Date Presented 04/05/19
As individuals with autism spectrum disorder age, they desire to drive, but often face challenges in driving confidence and performance. Driving simulator programs can positively impact on-road driving performance and self-competence with adolescents and young adults with autism spectrum disorder.
Primary Author and Speaker: Regina Drummond
Contributing Authors: Vanessa Jewell
PURPOSE: As individuals with ASD age, they desire to drive, but often face challenges in driving confidence and performance (Lindsay, 2017). Driving simulators create a safe, virtual on-road experience and have been shown to be a valid tool in assessing age-related skills necessary to drive (Cox, 2015). However, no research exists examining on-road driving behavior in people with ASD. This systematic review examined the effectiveness of driving simulators to improve driving abilities in adolescents and young adults with autism spectrum disorder (ASD).
DESIGN: This review included studies published within the past 10 years that utilized quantitative driving performance outcome measurements. Participants had clinical diagnoses of ASD and had a mean age of 15 – 30 years old.
METHOD: Databases searched included Cochrane Library, PubMed, CINAHL, PsycINFO, ERIC, and OTSearch. After screening of titles and abstracts, the primary researcher reviewed 36 full-text articles. Inclusion criteria involved Sackett’s et al., levels of evidence I – III (1996), publication in a peer-reviewed journal, mean participant age 15 – 30 years, clinical diagnosis of ASD, and quantitative driving performance outcome measurement; studies were excluded if they were older than 10 years and absence of pre-/post-test driving simulator measurements. After full-text review, three studies were found to meet inclusion and exclusion criteria. Peer debriefing occurred to ensure accuracy and scope of the review.
RESULTS: Three studies were identified for review: one randomized controlled trial, one non-randomized two group study, and one non-randomized one group study. Individuals with ASD were more likely to perform worse than control groups on initial driving simulator tasks; however, these participants with ASD made significantly fewer driving errors after completion of a driving simulator training program. The three studies identified (levels of evidence I – III) show moderate evidence for using driving simulators with adolescents and young adults with ASD to improve driving abilities; after engaging in driving simulator programs, participants demonstrated significantly fewer driving errors.
CONCLUSION: Driving simulators can positively impact client factors related to driving performance in individuals with ASD. Occupational therapists working with this population should be knowledgeable regarding common challenges with this population in executive functioning and working memory as related to driving.
IMPACT STATEMENT: Occupational therapists working with individuals with ASD can utilize or recommend driving simulators to enhance feelings of self-competence and independence in social and vocational tasks. Continued research should be conducted to assess driving simulator use related to on-road driving performance.
References
Cox, S. M., Cox, D. J., Kofler, M. J., Moncrief, M. A., Johnson, R. J., Lambert, A. E., … Reeve, R. E. (2015). Driving simulator performance in novice drivers with autism spectrum disorder: The role of executive functions and basic motor skills. J Autism Dev Disord, 46, 1379-1391. doi:10.1007/s10803-015-2677-1
Lindsay, S. (2017). Systematic review of factors affecting driving and motor vehicle transportation among people with autism spectrum disorder. Disability and Rehabilitation, 39(9), 837-846. doi:10.3109/09638288.2016.1161849
Sackett, D.L., Rosenberg, W.M., Muir Gray, J.A., Haynes, R.B., & Richardson, W.S. (1996). Evidence-based medicine: What it is and what it isn’t. British Medical Journal, 312, 71-72.
