Showing posts with label access. Show all posts
Showing posts with label access. Show all posts

Thursday, 21 September 2017

"the likely effects of autism spectrum disorder on adolescent driving abilities"

"The literature revealed that drivers with autism (particularly males) were less likely to identify social hazards (e.g., pedestrians), had slower reaction times, more tactical driving difficulties, reported more traffic crashes, citations and intentional driving violations, and had poorer situation awareness skills than drivers without autism."

So said the literature review published by Clara Silvi and colleagues [1] looking at how young people diagnosed with an autism spectrum disorder (ASD) manage the multiple tasks involved in driving and how various characteristics linked to autism *might* translate into "driving-related challenges."

I feel I must add a caveat or two before proceeding with this post. First up is the quite widely known about association between age and driving ability (or inability). Younger drivers are, for various reasons, already more likely to be "overrepresented in road crash statistics." Inexperience, more risk-taking driving behaviours combined with the 'overconfidence of youth' are likely to be important reasons for such adverse driving statistics. Second, a diagnosis of autism does not automatically make everyone with autism a poor driver. Granted, here in the Blighty at least, a diagnosis of autism or ASD is something that needs to be considered in the context of licencing for driving (see here) but unlike something like epilepsy - "epileptic attacks, seizures, fits or blackouts" - the condition/label does not automatically disqualify someone from being licensed to drive.

OK, the Silvi review initially took in quite a lot of the literature on this topic, eventually being boiled down to 9 articles. These collected research papers provided various viewpoints on autism and driving behaviours/outcomes including that from parents/caregivers, driving instructors and importantly, young novice drivers with autism. The endpoint reached suggested that "symptoms of autism spectrum disorder can negatively affect the driving abilities of young drivers with autism spectrum disorder, further impacting their ability to drive, and in this way increasing their risk of crashing."

The authors have zoomed in quite a bit on a possible role for situational awareness when it comes to adverse outcomes in the context of autism and driving. Situational awareness combines various elements whereby the 'here and now' of the driving environment is constantly changing and hence drivers require a high degree of perceptual and cognitive flexibility and adaptation to adjust their driving behaviour accordingly. Indeed the authors talk about how: "Poor/underdeveloped situation awareness can represent a lack of mental models and schemas (thought/behavioral patterns)."

I can kinda see how some of the ways that autism has been defined *might* overlap with the findings talking about how "situation awareness skills were less developed in drivers with autism spectrum disorder." This is something picked up in other research too [2]. I'm not so sure about the whole 'lacking in mental models' thing applied specifically to autism (seemingly harking back to the sweeping generalisation of a 'lack of theory of mind') but can perhaps see a way forward for how cognitive flexibility might be something important in the context of traits related to being rule-bound and highly perseverative.

There is a balance to be struck between the safety of autistic drivers (and indeed, the safety of other road users) and ensuring that personal liberties are not impinged on too much as a result of the Silvi findings. As many drivers will tell you, the freedom that comes with driving a car or other vehicle is something that adds considerably to quality of life; a topic that has already revealed some quite profound issues in relation to some autism [3] (see here for my take). Indeed, if accessibility is a factor in ensuring those on the autism spectrum can live a good quality of life, moves to make driving safer and more readily available to more people on the spectrum should be further [carefully] investigated.

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[1] Silvi C. et al. A Literature Review of the Likely Effects of Autism Spectrum Disorder on Adolescent Driving Abilities. Adolescent Research Review. 2017. Sept 2.

[2] Chee DYT. et al. Investigating the driving performance of drivers with and without autism spectrum disorders under complex driving conditions. Disabil Rehabil. 2017 Aug 28:1-8.

[3] Ayres M. et al. A systematic review of quality of life of adults on the autism spectrum. Autism. 2017 Aug 1:1362361317714988.

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Saturday, 13 June 2015

Autism, higher education and employment: what happens long-term?

