The Three A’s: Autism, Asperger’s and Automobiles – Part 6

As previously noted, we’ve had good success collaborating with an OT who is a Certified Reahab Driving Specialist (CRDS).  She refers patients to me to ascertain that they have the requisite functional visual skills for driving and, if not, we assist them through necessary interventions such as lenses, prisms, and/or active vision therapy before they return to her.  The inverse is true, where I will refer patients to her who I feel need behind-the-wheel training, and she is the arbiter of whether acquired visual skills transfer to road conditions.  The PDF from The Association for Driver Rehabilitation Specialists with which I concluded Part 5 is so good that I simply wanted to reproduce it here to be sure that it is seen in its entirety.

Individuals with AS/ HFA typically have normal to gifted IQ and tend to be perfectionists. The tendency towards perfection can be anxiety provoking. Autism is considered a spectrum condition and therefore the degree of severity varies. Individuals on the autism spectrum should consider a driving evaluation before learning to drive.

Warning Signs

Information processing:  Individuals with AS/ HFA tend to have difficulty identifying which information on the roadway is important. In addition, they tend to have difficulty shifting their attention quickly around the roadway environment. These difficulties can cause:
 Delayed reaction or no reaction to changes in the traffic environment
 Looking too long into mirrors, or at information on the roadway. This can cause problems with lane changes and when driving in complex traffic
 Delayed reactions or no reaction to hazards on the roadway

Motor Coordination: Individuals with AS/ HFA have difficulty with motor and vision skills:
 Motor challenges can make it difficult to learn to operate steering, acceleration and braking to effectively control the vehicle through hills and curves
 Individuals with AS/ HFA may have difficulty steering because they do not use their vision effectively
 Motor challenges for steering, accelerating and braking as well as difficulty managing space can make it difficult to park and back up
 Motor challenges can interfere with the ability to coordinate the visual and physical steps required to make a lane change

Executive function: Individuals with AS/ HFA have difficulty planning, organizing and sequencing the steps required to solve a problem.
 These challenges can make it difficult for the individual with AS/ HFA to make a decision and an appropriate plan necessary to manage a road-side emergency, a routine police stop, a detour or a significant change in weather

Social skills: Individuals with AS/ HFA have difficulty interpreting verbal and nonverbal information. Individuals with AS/ HFA tend to be extremely literal. These difficulties can increase their risk for collisions
 Individuals with AS/ HFA may not be able to anticipate how their actions may impact other drivers, pedestrians or roadway users.
 Driver’s don’t tend to follow the rules all of the time. Therefore drivers need to rely on their ability to anticipate actions of other drivers. Individuals with AS/ HFA may misunderstand or misinterpret the actions of other drivers
 Not knowing what other drivers are going to do can cause anxiety and interfere with the individual’s ability to concentrate on driving and react appropriately

A Driver Rehabilitation Evaluation will examine these skills as they relate to driving. The goal is to create independent, safe drivers. Many of these challenges can be addressed through Driver Rehabilitation intervention provided the individual has the skills necessary to begin learning to drive.

This assessment should include:

A review of medical history and medication



Assessment of Life Skills Activities that assess visual and cognitive processing skills for driving

Behind-the-Wheel Evaluation or simulated driving activities to assess motor coordination

National Autistic Society. (1999). High-functioning autism and Asperger’s syndrome: What’s the difference? Retrieved December 16, 2008, from

Kowalski, T. (2007). Asperger’s syndrome: Assessment and intervention strategies from preschool to adulthood. Eau Claire, WI: Medical Educational Services

Fact sheet contributor: Miriam Watson Monahan, MS. OTR/L, CDRS
To locate the driver rehabilitation specialist in your area contact:
The Association for Driver Rehabilitation Specialists
2425 N. Center ST #369
Hickory, North Carolina 28601 – (828)855-1623, (866)672-9466 Toll Free in the US & Canada

2 thoughts on “The Three A’s: Autism, Asperger’s and Automobiles – Part 6

  1. More Optometrists should know about The Association for Driver Rehabilitation Specialists. There must be many patients who could use their assistance.

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