Autism behind the wheel

I can't count on my fingers how many clients over the portion of my career I've spent specializing in autism and ADHD have started therapy with a very specific driving-related goal: work up the courage to get behind the wheel; finally take my road test; drive without constantly worrying about crashing. However, every piece of content I've seen online about driving and neurodivergence of any kind has been centered on distractibility, speeding, impulsivity, novelty-seeking, adrenaline-seeking, road rage, or taking risks...you know, traits most commonly (stereotypically) associated with ADHD. So, why are these experience such a small fraction of the driving concerns I see in my office?

Folks that come to me struggling with driving aren't concerned with being too willing to take risks; rather, driving requires them to make rapid decisions with incomplete information. It asks them to coordinate a complicated series of motor actions, process a huge amount of sensory input, tolerate uncertainty, and constantly make judgments about what other people on the road might do. It's far more common that I hear "I care so much about whether this is safe that I can't reach a point of enough certainty to just do the thing" than "I don't care whether this is safe, I'm doing it" as the Internet seems to assume.

Driving is a tremendously demanding task for the brain and body, for some more than others.

To set the scene, a caveat: nothing I'm about to share about autism and driving indicates that autistic people are universally "good" or "bad" drivers; neither are ADHDers for that matter. Neurotype does not determine whether someone can perform a high-risk activity safely. Autistic people can speed, take risks, become distracted, etc, and people with ADHD can be extremely cautious and conscientious drivers, whether their intrinsic traits make them so or because they're masking to compensate for intrinsic risk-tolerant traits (similar to how many ADHDers are chronically early because otherwise they'd likely be late). Rather than assessing which neurotypes correlate to which styles of driving, I'm interested in the different mechanisms that make driving difficult.

Another quick note: while I'm using autism as shorthand throughout this blog, you don't need to identify as or be diagnosed as autistic for any of these experiences to be relevant to you because autistic traits are human traits. If you recognize yourself here, you don't need to decide what diagnostic category it belongs to before taking that information seriously.

Alright, let's start defining some specific challenges in detail:

Proprioception: Your body doesn't automatically know where the car is

Proprioception is defined as the sensory system that deals with your ability to understand where your body is in space. Driving a vehicle requires extending that awareness beyond your physical body. You have to develop an intuitive sense of where the edges of the car are, how much space you're occupying, how close you are to another vehicle, where your tires are in relation to the lane, and how much room you have when turning or parking. For some people, that sense develops almost automatically. It's usually the ones for whom it doesn't that end up talking to me about driving difficulties.

Those who struggle with proprioceptive awareness may have to consciously think about things that other drivers experience automatically, effortlessly. For example, parking may require considerably more effort. Narow lanes, tight garages, backing up, or judging distance from a curb can be particularly stressful.

This can overlap with dyspraxia or other motor-coordination differences, too. Steering, braking, accelerating, signaling, checking mirrors, changing lanes, and navigating turns all require coordinated motor sequences. Someone can understand perfectly well what they're supposed to do while still having difficulty getting their body to execute the sequence smoothly.

This is very different from not knowing how to drive! Consider that most of my driving anxiety clients pass their written driving test without an issue; it's the application of their knowledge that feels paralyzing.

Delayed processing: "I need another second"

Driving doesn't give us much time to think. A situation develops, and we're expected to notice what's happening, figure out what it means, predict what other people might do, decide what we should do, and execute that decision. For someone with a slower processing speed, that can be a lot. Keep in mind that even someone who considers themselves to be a quick thinker in things like wordplay and socializing may be slower in the visual arena.

Imagine approaching an intersection. A car is coming toward you. Is it turning? Is the driver slowing down? Are they yielding? Can you go? Is the pedestrian going to cross? Is the person behind you expecting you to move? Those who can't make that calculation quickly or reasonably trust their instincts might still be processing the situation while the available window for making a decision disappears.

