EFFECTIVE USE OF A DRIVING SIMULATOR AS AN INTERVENTION TOOL FOR ADOLESCENTS AND YOUNG ADULTS WITH AUTISM SPECTRUM DISORDER

Abstract

Purpose: The purpose of this study was to determine the effectiveness of the interactive driving simulator as an intervention tool for adolescents and young adults with high-functioning autism spectrum disorder. Method: Using two interactive driving simulators, a pre-test/post-test design was used to assess driving performance on three types of driving scenarios. Fourteen participants with autism spectrum disorder, nine of which participated in the driving intervention in the context of a summer-intensive driving boot camp and five of which participated only in the driving intervention, completed the intervention on the driving simulator. Intervention sessions targeted 10 critical skills: use of turn signals, stop signs, traffic signals, avoidance of hazards, lane maintenance, lane changes, right and left turns, speed maintenance, hazard identification, and navigation. Pre-test and post-test driving assessments were scored using P-Drive, a standardized observational driving evaluation tool. The simulator output data was also used for one simulator. Results: Simulator output data revealed a highly statistically significant difference for minimum distance to collision for vehicle backing onto roadway (p<0.001) before and after adjusting for outliers. A few others were below the nominal 5% level, but these would not be significant after adjusting for multiple comparisons. The P-Drive mean total scores demonstrated significant differences between pre-test and post-test among the participants for all three driving scenarios. Conclusion: Although a small sample size, there were limited significant differences for measures on the simulator output data, suggesting simulator output may not be sensitive enough to measure overall driving performance in this population. However, majority of the data shows positive improvements in participant driving performance from pre- to post-test. The difference in mean P-Drive total scores demonstrated a statistically and clinically significant difference from pre- to post-test on Road Test Version 2 (p<0.001; 95% CI [-31.13, -15.64]), Town & Country (p<0.001; 95% CI [-33.86, -15.97]), and Residential & Suburban (p=0.001; 95% CI [-33.37, -12.00]) driving scenarios. These results demonstrate an overall increase in mean scores on the P-Drive from pre- to post-test, which suggests improved overall driving performance. These results, with observations during sessions, suggest that the driving simulator can be an effective intervention tool for improving driving knowledge, skills, and abilities in adolescents and young adults with high-functioning autism spectrum disorder.