Michelle Kersten, Registered OT, is PhD Candidate, School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia;
Kristy Coxon, Registered OT, PhD, is Senior Lecturer in Occupational Therapy, School of Health Science, Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia.
Am J Occup Ther. 2020 Sep/Oct;74(5):7405205140p1-7405205140p17. doi: 10.5014/ajot.2020.040311.
Autistic adults face decreased community participation for employment, education, and social activities plus barriers to driving and transportation. However, little is known about their experiences of moving around community environments.
To explore contextual issues and experiences of independent community mobility and driving for autistic adults and to determine the modes of community mobility, regions studied, and methodologies used.
Seven databases were searched from 2000 to 2019. All empirical research relating to autism, community mobility, and driving for people older than age 5 yr was mapped. Studies examining experiences of community mobility and driving were selected for scoping review.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews methodology was used. Thirteen studies reporting specifically on autistic adults' experiences with public transportation, driving, and pedestrian navigation of community environments were included. These studies were analyzed using concepts from the Person-Environment-Occupation-Performance Model.
Nine studies examined experiences of autistic adults. Seven studies explored proxy perspectives. Those studies examining driving primarily focused on learner driver experiences. Although most studies reported on personal and environmental factors, some studies reported on broader social communication and personal narrative factors. None used inclusive methodology involving autistic adults.
A broader focus on the contextual experiences of community mobility and driving is needed to support participation of autistic adults in their communities. Linking community mobility experiences with participation outcomes and expanding research to include experienced drivers and nonurban populations is an important component of this work.
Occupational therapy interventions should address community mobility and driving skills before school transition. Autistic adults' skill development may be affected by person factors such as motivation, anxiety, social skills, communication, and occupational performance desires. Environmental factors such as parental concerns, community safety, pedestrian environments, traffic volume, and public transportation design are important. Further research partnering with autistic adults could better inform future occupational therapy interventions for community mobility and driving.
自闭症成年人在就业、教育和社会活动方面的社区参与度降低，并且在驾驶和交通方面也面临障碍。然而，对于他们在社区环境中四处走动的体验，人们知之甚少。
探索自闭症成年人独立社区流动性和驾驶的背景问题和体验，并确定社区流动性模式、研究区域和使用的方法。
从 2000 年到 2019 年，搜索了七个数据库。所有与自闭症、社区流动性和 5 岁以上人群驾驶相关的实证研究都进行了映射。选择了研究社区流动性和驾驶经验的研究进行范围审查。
使用了系统评价和元分析扩展的首选报告项目，以进行范围审查。纳入了 13 项专门研究自闭症成年人公共交通、驾驶和社区环境行人导航经验的研究。使用个人-环境-职业-表现模型的概念对这些研究进行了分析。
九项研究考察了自闭症成年人的经验。七项研究探索了代理观点。那些研究驾驶的主要集中在学习者驾驶员的经验上。尽管大多数研究报告了个人和环境因素，但一些研究报告了更广泛的社会沟通和个人叙事因素。没有一项研究使用包括自闭症成年人在内的包容性方法。
需要更广泛地关注社区流动性和驾驶的背景体验，以支持自闭症成年人在社区中的参与。将社区流动性经验与参与结果联系起来，并将研究扩展到包括有经验的司机和非城市人口，这是这项工作的重要组成部分。
职业治疗干预措施应在学校过渡前解决社区流动性和驾驶技能。自闭症成年人的技能发展可能受到个人因素的影响，例如动机、焦虑、社交技能、沟通和职业表现愿望。环境因素，如父母的担忧、社区安全、行人环境、交通量和公共交通设计也很重要。与自闭症成年人合作进行进一步的研究可以为社区流动性和驾驶的未来职业治疗干预措施提供更好的信息。
