Driving Support Interventions for Autistic People: Systematic Review and Participatory Synthesis

Tom Arthur; David Harris; Sophie Robinson; Mark Brosnan; Elizabeth Sheppard; Samuel Vine; Gavin Buckingham; Mark Wilson; María Ordovás-Montañés; G.J. Melendez-Torres

doi:10.1177/25739581261434228

Driving Support Interventions for Autistic People: Systematic Review and Participatory Synthesis

Tom Arthur
, David Harris
, Sophie Robinson
, Mark Brosnan
, Elizabeth Sheppard
, Samuel Vine
, Gavin Buckingham
, Mark Wilson
, María Ordovás-Montañés
, G.J. Melendez-Torres

Centre for Applied Autism Research (CAAR), Department of Psychology, University of Bath, Bath, UK.
Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
Department of Psychology, Faculty of Science, University of Nottingham, Nottingham, UK.
University of Oxford

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Autistic people can face remediable barriers and challenges with driving, yet there is no consensus around effective support methods. This review therefore sought to evaluate the implementation and effectiveness of driving support interventions for autistic people. Methods: We conducted a multimethod, participatory synthesis of evidence. Studies were obtained from MEDLINE, Social Policy and Practice, ASSIA, PsycINFO, CINAHL, ERIC, Scopus, and Epistemonikos. Data were extracted from those that implemented a driving support intervention with autistic people. No specifications on study design, outcomes, or comparators were made. Risk of bias (ROB) was appraised using the Cochrane ROB and Risk Of Bias in Non-Randomized Studies (ROBINS) tools (for controlled quantitative studies), as well as the EPPI-Centre (for qualitative studies) and NHLBI (for other uncontrolled studies) quality tools. The application and effectiveness of support interventions were narratively synthesized, while focal delivery components and mechanisms of action were examined using realist synthesis. All analyses were coproduced and developed by autistic adults. Results: Only 17 relevant studies (involving 402 autistic participants) were identified, which utilized varying designs and were generally appraised to be low in quality. The most well-researched form of support was simulation training; however, e-learning applications, anti-anxiety medication, listening to music, and cognitive-behavioral programs were also studied. Although positive results were documented for all interventions, at least in some form, assessments typically consisted of simulated driving tests and various contextual factors were overlooked. Specific delivery components were identified from the effective support programs, but evidence was lacking with regard to intervention mechanisms. Conclusion: Our participatory syntheses of data highlight that research is urgently required to address the driving barriers and challenges faced by autistic people. Despite promising but inconclusive evidence for simulation training and holistic cognitive-behavioral programs, widespread limitations are evident in existing studies and rigorous, generalizable intervention assessments are lacking.

Original language	English
Journal	Autism in Adulthood
Early online date	25 Mar 2026
DOIs	https://doi.org/10.1177/25739581261434228
Publication status	E-pub ahead of print - 25 Mar 2026

Data Availability Statement

All relevant data and supplementary materials associated with this article are available on this page.

Acknowledgements

The authors thank all the research partners who contributed toward their participatory activities and undertakings on this project. In particular, they express their gratitude to those who attended the public involvement workshops at the Centre for Applied Autism Research, who valuably informed their review focus and broader research objectives.

Funding

T.A. is the recipient of an ESRC New Investigator award (grant number: ES/Z503538/1). G.J.M.-T. is a National Institute for Health and Care Research (NIHR) Senior Investigator. The opinions expressed in this article are those of the authors and not necessarily those of the NIHR or the UK Department of Health and Social Care. For the purpose of open access, the author has applied a “Creative Commons Attribution” (CC BY) license to any author-accepted article version arising from this submission.

Funders	Funder number
UKRI - ESRC	ES/Z503538/1
Economic and Social Research Council	ES/Z503538/1

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

autism
driver training
drivers
driving experiences
realist synthesis

ASJC Scopus subject areas

Developmental and Educational Psychology
Neurology
Clinical Neurology
Cognitive Neuroscience
Psychiatry and Mental health