A term for what I'm talking about here is decision paralysis. This is what happens when there are too many variables and not enough certainty, regardless of the breadth of knowledge the individual might have. Driving is full of situations where there is no objectively perfect decision. I remember feeling hopelessly confused at my driver's ed instructor's insistence that there's a point at which slowing down if the light is turning yellow as you approach is dangerous, but immediately before that point it's dangerous not to slow down. "Where is that point? How do I know if I've crossed it, let alone assess for this possibility in milliseconds of opportunity?" I thought. But no one else in the class seemed confused, so I figured I'd just figure it out with practice. I didn't! I don't think I've ever felt confident about whether I should've sped up or slowed down at a yellow light in my nearly 20 years as a driver.

Compensatory cautiousness ≠ safety

As I mentioned above, many people experience the opposite of the stereotype that impulsivity is the biggest problem neurodivergent drivers face. They leave a huge following distance, wait longer than necessary to make a turn, avoid changing lanes unless they're absolutely sure they have enough space, take the long way around rather than making a complicated left turn, avoid unfamiliar roads, drive significantly below the speed limits because the posted speed feels too fast for their processing capacity. Sometimes, these are totally reasonable safety choices. The problem comes in when driving requires us to act before we can achieve certainty.

We can say the same about other drivers as I said about yellow lights: no one can be 100% confident that they see us, that the person in front of us is going to do what they should (according to the rules of the road), or that someone won't suddenly merge into your lane. Ever looked over your shoulder and saw that you were clear to change lanes but then someone two lanes over did the same, and you narrowly avoided a collision? Great minds think alike, I suppose...point is, no one did anything wrong, and both drivers were being "safe" to the greatest extent that they could. It can be extremely anxiety-provoking to know that even when you drive exactly as you're taught, there is still risk.

At some point, you have to make a judgment and move. Driving often looks like making dozens of high-stakes decisions every few minutes, especially for those whose need for certainty is greater than average.

Rejection sensitivity, communication, and the social components of driving

When you're driving, you're not just navigating a physical environment; you're navigating other people's behavior. You're trying to interpret what they think of you, too. Whether it's someone honking, following closely behind you, speeding to pass you, or appearing irritated in your rearview mirror, intellectually knowing another driver's impatience isn't your responsibility doesn't do much for your nervous system's response.

Many of us make sense of fellow drivers' behavior by reasoning, "I'm inconveniencing someone and now they're mad at me" or "I must be doing this wrong." For people particularly sensitive to rejection and/or negative evaluation, that can make driving substantially harder. There's a frustrating feedback loop at play in which you might already be driving cautiously because you're trying to be safe and then you notice someone behind you getting frustrated. Their impatience (or at least cues that this is how they feel) increases your anxiety, and anxiety makes it harder to process information and make decisions, which can make you feel even more hesitant. Suddenly, you're not just driving but also monitoring whether everyone else thinks you're driving correctly. The cognitive load alone is heavy before you even consider the physical aspects of driving.

Additionally, driving requires a ton of implicit communication. People make their feelings, intentions, and requests known to others through speed, positioning, gestures, headlights, eye contact, and tiny changes in movement. It's up to you to decode whether they're letting you merge, waving you through, slowing down because they're yielding to you or because something is happening ahead, planning on turning, and more. We're expected to take an educated guess about why strangers (often several at once) are behaving in such a wide variety of ways. That's a form of social cognition, and if interpreting ambiguous social information is already effortful for you, driving adds another layer of uncertainty to it.

The sensory experience of driving

So much sensory information comes at us while we're behind the wheel! Just off the top of my head: headlights and glare, sunlight and reflections, road noise, road noise, engine vibration, gasoline smells, windshield wiper movement, billboards and signs, pedestrians, cyclists, several vehicles at once going different speeds and directions, construction, sirens, GPS instructions, the radio, and passengers talking.

If you have sensory sensitivities in any system, then none of this is background noise til your nervous system is done processing it (and then it's on to the next piece of sensory data, so there's no real break). Unlike many sensory environments, you can't easily step away when you've had enough. You're operating a vehicle. This is one reason a person might be perfectly comfortable driving on a quiet residential street but become overwhelmed on a freeway at night in the rain.

