An integrated approach to establish the scientific foundation for driving among adolescents with autism

为自闭症青少年驾驶奠定科学基础的综合方法

• 批准号: 10180993
• 负责人: Allison Elizabeth Curry
• 金额: $ 63.1万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-12 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10180993
• 关键词: 21 year old; Address; Adolescence; Adult; Automobile Driving; Behavior; Cause of Death; Cellular Phone; Childhood; Community Participation; Data; Databases; Decision Making; Development; Education; Electronic Health Record; Employment; Event; Family; Family Process; Foundations; Funding; Goals; Gravitation; Health; Health Personnel; Impairment; Intellectual functioning disability; Intervention; Interview; Knowledge; Learning; Licensing; Licensure; Link; Longitudinal cohort study; Measures; Monitor; Outcome; Outcomes Research; Parents; Pattern; Pediatric Hospitals; Performance; Personal Satisfaction; Philadelphia; Police; Positioning Attribute; Prevalence; Quality of life; Reporting; Research; Research Project Grants; Resources; Retrospective cohort study; Risk; Safety; Sampling; Series; Speed; Support Groups; Surveys; Technology; Teenagers; Time; Vehicle crash; Work; adolescent with autism spectrum disorder; adverse outcome; autism spectrum disorder; cohort; data warehouse; driving behavior; driving safety; driving skills; evidence base; family support; high risk; high school; improved; individuals with autism spectrum disorder; informant; innovation; interest; intervention program; kinematics; multidisciplinary; programs; risky driving; skills; social; teen drivers; unsafe driving; young adult with autism spectrum disorder

Project Abstract The transition from adolescence to adulthood is particularly challenging for individuals with autism spectrum disorders (ASD). The ability to drive a vehicle has great potential to increase independence and mobility for teens with ASD—ultimately improving long-term well-being and health. We know that 1 in 3 individuals with ASD are licensed by age 21, but there is a notable gap between these families' interest in driving and the percentage of teens who are actually driving. For teens with ASD who do drive independently, impairments in skills known to be critical for safe driving may put them at heightened risk of a motor vehicle crash—the leading cause of death among teens. Given both the importance of safely encouraging independence and the potential for increased risk for negative driving outcomes, research on driving among teens with ASD is critical. Our long-term goal is to develop tailored resources and interventions that support teens with ASD and their families during the transition-to-driving period and optimize both their safety as independent drivers and positive long-term health outcomes. The overall objective of this research project is to provide much-needed evidence to directly inform development of these driving supports for teens and young adults with ASD. We will conduct an integrated series of three studies to: (1) identify underlying factors and outcomes of families' driving decisions; (2) characterize the driving patterns, behaviors, and performance of licensed teen drivers with ASD; and (3) establish the risk of negative driving outcomes among teen drivers with ASD. In Aim 1, we will first conduct qualitative interviews with driver educators, healthcare providers, and teens with ASD and their parents. Results will then directly inform quantitative surveys employed in a longitudinal cohort study of more than 500 teen with ASD-parent dyads that aims to determine how teens and their parents decide to drive and assess whether driving is associated with higher rates of quality of life measures. In Aim 2, we will characterize the driving patterns, behaviors, and performance of 40 newly licensed teens with ASD by continuously monitoring their driving for the first 12 months of licensure via innovative in-vehicle technology. We will estimate the prevalence of driving exposure (e.g., miles driven) and unsafe driving behaviors (e.g., speeding, cell phone use) among teens with ASD and compare the rates of unsafe driving events to a sample of teens without ASD derived from a prior naturalistic driving study. In Aim 3, we will conduct a retrospective cohort study using a unique linked data warehouse of childhood electronic health records and state traffic safety data to compare the risk of motor vehicle crashes and traffic citations for licensed teen drivers with and without ASD over the first four years of licensure. This study is innovative in that it is the first longitudinal research program to investigate real-world driving outcomes among teens with ASD. We expect that results generated from this project will lead to identification of new targets of driving interventions and programs for teens with ASD, provide knowledge about important aspects of the decision-making process for families during the transition-to-driving period, and ultimately improve the safety of drivers with ASD.

项目摘要 从青春期到成年期的过渡对于自闭症谱系的个体来说尤其具有挑战性 自闭症（ASD）。驾驶车辆的能力有很大的潜力，以增加独立性和流动性的青少年 最终改善长期的幸福和健康。我们知道三分之一的ASD患者 但是，这些家庭对驾驶的兴趣与他们在21岁之前获得驾驶执照的比例之间存在显着差距。 真正开车的青少年对于独立驾驶的ASD青少年来说， 对安全驾驶至关重要可能会使他们面临更高的机动车碰撞风险-这是死亡的主要原因 在青少年中。考虑到安全地鼓励独立的重要性和增加 风险的负面驾驶结果，研究驾驶青少年与ASD是至关重要的。我们的长期目标是 开发量身定制的资源和干预措施，支持ASD青少年及其家庭， 过渡到驾驶阶段，并优化他们作为独立驾驶员的安全性和积极的长期健康状况 结果。该研究项目的总体目标是提供急需的证据， 为患有ASD的青少年和年轻人开发这些驾驶支持。我们将进行一个综合系列 三项研究的目的是：（1）确定家庭驾驶决策的潜在因素和结果;（2）描述 驾驶模式，行为，并与ASD持牌青少年司机的表现;和（3）建立风险 ASD青少年司机的负面驾驶结果。在目标1中，我们将首先进行定性访谈， 司机教育工作者，医疗保健提供者，ASD青少年及其父母。结果将直接通知 在一项对500多名患有ASD的青少年-父母二人组的纵向队列研究中采用了定量调查， 旨在确定青少年及其父母如何决定驾驶，并评估驾驶是否与 更高的生活质量衡量标准。在目标2中，我们将描述驾驶模式、行为和 40名新获得执照的ASD青少年在前12个月的驾驶情况持续监测， 通过创新的车载技术获得许可证。我们将估计驾驶暴露的患病率（例如，英里 驾驶）和不安全的驾驶行为（例如，超速，手机使用）与ASD青少年之间的比较， 从先前的自然驾驶研究中得出的没有ASD的青少年样本的不安全驾驶事件的发生率。在 目标3，我们将使用一个独特的儿童电子数据库进行一项回顾性队列研究。 健康记录和国家交通安全数据，以比较机动车碰撞和交通引用的风险， 有执照的青少年司机和没有ASD在前四年的执照。本研究的创新之处在于， 这是第一个纵向研究项目，调查自闭症青少年在现实世界中的驾驶结果。 我们预计该项目产生的结果将导致确定推动干预的新目标 和自闭症青少年项目，提供决策过程中重要方面的知识， 为家庭在过渡到驾驶期间，并最终提高与ASD驾驶员的安全。