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April 11, 2017

One in 3 teens with autism spectrum disorder gets driver's license, CHOP study says

Research suggests families' decision to drive occurs before learner's permit

One in three adolescents with autism spectrum disorder will acquire an intermediate driver's license  – most of them at the age of 17 – according to a new study from Children's Hospital of Philadelphia.

Of those who get a learner's permit, the vast majority obtain a driver's license within two years after becoming eligible. That suggests families are deciding whether their children with ASD will learn to drive and pursue a license before their teens ever get behind the wheel, said the study, published Tuesday in the journal, Autism.

"We know that driving can increase mobility and independence for adolescents with ASD, but little was known about their rates of licensure," said Allison E. Curry, Ph.D., MPH, a senior scientist at the Center for Injury Research and Prevention at CHOP and principal investigator of the study, in a statement. "Our results indicate that a substantial proportion of adolescents with ASD do get licensed, and support is needed to help families make the decision whether or not to drive before these adolescents become eligible for a learner's permit."

Researchers accessed more than 52,000 electronic health records of children born from 1987 to 1995 and New Jersey driver licensing data to determine current rates and patterns of licensure among adolescents and young adults with ASD (without intellectual disability) and those without ASD. Nearly 90 percent of learner's permit holders with ASD obtained an intermediate license within two years, at a median rate of 9.2 months later than other adolescents. By age 21, more than 34 percent of drivers with ASD received their intermediate license. With an intermediate license, drivers are allowed to travel without an adult in the car, but are not able to drive between the hours of 11 p.m. and 5 a.m. and are limited to one non-family passenger.

The CHOP study was the first large-scale effort to determine the number of adolescents with ASD who are licensed and the rate at which they move through the Graduated Driver Licensing (GDL) system. 

Teens with ASD who receive their permit are obtaining licenses at nearly the same rate as other adolescents, which leads researchers to believe families who decide to have their children get a learner's permit are committed to then obtaining a full license. Nearly 82 percent of teens with ASD with a learner's permit received their license within 12 months. That number is about 94 percent for teens without ASD. Within 24 months, nearly 90 percent of those with ASD were licensed, compared to nearly 98 percent of those without ASD. 

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"For teens on the autism spectrum, the decision to pursue a driver's license is one of several milestones that other families might take for granted. Independent means of transportation contributes to other long-term opportunities, such as post-high school education or employment and being socially involved and connected within their community," says Benjamin Yerys, Ph.D., study co-author and a scientist at the Center for Autism Research at CHOP, in a statement. "ASD can affect decision-making, information processing and attention to varying degrees, and we need to understand what resources, specialized instruction, and other supports might be helpful for teens and adults with ASD who are considering or preparing to drive."

One in 68 children in the United States is diagnosed with ASD, a significant increase over the past decade. More than two-thirds of the do not have an intellectual disability. 

"Our best advice to parents and caregivers of teens with ASD who are considering driving is to schedule a doctor's appointment to address any concerns, such as attention issues," says Patty Huang, M.D., study co-author and a developmental and behavioral pediatrician at CHOP. "Parents may also want to seek the advice of an occupational therapist who specializes in driving or a driving educator who has training in working with individuals with special needs."

Funding for the study was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health.

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