All ETDs from UAB

Advisory Committee Chair

Rajesh K Kana

Advisory Committee Members

Rajesh K Kana

Despina Stavrinos

Edwin W Cook III

Sarah O'Kelley

Kristina Visscher

Document Type

Dissertation

Date of Award

2021

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Individuals with autism spectrum disorder (ASD) and with attention- deficit/hyperactivity disorder (ADHD) commonly exhibit difficulty with driving. Understanding the neuropsychological factors that contribute to driving difficulty can inform designing effective training programs for these groups. The overarching goal of the current project was to examine how core sociocognitive deficits of ASD and of ADHD (specifically executive functioning (EF) and theory of mind (ToM)) relate to driving behavior among licensed drivers. To comprehensively investigate this question, we employed a multipronged approach involving three modalities of measurement: 1) driving performance in a driving simulator, 2) comprehensive neuropsychological assessment, and 3) neural response during a driving task in the MRI scanner. The three papers included in this dissertation investigate the relationships between ToM and EF, response to social and nonsocial hazards in a driving simulator, and neural activation during a hazard detection task. A total of 55 participants (ages 16-30 years) with a diagnosis of ASD, ADHD, or typical development (TD) participated in the study. Overall, the results of these three studies suggest that drivers with ASD respond more slowly to social driving hazards. However, the neural underpinnings of this finding remain unclear, as no group differences in neural activation were observed during the driving task. Within the ASD group, measures of social inference-making, attention, processing speed, and cognitive flexibility were associated with response to social hazards. In comparison, the ADHD group did not show behavioral differences in their speed or accuracy of responding to hazards compared to the TD group. However, a relationship was established between EF network brain activation and speed of responding to social hazards. Overall, these findings suggest that cognitive factors such as ToM and EF are important to social hazard detection among drivers with ASD, while engagement of the EF network is important to social hazard detection among drivers with ADHD. Overall, this study is the first study to utilize both driving simulator and imaging technology to examine the neuropsychological correlates of driving behavior among individuals with NDDs, and it lays the groundwork for future translational driving research.

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