Autism and Driving: How an OT Driving Assessment Can Help

Learning to drive is a significant milestone for most young adults. For people on the autism spectrum, it can come with extra considerations. The good news is that many autistic drivers learn to drive successfully and go on to drive safely for life.

An OT driving assessment can help identify the right supports and path forward. Here's how it works.

Can people with autism drive?

Yes. Autism itself is not a barrier to driving. Many autistic people are excellent drivers. Some of the traits associated with autism (attention to detail, rule-following, consistency) can actually be advantages behind the wheel.

That said, certain aspects of driving can be more challenging for some autistic people, and this is where a thorough assessment helps identify whether additional support is needed.

Why autism might affect driving

Every autistic person is different, and the impact on driving varies significantly from one person to another. Some areas that may be relevant include:

• Sensory processing. Driving involves a lot of sensory input at once (visual, auditory, vestibular). Some autistic drivers find certain sensory environments overwhelming, such as busy roads with lots of traffic, bright sun, loud music, or rain.

• Processing speed. Driving requires rapid processing of information and decision-making. Some autistic people take a little longer to process complex situations, though this is highly individual.

• Attention and divided attention. Driving requires holding attention across multiple tasks (watching the road, monitoring mirrors, anticipating other drivers, managing controls). This can be more demanding for some autistic drivers.

• Social cognition. Much of driving involves anticipating what other drivers will do. This requires reading subtle social cues (a glance, a small hand movement, body language in a car). Some autistic drivers find this aspect more challenging.

• Anxiety. Driving anxiety is common among learner drivers generally, and can be particularly significant for autistic people, especially in unfamiliar situations.

• Executive function. Planning a route, managing time, responding to unexpected changes, and self-monitoring while driving all draw on executive function skills.

It's worth saying clearly: these are things that may be more challenging, not things that are challenging for every autistic person. Some autistic drivers have none of these issues. Others have some. A proper assessment identifies what, if anything, needs support.

When to consider an OT driving assessment

An OT driving assessment is often helpful for autistic learner drivers in a few situations:

Before starting to learn. A pre-driving assessment can identify strengths and areas that may need targeted support. This can save significant time and money compared to starting lessons and discovering issues later.

When standard lessons aren't working. If a learner has started driving lessons but is struggling to progress, an OT assessment can identify why, and recommend a tailored approach.

When NDIS funding is involved. If you're an NDIS participant and driving is part of your goals, an OT assessment is often required as part of accessing NDIS-funded driving supports.

Before attempting the practical driving test. Some learners benefit from an OT assessment as a final check before the Transport for NSW test.

What the assessment involves

The assessment has two parts, adapted for learner drivers.

Part 1: Off-road (clinical) assessment

This is conducted at your home and includes:

A clinical interview. A conversation about the learner's experience so far (if any), their goals, any concerns, sensory preferences, and how they usually manage new and demanding situations. Parents or support workers can be involved.

Vision screening. Visual acuity, visual fields, and related skills.

Cognitive assessment. Areas such as attention, processing speed, decision-making, spatial awareness, and executive functions.

Physical assessment. Strength, coordination, reaction time, and fine motor control.

Throughout the assessment, the OT is observing how the learner manages new tasks, follows instructions, and copes with the demands of the situation.

Part 2: On-road assessment

For experienced learners, this is a one-hour drive with the OT and a specialist driving instructor in a dual-controlled vehicle.

For very early-stage learners (or those who haven't yet started lessons), the approach may be different. Some may not be ready to drive on public roads and will instead complete an off-road driving evaluation in a controlled environment, with a view to starting lessons once supports are in place.

The OT is looking at general driving skills but also specifically at things like:

• How the learner handles sensory demands (particularly in complex traffic)

• Processing speed in real-world driving situations

• Hazard perception and anticipation of other drivers

• Response to unexpected situations

• Self-monitoring (does the learner notice and correct their own errors?)

Possible outcomes

Ready to progress with driving lessons. The assessment identifies no significant barriers, and the learner can proceed with standard lessons (or continue them).

Driving lessons recommended with specific focus areas. The OT identifies specific skills to work on with a rehabilitation driving instructor. This targeted approach often works better than generic lessons.

Additional supports recommended. For some learners, things like sensory-aware instruction, structured lesson plans, or a slower pace of learning are recommended.

Not ready to learn at this time. In some cases, the assessment identifies that the learner would benefit from further development in related skills before starting lessons. This isn't a closed door, just a redirection.

How NDIS funding works

For NDIS participants, driving can often be funded as part of a plan. The typical pathway involves:

Identifying driving as a goal in the NDIS plan, framed around the independence and community access it provides.

An OT driving assessment to evaluate current abilities, identify any supports needed, and recommend a lesson plan. This assessment itself is usually funded through the plan.

A set of rehabilitation driving lessons with a specialist driving instructor, often funded under NDIS Capacity Building supports.

A reassessment after the lesson block to evaluate progress.

Ongoing driving lessons or further assessment as needed.

Your NDIS support coordinator or plan manager can help work out the funding details. The OT can also advise on what's typically included in the plan.

Why a specialist OT and instructor matter

Not every driving instructor has experience working with autistic learners. The combination of a driver-trained OT and a rehabilitation driving instructor means:

• The learner is assessed and taught by people who understand the clinical context

• The teaching approach can be adapted (clearer instructions, structured routines, appropriate pacing)

• Sensory demands can be managed (quieter times of day, familiar routes to start, predictable lesson structures)

• The pace of progression is tailored to the individual

This is often a better experience than starting with a standard driving instructor who may not recognise what's causing difficulties or know how to adapt their approach.

How to start the process

Your GP, paediatrician, psychiatrist, or specialist can refer you or your child for an OT driving assessment. If driving is part of your NDIS goals, your support coordinator can also help arrange the referral.

You can start the process at steerdriving.com.au/referral.

This article was written by Elise, an AHPRA-registered Occupational Therapist and Transport for NSW-registered driver assessor. Elise is the founder of Steer Driving, a mobile OT driving assessment practice in Sydney.

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