One-third of autistic individuals obtain a driver’s license by age 21; however, prior studies suggest they may be at heightened risk for motor vehicle crashes. We compared objective rates of crashes, traffic violations, and license suspensions for newly licensed autistic and non-autistic adolescents.
This retrospective cohort study included New Jersey residents born 1987-2000 who were patients of the Children’s Hospital of Philadelphia healthcare network. Electronic health records were linked with statewide driver licensing and crash databases. Autism status was classified via ICD diagnostic codes; those with intellectual disability were excluded. We compared rates among 486 autistic and 70,990 non-autistic licensed drivers over their first 48 months of driving. Further, we examined the proportion of crashes attributed to specific driver actions and crash types.
Compared with non-autistic drivers, autistic drivers were estimated to have lower average monthly rates of crash involvement (adjRR: 0.89 [0.75-1.05]), moving violations (0.56 [0.48-0.67]), and suspensions (0.32 [0.18-0.58]). Among drivers involved in a crash, autistic drivers were half as likely to crash due to unsafe speed, but substantially more likely to crash due to their failure to yield to a vehicle/pedestrian and while making left- or U-turns.
Newly licensed autistic adolescent drivers have similar to lower estimated rates of adverse driving outcomes; the extent to which these can be attributed to different driving patterns is a critical point for future investigation. There were several notable differences in the characteristics of these crashes, which directly inform interventions to improve driving safety of autistic adolescent drivers.

Copyright © 2021. Published by Elsevier Inc.