Research Article
Issue Date: September/October 2020
Published Online: July 30, 2020
Updated: August 07, 2020
Independent Community Mobility and Driving Experiences of Adults on the Autism Spectrum: A Scoping Review
Author Affiliations
  • Michelle Kersten, Registered OT, is PhD Candidate, School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia; m.kersten@westernsydney.edu.au
  • Kristy Coxon, Registered OT, PhD, is Senior Lecturer in Occupational Therapy, School of Health Science, Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia.
  • Hoe Lee, MSc(OT), PhD, is Associate Professor in Occupational Therapy, School of Occupational Therapy, Social Work, and Speech Pathology, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.
  • Nathan J. Wilson, RN, PhD, is Associate Professor in Nursing, School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia.
Article Information
Autism/Autism Spectrum Disorder / Community Mobility and Driving / Research Articles
Research Article   |   July 30, 2020
Independent Community Mobility and Driving Experiences of Adults on the Autism Spectrum: A Scoping Review
American Journal of Occupational Therapy, July 2020, Vol. 74, 7405205140. https://doi.org/10.5014/ajot.2020.040311
American Journal of Occupational Therapy, July 2020, Vol. 74, 7405205140. https://doi.org/10.5014/ajot.2020.040311
Abstract

Importance: Autistic adults face decreased community participation for employment, education, and social activities plus barriers to driving and transportation. However, little is known about their experiences of moving around community environments.

Objective: To explore contextual issues and experiences of independent community mobility and driving for autistic adults and to determine the modes of community mobility, regions studied, and methodologies used.

Data Sources: Seven databases were searched from 2000 to 2019. All empirical research relating to autism, community mobility, and driving for people older than age 5 yr was mapped. Studies examining experiences of community mobility and driving were selected for scoping review.

Study Selection and Data Collection: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews methodology was used. Thirteen studies reporting specifically on autistic adults’ experiences with public transportation, driving, and pedestrian navigation of community environments were included. These studies were analyzed using concepts from the Person–Environment–Occupation–Performance Model.

Findings: Nine studies examined experiences of autistic adults. Seven studies explored proxy perspectives. Those studies examining driving primarily focused on learner driver experiences. Although most studies reported on personal and environmental factors, some studies reported on broader social communication and personal narrative factors. None used inclusive methodology involving autistic adults.

Conclusions and Relevance: A broader focus on the contextual experiences of community mobility and driving is needed to support participation of autistic adults in their communities. Linking community mobility experiences with participation outcomes and expanding research to include experienced drivers and nonurban populations is an important component of this work.

What This Article Adds: Occupational therapy interventions should address community mobility and driving skills before school transition. Autistic adults’ skill development may be affected by person factors such as motivation, anxiety, social skills, communication, and occupational performance desires. Environmental factors such as parental concerns, community safety, pedestrian environments, traffic volume, and public transportation design are important. Further research partnering with autistic adults could better inform future occupational therapy interventions for community mobility and driving.