Learner and Novice Drivers with Attention Deficit Hyperactive Disorder or Autism Spectrum Disorder

Background: Potential learner drivers in Sweden with a disorder or a medical condition must present a medical certificate initially which states that the individual fulfils the legal medical requirement for a driving licence. In Sweden, medical practitioners have the legal obligation to consider a diversity of medical aspects of fitness to drive and specific pre-driving assessments can be used if in doubt. However, evaluating young people with Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactive Disorder (ADHD) is difficult for clinicians as no guidelines or validated tool exists for these groups. These pre-assessments, in addition to the use of driving manuals and instructions that are not adapted to learners with ASD/ADHD, are likely barriers for individuals with these diagnoses in regards to learning to drive, hence, indirectly hindering social participation. However, no research has previously explored the experiences of individuals with ASD and/or ADHD who actually started as learner drivers.

Objectives: To explore and describe the experiences of adolescents and young adults with ASD or ADHD, who had passed a pre-driving assessment and engaged in the process of obtaining a driving licence

Methods: A questionnaire was sent out to 33 participants with ASD and/or ADHD (Table 1) and 9 of their driving instructors. In addition, interviews were conducted with the 42 participants in order to obtain in-depth information related to the process of learning to drive and of teaching individuals with ASD/ADHD to drive.

Results: There was a significant difference in the number of lessons and test required between the participants with ADHD, compared with participants with ASD, as shown in Table 1.

		Mean	Minimum	Maximum
ADHD (n=11)	Driving lessons (SD)	20,0 (12,8)	10	50
	Theoretical tests (SD)	2,8 (2,7)	1	10
	On-road tests (SD)	1,7 (1,0)	1	4
ASD (n=12)	Driving lessons (SD)	37,6 (24,4)	10	80
	Theoretical tests (SD)	1,8 (1,3)	1	5
	On-road tests (SD)	2,4 (1,8)	1	8

The individuals with ASD had on average twice as many driving lessons and more on-road tests than the individuals with ADHD. However, the group with ADHD required more written tests. This was consistent with the driving instructors’ comments; in which they perceived that learning the driving licence theory was more challenging for individuals with ADHD. For the learners with ASD the largest challenge was translate the theory into practice, i.e., to ‘read’ other traffic users and traffic situations, and adjust the driving to “new” driving situations or areas.

Conclusions: The association between receiving a driving licence is not limited to stressful training experiences but also includes the cost as participants with ADHD and ASD compared with typically developing individuals find it more expensive. Additionally, driving instructions need to be specialised in different ways in order to suite learner drivers with ASD and ADHD. The instructor would need to adapt to accommodate drivers with ASD due to the difficulties experienced in social aspects and possible short term memory.  Training focusing on risk awareness for people with ASD and ADHD would be beneficial for promoting positive driving behaviour.