Department of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH.
EdMent Consulting, Philadelphia, PA.
J Dev Behav Pediatr. 2018 Jul/Aug;39(6):451-460. doi: 10.1097/DBP.0000000000000581.
Many individuals with autism spectrum disorder (ASD) are reluctant to pursue driving because of concerns about their ability to drive safely. This study aimed to assess differences in simulated driving performance in young adults with ASD and typical development, examining relationships between driving performance and the level of experience (none, driver's permit, licensed) across increasingly difficult driving environments.
Participants included 50 English-speaking young adults (16-26 years old) with ASD matched for sex, age, and licensure with 50 typically-developing (TD) peers. Participants completed a structured driving assessment using a virtual-reality simulator that included increasingly complex environmental demands. Differences in mean speed and speed and lane variability by diagnostic group and driving experience were analyzed using multilevel linear modeling.
Young adults with ASD demonstrated increased variability in speed and lane positioning compared with controls, even during low demand tasks. When driving demands became more complex, group differences were moderated by driving experience such that licensed drivers with ASD drove similarly to TD licensed drivers for most tasks, whereas unlicensed drivers with ASD had more difficulty with speed and lane management than TD drivers.
Findings suggest that young adults with ASD may have more difficulty with basic driving skills than peers, particularly in the early stages of driver training. Increased difficulty compared with peers increases as driving demands become more complex, suggesting that individuals with ASD may benefit from a slow and gradual approach to driver training. Future studies should evaluate predictors of driving performance, on-road driving, and ASD-specific driving interventions.
许多自闭症谱系障碍（ASD）患者由于担心自己的安全驾驶能力而不愿意开车。本研究旨在评估 ASD 患者和典型发育患者在模拟驾驶表现方面的差异，考察在越来越困难的驾驶环境中，驾驶表现与驾驶经验水平（无、驾驶许可证、有证）之间的关系。
参与者包括 50 名讲英语的 ASD 青年（16-26 岁），按性别、年龄和许可证与 50 名典型发育（TD）同龄人相匹配。参与者使用虚拟现实模拟器完成了一项结构化的驾驶评估，其中包括越来越复杂的环境要求。采用多层次线性建模分析诊断组和驾驶经验对平均速度和速度及车道变异性的差异。
与对照组相比，即使在低需求任务中，ASD 青年的速度和车道定位也表现出更大的变异性。当驾驶需求变得更加复杂时，驾驶经验会调节组间差异，因此，大多数任务中，有证的 ASD 患者与 TD 有证患者的驾驶方式相似，而无证的 ASD 患者在速度和车道管理方面比 TD 患者更困难。
研究结果表明，与同龄人相比，ASD 青年可能在基本驾驶技能方面更困难，尤其是在驾驶培训的早期阶段。与同龄人相比，难度增加随着驾驶需求变得更加复杂，这表明 ASD 患者可能受益于缓慢而渐进的驾驶培训方法。未来的研究应评估驾驶表现、路考和 ASD 特定的驾驶干预措施的预测因素。