Unpredictability is a given

Familiarity with routes can make a dramatic difference. When you already have a mental map, it's less effortful to establish that this is where you turn, this lane becomes the exit, there's a weird merge here, parking is usually available behind the building, etc.

Even so, you're bound to eventually hit a road closure, a construction slowdown or detour, to miss your exit or be rerouted by your GPS. Then suddenly you're somewhere unfamiliar and have to reconstruct the entire mental model of what your'e doing while the car is still moving. If you rely heavily on predictability to get through situations, this can be disproportionately stressful. I'm not just talking about not liking change but a huge spike in the amount of cognitive processing required with little to no warning.

Attention beyond distracted driving

I got a ticket for texting and driving once. Learned my lesson: not just "don't do that, it's illegal," but that I'm a person with a high need for constant stimulation, and without it, I'm bound to take risks I probably wouldn't if I had access to better judgment because I wasn't responding to internal desperation. I started taking greater care to pick out ideal forms of legal and safe stimulation, like the music I'm listening to, and paying the neurodivergent tax to buy the nice, longer-lasting "car jar" air fresheners that are like candles. Cool, problem solved, right?

Well, no. Some people have difficulty distributing attention across multiple competing sources of information. I still become intensely focused on the car in front of me and then have difficulty monitoring everything else that's happening around me. This is actually more likely to happen when I'm on my ADHD meds, which help with many other aspects of safe driving but leave me overly focused on the "wrong" things sometimes. There's a tradeoff. Some people describe needing complete silence to navigate an unfamiliar intersection, but they don't really have control over whether they get that. In the meantime, other information becomes harder to integrate.

This can look very different from the stereotypical ADHD driving problem of simply being distracted and making better choices. It's possible for someone to be extremely attentive and still struggle with the attentional demands of driving.

Fatigued driving is often considered to fall under the "distracted" umbrella, too. I'm talking about fatigue that hits after you've decided to get in the car, so it's not a matter of being more careful. Driving can be safe and still be exhausting. Someone may be capable of or even energized by driving 20 minutes but find a 90-minute drive completely depleting. They may be consciously monitoring their body position, speed, mirrors, lane placement, traffic, navigation, sensory input, and other drivers the entire time. What another person experiences as an automatic task may remain a largely conscious task for them and drain energy in the background without their knowledge.

AuDHD as a tug-of-war

For those of us who have both ADHD and autistic traits, the experience of driving doesn't necessarily equal out to a little bit of each. My own tug-of-war often looks like a part of me saying "We're late, just go!" and another responding, "I can't see well enough beyond that car to know if I'm clear, I am not moving til I have the green light."

We are more likely to seek stimulation while also becoming overwhelmed by input and to have trouble sustaining attention on driving as a whole while also becoming hyperfocused on a single task, like cleaning bird poop off the window or adjusting the mirrors. We might want the spontaneity and independence of being able to get in the car and go somewhere while finding the actual process of driving extremely demanding. These things sound like contradications, but they're dialectics. Different neurocognitive traits can pull us in different directions.

Motivation check

Do you actually want to drive, though? I don't mean "If you wanted it enough, you would just try harder, and you wouldn't be struggling so much" as your inner (or outer) critic might be telling you. I mean that people tend to come to therapy telling me they need to learn how to drive or become less anxious driving, but when we start unpacking their motivation for this goal, the answer is sometimes not that driving would make their life better but rather something like "I'm an adult, and I should be able to drive." Their rationales are filled with shoulds, comparisons, narratives from family members concerned about them being behind, embarrassment about dependence on others for transportation.

In other words, the goal of driving may be inherited from others' expectations rather than chosen by the individual. That doesn't mean the desire for independence isn't real, it's just worth distinguishing "I want this" from "I believe I am supposed to want this." Doing that work does commonly land people at the conclusion that yes, they do want to drive because it would meaningfully improve their lives: they want to be able to go places spontaneously without waiting for a ride, public transportation doesn't run close enough to their destinations, a job they're interested in requires having a license. Whatever the reason, increasing confidence that the goal belongs to them is never a bad thing for motivation. Intrinsic motivation is far more sustainable and effective than shame. The task of driving may become less daunting when a person takes ownership over it and is less focused on what others will think if they fail.

