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7. Driving/Transportation and Transition

Author

Bishop, Haley J., Curry, Allison E., Yerys, Benjamin E., Cooley, Dennis R., Series Editor, Weisstub, David N., Advisory Editor, Thomasma, David C., Founding Editor, Kimbrough Kushner, Thomasine, Founding Editor, Carney, Terry, Editorial Board Member, Düwell, Marcus, Editorial Board Member, Holm, Søren, Editorial Board Member, Kimsma, Gerrit, Editorial Board Member, Sulmasy, Daniel P., Editorial Board Member, Hodge, David Augustin, Editorial Board Member, Jones, Nora L., Editorial Board Member, Elster, Nanette, editor, and Parsi, Kayhan, editor

Published
2022
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18. Longitudinal Study of Driver Licensing Rates among Adolescents and Young Adults with Autism Spectrum Disorder

Author

Curry, Allison E., Yerys, Benjamin E., Huang, Patty, and Metzger, Kristi B.

Abstract

Driving may increase mobility and independence for adolescents with autism without intellectual disability (autism spectrum disorder); however, little is known about rates of licensure. To compare the proportion of adolescents with and without autism spectrum disorder who acquire a learner's permit and driver's license, as well as the rate at which they progress through the licensing system, we conducted a retrospective cohort study of 52,172 New Jersey residents born in the years 1987-1995 who were patients of the Children's Hospital of Philadelphia healthcare network ?12 years of age; 609 (1.2%) had an autism spectrum disorder diagnosis. Electronic health records were linked to New Jersey's driver licensing database (2004-2012). Kaplan-Meier curves and log-binomial regression models were used to determine the age at and rate of licensure, and estimate adjusted risk ratios. One in three adolescents with autism spectrum disorder acquired a driver's license versus 83.5% for other adolescents and at a median of 9.2 months later. The vast majority (89.7%) of those with autism spectrum disorder who acquired a permit and were fully eligible to get licensed acquired a license within 2 years. Results indicated that a substantial proportion of adolescents with autism spectrum disorder do get licensed and that license-related decisions are primarily made prior to acquisition of a permit instead of during the learning-to-drive process.

Published
2018
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22. Changes in the burden of medications that may impair driving among older adults before and after a motor vehicle crash.

Author

Riester, Melissa R., D'Amico, Adam M., Khan, Marzan A., Joyce, Nina R., Pfeiffer, Melissa R., Margolis, Seth A., Ott, Brian R., Curry, Allison E., Bayer, Thomas A., and Zullo, Andrew R.

Subjects
ANTIHYPERTENSIVE agents, DIURETICS, DRUGGED driving, TRAFFIC accidents, SCIENTIFIC observation, MUSCLE relaxants, POLYPHARMACY, DEPRESCRIBING, ANTIHISTAMINES, DISEASE incidence, RISK assessment, COMPARATIVE studies, BENZODIAZEPINES, DRUGS, DESCRIPTIVE statistics, RESEARCH funding, MEDICAL prescriptions, OPIOID analgesics, DRUNK driving, MEDICARE, TRANQUILIZING drugs, OLD age
Abstract

Background: Medications are one of the most easily modifiable risk factors for motor vehicle crashes (MVCs) among older adults, yet limited information exists on how the use of potentially driver‐impairing (PDI) medications changes following an MVC. Therefore, we examined the number and types of PDI medication classes dispensed before and after an MVC. Methods: This observational study included Medicare fee‐for‐service beneficiaries aged ≥67 years who were involved in a police‐reported MVC in New Jersey as a driver between 2008 and 2017. Analyses were conducted at the "person‐crash" level because participants could be involved in more than one MVC. We examined the use of 36 PDI medication classes in the 120 days before and 120 days after MVC. We described the number and prevalence of PDI medication classes in the pre‐MVC and post‐MVC periods as well as the most common PDI medication classes started and stopped following the MVC. Results: Among 124,954 person‐crashes, the mean (SD) age was 76.0 (6.5) years, 51.3% were female, and 83.9% were non‐Hispanic White. The median (Q1, Q3) number of PDI medication classes was 2 (1, 4) in both the pre‐MVC and post‐MVC periods. Overall, 20.3% had a net increase, 15.9% had a net decrease, and 63.8% had no net change in the number of PDI medication classes after MVC. Opioids, antihistamines, and thiazide diuretics were the top PDI medication classes stopped following MVC, at incidences of 6.2%, 2.1%, and 1.7%, respectively. The top medication classes started were opioids (8.3%), skeletal muscle relaxants (2.2%), and benzodiazepines (2.1%). Conclusions: A majority of crash‐involved older adults were exposed to multiple PDI medications before and after MVC. A greater proportion of person‐crashes were associated with an increased rather than decreased number of PDI medications. The reasons why clinicians refrain from stopping PDI medications following an MVC remain to be elucidated. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Driving Skills at Licensure and Time to First Crash

Author

Walshe, Elizabeth A., primary, Elliott, Michael R., additional, Cheng, Shukai, additional, Romer, Daniel, additional, Curry, Allison E., additional, Grethlein, David, additional, Gonzalez, Alexander K., additional, and Winston, Flaura K., additional

Published
2023
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42. Brief Report: Healthcare Providers' Discussions Regarding Transportation and Driving with Autistic and Non-autistic Patients.

Author

Sartin, Emma B., Myers, Rachel K., Labows, Christina G., Metzger, Kristina B., Carey, Meghan E., Yerys, Benjamin E., McDonald, Catherine C., Mollen, Cynthia J., and Curry, Allison E.

Subjects
DIAGNOSIS of autism, ATTITUDES of medical personnel, CROSS-sectional method, MEDICAL personnel, MEDICAL care, MANN Whitney U Test, COMPARATIVE studies, PSYCHOSOCIAL factors, AUTOMOBILE driving, COMMUNICATION, DESCRIPTIVE statistics, CHI-squared test, TRANSPORTATION, MENTAL health services, ADOLESCENCE
Abstract

Objective: To characterize healthcare and behavioral service providers' transportation-related discussions with their autistic and non-autistic patients. Method: 78 providers completed a cross-sectional survey assessing their transportation discussions with patients. We used Mann–Whitney U tests and chi-square tests to compare differences in provider reports by patient diagnosis. Results: Compared with one in two providers who reported they discuss transportation with non-autistic patients, only one in five have these conversations with their autistic patients. Few (8%) providers felt prepared to assess driving readiness in autistic patients, yet only a quarter refer patients elsewhere. Conclusion: There is a critical need to develop resources for use in medical settings to effectively support autistic adolescents' independence and mobility as they transition into adulthood. [ABSTRACT FROM AUTHOR]

Published
2023
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