Note: I wish I knew who to attribute this fantastic picture to.
I want to draw your attention to the paper by Julie Lounds Taylor and colleagues [1] in today's post and some slightly worrying findings based on their longitudinal investigation of postsecondary (higher) education and employment experiences for a group of 73 adults diagnosed as being on the autism spectrum.

To quote: "Although two-thirds of adults with autism spectrum disorder participated in competitive employment/postsecondary education during the study, fewer than 25% maintained these activities over the study period."

I was interested in this specific sentence given some recent discussions with colleagues about how quite a lot of the conversations about employment and/or higher education access for those on the autism spectrum seemed to be missing some important elements including: (a) 'what factors successfully 'keep' a person in employment/education?' and (b) 'does long-term participation in education/employment really improve quality of life for everyone on the autism spectrum?'

Before anyone gets any ideas about me being somehow opposed to employment and higher education access for anyone and everyone who wants it, I'm not. As per some previous ramblings on this topic, I do think there are plenty of ways that the jobs market for example, can be opened up for those on the autism spectrum (see here) and society is poorer by not recognising the talents available. What I am slightly concerned about is quite a typical feature for autism research and practice with some of the sweeping generalisations that are often made that there is some sort of one-size-fits-all 'life plan' for everyone on the autism spectrum. There isn't and when it comes to jobs and education, there certainly isn't [2].

Appreciating that discussions about education and employment are quite prevalent in the research literature these days, I would very much like to see quite a bit more science done on the various reasons why higher education and/or employment in their current form might not necessarily be right for everyone on the autism spectrum and what can be done about it. Things like anxiety - which can be extremely disabling for some on the autism spectrum - affecting a person's ability to hold down a job for example, and the additional pressures that it can result in for both employees and employers. In these times of Governments striving for full employment, compassion for those not able to hold employment (including on the topic of benefits sanctions) should be extended at the same time as striving for improvements in offering opportunities. Drawing also on the idea that higher education might invoke certain stresses and strains that may uniquely affect some on the autism spectrum (see here) I'd like to see more investigations on what can be done to mitigate such issues and improve the learning experience for those on the spectrum who choose this particular direction.

"Women were considerably less likely than men to maintain employment/postsecondary education over time." This is another worrying finding reported by Taylor et al reiterating other work coming to similar conclusions [3]. I don't yet have any specific ideas why men with autism were more likely to hold down employment/education compared with women with autism but it strikes me that some further investigation should be quickly forthcoming.

To reiterate, I am by no means opposed to increasing access / participation in higher education and employment for those on the autism spectrum; society owes all it's citizens equal rights and importantly justice (see attached picture). What I do have a problem with is when equality assumes 'one-size-fits-all' and fails to understand the individual needs, wants and wishes of individuals [4]. This also includes the further requirement to debunk the idea that "natural science, engineering and IT" are the only educational / occupational courses 'right' for people on the autism spectrum [5].

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[1] Taylor JL. et al. Longitudinal patterns of employment and postsecondary education for adults with autism and average-range IQ. Autism. 2015 May 27. pii: 1362361315585643.

[2] Marshall D. & Goodall C. The Right to Appropriate and Meaningful Education for Children with ASD. JADD. 2015. June 3.

[3] Holwerda A. et al. Predictors of sustainable work participation of young adults with developmental disorders. Res Dev Disabil. 2013 Sep;34(9):2753-63.

[4] Griffith GM. et al. 'I just don't fit anywhere': support experiences and future support needs of individuals with Asperger syndrome in middle adulthood. Autism. 2012 Sep;16(5):532-46.

[5] Lorenz T. & Heinitz K. Aspergers--different, not less: occupational strengths and job interests of individuals with Asperger's Syndrome. PLoS One. 2014 Jun 20;9(6):e100358.

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ResearchBlogging.org Taylor JL, Henninger NA, & Mailick MR (2015). Longitudinal patterns of employment and postsecondary education for adults with autism and average-range IQ. Autism : the international journal of research and practice PMID: 26019306