Alternatively, some people arrive at a conclusion that they don't actually want to drive. What they want is the freedom and independence they've been told driving will provide. If you decide not to pursue driving any further, that doesn't mean you've failed at adulthood. You can build a life around what actually works for you. That might mean that throughout your life, you prioritize living somewhere with excellent public transportation the way someone who is very sensitive to cold might choose to always live in a warm climate. It's a neutral accommodation, not avoidance or thin skin. Additionally, you might choose housing where groceries are within walking distance; put money others would spend on gas and car payments toward Uber when needed; coordinate rides with friends and family; or use a bicycle or other form of transportation.

For someone who does want to drive, accommodations and skill-building may make driving more accessible. For someone who doesn't, the goal doesn't have to be teaching them to tolerate something they don't actually want. Sometimes the most autonomous decision isn't about forcing yourself to become someone who drives but rather building a life where you don't need to.

If driving is hard for you, it may be worth breaking the challenge down into parts: what specifically about driving is difficult for your mind and your body? Without pinpointing the source of your struggle, you risk concluding that there is simply something wrong with you.

I'm always going to be autistic...so will driving always be this hard?

If you've recognized yourself in any of the barriers to driving listed above, you might be wondering, "Okay, but if these are just inherent traits that I can't change without masking in some way, am I doomed to always struggle with driving?"

Short answer: no.

Long answer: the goal isn't to become less autistic so that you can drive. Some aspects of driving may become easier with practice. Many bodies can learn motor patterns. Familiar routes can become more automatic. You can learn strategies for managing sensory input, anticipating difficult situations, or giving yourself more processing time. You can also structure your driving around the conditions in which your mind works best. For example, you might:

• Practice a familiar route repeatedly before tackling unfamiliar ones or practice complex maneuvers like parallel parking and K-turns in an empty parking lot with traffic cones before increasing the stakes and being perceived in public

• Use GPS even on routes you know so that you don't have to hold the entire route in working memory on top of the cognitive labor of driving the car

• Choose quieter times of day or more direct routes (perhaps paying a toll to skip stressful traffic or dozens of turns you'd need more attention to keep up with)

• Avoid driving at night or in heavy rain or fog to keep visual processing as simple as possible

• Reduce sensory input by adjusting music, temperature, lighting, or passenger expectations

• Build in extra time so you don't have to make decisions while you already feel rushed

• Practice specific motor skills, like parking, merging, or lane changes, separately rather than expecting yourself to master "driving" as one giant skill

• Use a driving instructor who understands dyspraxia, autism, and a broad spectrum of learning needs (still waiting on someone to create a database of people who fit this criteria!)

• Gradually expand from familiar, predictable conditions into more complex ones rather than treating every driving situation as an all-or-nothing test

Therapy can be useful here, too, but the objective doesn't have to be "Make me comfortable with driving." Instead, you might bring in questions like:

• What part of driving is actually difficult for me?

• Which parts are skills I could practice, and which are environmental mismatches I could accommodate?

• Am I afraid of driving itself, or am I afraid of making a mistake and being judged?

• What level of driving would improve my life? Do I need to be able to drive everywhere, or would being comfortable with a few specific routes accomplish what I actually want?

• Do I genuinely want to drive, or am I trying to prove I'm mature and "launch" in the way I'm expected to?

If driving is something you genuinely want, you don't have to become allistic to make it happen. You may always be someone who needs a little more processing time, who is more sensitive to sensory input, who prefers familiar routes and becomes stressed navigating new roads, who needs to consciously think about things you wish could be automatic...that's okay. Just as in any conversation about unmasking your authentic self, it remains true that you don't have to drive like an allistic person drives to drive safety and effectively.