potential drivers with ASD will help to ensure optimal independence and quality of life as these individuals transition to adulthood.