Importance: Motor vehicle accidents are the leading cause of unintentional deaths of children ages 1 and older, particularly children with health care needs. Objective: To explore family caregivers’ experiences and current practices while transporting children diagnosed with autism spectrum disorder (ASD). Design: A concurrent nested mixed-methods approach was used to gain insight into caregiver experiences. Setting: Participants completed an online Qualtrics survey. Participants: A convenience sample of 54 caregivers of children with ASD from 17 U.S. states. Results: Themes that emerged include sensory behaviors of children, education related to child passenger safety, and participation in the community. Statistically significant findings suggest a correlation between caregivers (n = 39) being less likely to participate in activities away from home if the child had attempted to elope (p = .013), displayed aggressive behaviors (p = .005), or demonstrated self-injurious behaviors (p = .001). Conclusions and Relevance: The findings suggest a correlation between caregivers limiting the distance traveled during vehicular transportation and behavioral safety concerns. If caregivers must limit travel, they may refrain from accessing the community and engaging in leisure pursuits. What This Article Adds: The findings suggest that therapists who treat children with ASD should be familiar with child passenger safety restraints, particularly for elopement.

Date Presented 04/8/21 People with developmental disabilities (DD) often face transportation challenges that impede community participation. The purpose of this study was to examine the impact of a comprehensive intervention program on the travel skills of individuals with DD to increase community mobility. Primary Author and Speaker: Elizabeth Pfeiffer Contributing Authors: Allison Smith

Date Presented 04/13/21 Automated vehicles (AVs) may provide many societal benefits, including reducing road fatalities, improving participation, and increasing equity of transportation services. However, societal benefits will not occur if individuals do not accept and adopt this technology. The aim of this study was to design a survey that would assess users' perceptions of AVs after exposure to the technology. Although further validation is required, this survey provides insight into users' perceptions of AVs. Primary Author and Speaker: Justin Mason Additional Authors and Speakers: Linda Olson

Date Presented 04/20/21 The meaning of driving for older adults was investigated using qualitative in-depth interviews. Eleven adults, currently driving and residing in suburban low-income housing, were interviewed twice. After verbatim transcription of the first interview, the second interview confirmed and expanded data. Six unique themes emerged: driving integrated into identity, driving is meaningful and important, barriers to driving, supports for driving, driving cessation, and alternative transportation options. Primary Author and Speaker: Winifred Schultz-Krohn Additional Authors and Speakers: Cynthia Evetts

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This mixed-methods online survey collected self-report data from 88 older adults on self-restricting driving behaviors. Data identified trends in various factors, including overall driving behaviors, community mobility, use of alternative transportation, and age of older adults independently living in urban and suburban California. Increased self-restricted driving behaviors were reported with the increased age of respondents. This change in driving results in diminished occupational participation. Primary Author and Speaker: Winifred Schultz-Krohn Additional Authors and Speakers: Elisa Chan, Alyson Bothman, Lisa Bullard, Nicholas Chambers, and Derek Colvin Contributing Authors: Chiao-Ju Fang

Importance: Driving is one of the most important instrumental activities of daily living. As adults age, many face challenges with maintaining independent driving, leading to risk for decreased occupational engagement and quality of life. The extent to which occupational therapy services meet the driver rehabilitation needs of older adults is unknown. Objective: To characterize driver rehabilitation service utilization among a nationally representative sample of community-dwelling older adults. Design: Exploratory, descriptive cross-sectional study using the National Health and Aging Trends Study 2016 wave. Participants: Community-dwelling adults age 65 and older who received rehabilitation services in the past year (N = 1,173). Outcomes and Measures: Sociodemographic information, comorbidities, rehabilitation use, community mobility, and participation restrictions were collected using self-report and performance-based measures. Results: Of this sample of older adults, 63.0% reported driving as their primary mode of transportation, 25.8% reported limitations in community participation related to transportation, and 9.2% reported having received rehabilitation focused on driving or other transportation goals in the past year. Findings from this study suggest a discrepancy between utilization of driver rehabilitation and self-reported need. Conclusions and Relevance: Many older adults reported limitations in community participation for transportation-related reasons, yet driver rehabilitation represented only a small proportion of services used. As experts in driver rehabilitation, occupational therapy practitioners should lead the way in advocating for increased utilization of driver rehabilitation and development of innovative, accessible transportation options to promote community mobility and participation among older adults. What This Article Adds: The results of this study illustrate an important discrepancy between self-reported need for and utilization of driver rehabilitation services. Occupational therapy practitioners can play an important role in meeting older adults’ driving and transportation needs to enable them to fully participate in their community and daily routines.

Importance: A key objective of the Americans With Disabilities Act of 1990 (ADA) is community integration; yet, nearly 30 yr later, little is known about the participation of people with disabilities who transition from institutions to the community. Objective: To understand how people with disabilities describe full participation after transitioning from an institution to the community and to identify environmental barriers and facilitators to participation during and after this transition. Design: The ADA–Participatory Action Research Consortium (ADA–PARC), a collaboration among researchers, people with disabilities, and community organizations, is implementing a multimethod, participatory action research study of participation among people with disabilities posttransition. This article presents qualitative findings from semistructured interviews collected as part of the larger ADA–PARC project. Setting: ADA–PARC community partners across the United States. Participants: One hundred fifty-three adults with disabilities. Outcomes and Measures: We used a semistructured interview guide to ask participants about their experiences during and after transition to the community. Results: We identified four themes: (1) the process of transition as ongoing rather than a single event, (2) access to everyday occupations as full participation and what fully represents “living a life,” (3) environmental barriers to participation, and (4) social identity as participation as the transformative process of moving from the disempowering isolation of the institution to being integrated into the community. Conclusions and Relevance: As people with disabilities transition into community settings, they require ongoing supports to facilitate their full, long-term participation. What This Article Adds: People with disabilities reported that transitioning from institutions to the community was itself not enough to support their full community participation; rather, they viewed transition as an ongoing process, and they needed services and supports to fully participate. Occupational therapy practitioners working in institutional and community settings can partner with local disability advocacy communities to support their clients’ sense of identity and self-confidence during and after transition to the community.

Although many students with disabilities are transported daily in school vehicles, few state guidelines address special transportation needs. This study collected information from two states on the types of vehicles and safety restraints used, and the problems encountered by public schools, community agencies, and rehabilitation centers that transport people with disabilities from birth to 21 years of age. The information collected, together with a review of research on special needs transportation, contributed toward development of state regulations for school buses used to transport special education students. Vehicular transportation safety is an important part of individualized education planning for the 18.6% of occupational therapists working in schools. Using this study’s questionnaires occupational therapists who are primary resources for selection of seating and transportation equipment may become informed advocates for implementing safer transportation on an individual and state level for clients with disabilities.