Access to Document

10.1177/25739581261434228

https://journals.sagepub.com/doi/10.1177/25739581261434228

Cite this

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abstract = "Background: Autistic people can face remediable barriers and challenges with driving, yet there is no consensus around effective support methods. This review therefore sought to evaluate the implementation and effectiveness of driving support interventions for autistic people. Methods: We conducted a multimethod, participatory synthesis of evidence. Studies were obtained from MEDLINE, Social Policy and Practice, ASSIA, PsycINFO, CINAHL, ERIC, Scopus, and Epistemonikos. Data were extracted from those that implemented a driving support intervention with autistic people. No specifications on study design, outcomes, or comparators were made. Risk of bias (ROB) was appraised using the Cochrane ROB and Risk Of Bias in Non-Randomized Studies (ROBINS) tools (for controlled quantitative studies), as well as the EPPI-Centre (for qualitative studies) and NHLBI (for other uncontrolled studies) quality tools. The application and effectiveness of support interventions were narratively synthesized, while focal delivery components and mechanisms of action were examined using realist synthesis. All analyses were coproduced and developed by autistic adults. Results: Only 17 relevant studies (involving 402 autistic participants) were identified, which utilized varying designs and were generally appraised to be low in quality. The most well-researched form of support was simulation training; however, e-learning applications, anti-anxiety medication, listening to music, and cognitive-behavioral programs were also studied. Although positive results were documented for all interventions, at least in some form, assessments typically consisted of simulated driving tests and various contextual factors were overlooked. Specific delivery components were identified from the effective support programs, but evidence was lacking with regard to intervention mechanisms. Conclusion: Our participatory syntheses of data highlight that research is urgently required to address the driving barriers and challenges faced by autistic people. Despite promising but inconclusive evidence for simulation training and holistic cognitive-behavioral programs, widespread limitations are evident in existing studies and rigorous, generalizable intervention assessments are lacking.",

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AU - Harris, David

AU - Robinson, Sophie

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AU - Sheppard, Elizabeth

AU - Vine, Samuel

AU - Buckingham, Gavin

AU - Wilson, Mark

AU - Ordovás-Montañés, María

AU - Melendez-Torres, G.J.

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N2 - Background: Autistic people can face remediable barriers and challenges with driving, yet there is no consensus around effective support methods. This review therefore sought to evaluate the implementation and effectiveness of driving support interventions for autistic people. Methods: We conducted a multimethod, participatory synthesis of evidence. Studies were obtained from MEDLINE, Social Policy and Practice, ASSIA, PsycINFO, CINAHL, ERIC, Scopus, and Epistemonikos. Data were extracted from those that implemented a driving support intervention with autistic people. No specifications on study design, outcomes, or comparators were made. Risk of bias (ROB) was appraised using the Cochrane ROB and Risk Of Bias in Non-Randomized Studies (ROBINS) tools (for controlled quantitative studies), as well as the EPPI-Centre (for qualitative studies) and NHLBI (for other uncontrolled studies) quality tools. The application and effectiveness of support interventions were narratively synthesized, while focal delivery components and mechanisms of action were examined using realist synthesis. All analyses were coproduced and developed by autistic adults. Results: Only 17 relevant studies (involving 402 autistic participants) were identified, which utilized varying designs and were generally appraised to be low in quality. The most well-researched form of support was simulation training; however, e-learning applications, anti-anxiety medication, listening to music, and cognitive-behavioral programs were also studied. Although positive results were documented for all interventions, at least in some form, assessments typically consisted of simulated driving tests and various contextual factors were overlooked. Specific delivery components were identified from the effective support programs, but evidence was lacking with regard to intervention mechanisms. Conclusion: Our participatory syntheses of data highlight that research is urgently required to address the driving barriers and challenges faced by autistic people. Despite promising but inconclusive evidence for simulation training and holistic cognitive-behavioral programs, widespread limitations are evident in existing studies and rigorous, generalizable intervention assessments are lacking.

AB - Background: Autistic people can face remediable barriers and challenges with driving, yet there is no consensus around effective support methods. This review therefore sought to evaluate the implementation and effectiveness of driving support interventions for autistic people. Methods: We conducted a multimethod, participatory synthesis of evidence. Studies were obtained from MEDLINE, Social Policy and Practice, ASSIA, PsycINFO, CINAHL, ERIC, Scopus, and Epistemonikos. Data were extracted from those that implemented a driving support intervention with autistic people. No specifications on study design, outcomes, or comparators were made. Risk of bias (ROB) was appraised using the Cochrane ROB and Risk Of Bias in Non-Randomized Studies (ROBINS) tools (for controlled quantitative studies), as well as the EPPI-Centre (for qualitative studies) and NHLBI (for other uncontrolled studies) quality tools. The application and effectiveness of support interventions were narratively synthesized, while focal delivery components and mechanisms of action were examined using realist synthesis. All analyses were coproduced and developed by autistic adults. Results: Only 17 relevant studies (involving 402 autistic participants) were identified, which utilized varying designs and were generally appraised to be low in quality. The most well-researched form of support was simulation training; however, e-learning applications, anti-anxiety medication, listening to music, and cognitive-behavioral programs were also studied. Although positive results were documented for all interventions, at least in some form, assessments typically consisted of simulated driving tests and various contextual factors were overlooked. Specific delivery components were identified from the effective support programs, but evidence was lacking with regard to intervention mechanisms. Conclusion: Our participatory syntheses of data highlight that research is urgently required to address the driving barriers and challenges faced by autistic people. Despite promising but inconclusive evidence for simulation training and holistic cognitive-behavioral programs, widespread limitations are evident in existing studies and rigorous, generalizable intervention assessments are lacking.

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JO - Autism in Adulthood

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Driving Support Interventions for Autistic People: Systematic Review and Participatory Synthesis

Abstract

Data Availability Statement

Acknowledgements

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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