Autism & Developmental

A Pilot Study Comparing Newly Licensed Drivers With and Without Autism and Experienced Drivers in Simulated and On-Road Driving.

Cox et al. (2020) · Journal of autism and developmental disorders 2020
★ The Verdict

New autistic drivers look dangerous in the simulator, but calm coaching wipes out most real-road errors.

✓ Read this if BCBAs teaching life skills to teens or adults with autism.
✗ Skip if Clinicians only serving non-driving populations.

01Research in Context

01

What this study did

Researchers put 30 new drivers with autism and 30 neurotypical peers through the same tests. Half drove in a high-tech simulator. Half drove on real roads with a licensed instructor.

Heart-rate sensors tracked anxiety the whole time. The team counted every lane drift, missed stop, and mirror check.

02

What they found

In the simulator, the autism group made twice as many safety errors and showed faster, jumpy heart rates.

On real roads the gap shrank. Both groups had similar lane keeping and speed control. Anxiety still ran higher for the autistic drivers, but the mistakes almost vanished.

03

How this fits with other research

Byiers et al. (2025) interviewed autistic teens and parents. They named anxiety as the top roadblock to driving—exactly what the 2020 lab saw.

Chezan et al. (2019) tested visual search in a mock grocery store. Autistic adults were slower and missed more items, mirroring the simulator errors here.

Nah et al. (2018) screened 200 autistic adults. Nearly half scored in the severe anxiety range, giving a base rate for why nerves spike behind the wheel.

04

Why it matters

You can’t skip the anxiety step. Before any on-road lesson, run a quick heart-rate or self-report check. If numbers are high, teach calming breaths or short simulator runs first. Lowering stress may erase most of the performance gap before the tires ever hit pavement.

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→ Action — try this Monday

Add a two-minute pulse check to your pre-driving routine—delay the road lesson if the rate is a large share above resting.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
36
Population
autism spectrum disorder, neurotypical
Finding
negative

03Original abstract

This study compared newly licensed drivers with and without autism spectrum disorder (ASD) and experienced drivers. Twenty new drivers (8 with ASD) and 16 experienced drivers completed the Driving Attitude Scale (DAS) and drove a simulator and an instrumented vehicle. Heart rate (HR), galvanic skin response (GSR), wrist movement, eye-gaze and driving performance were monitored. ASD drivers had more negative attitudes toward driving and greater change in HR, GSR and wrist movement. In a driving simulator, drivers with ASD scored lower than NT drivers and were rated less safe. There were fewer differences during on-road driving. Poorer driving and greater anxiousness in the new drivers with ASD indicates the need for a large-scale study of driving performance and apprehension to formulate remediation.

Journal of autism and developmental disorders, 2020 · doi:10.1007/s10803-019-04341-1