“Gary”, an autistic young man in his late twenties, messaged me on Facebook and asked to meet at a McDonald’s near his house a few years ago. He wasn’t able to come to my office—transportation was out of reach, even the $5 fare for a county ride service. My heart ached when he shuffled into the restaurant, peering around like he couldn’t see well. He seemed tired and worn down, and it was clear that life had been asking a lot of him for a very long time.
We chatted for a couple of hours. As we talked, I began to see just how many barriers Gary was navigating—health concerns, limited access to care, and the daily strain of trying to manage it all without consistent support. I could tell that Gary needed appointments with doctors, a dentist and a developmental optometrist (among many things!). He spoke candidly about not feeling well and about his frustration with how few resources exist for autistic adults.
Listening to Gary, I began to picture a line of dominoes.
The first wasn’t visible from the outside. It wasn’t missed appointments or unstable housing. It was something quieter—his experience of brain fog. The kind of mental cloudiness that can come from underlying physical stressors in the body, including inflammation, digestive challenges, and other health conditions that are common for many on the autism spectrum.
When that first domino wobbles, the next one is already at risk.
When thinking feels unclear, organizing time becomes harder. When time slips away, appointments are missed. When health needs go unmet, energy drops even further. And with each falling piece, independence, mobility, and opportunities—like learning to drive or maintaining employment—become more difficult to hold in place.
From the outside, it can look like a series of unrelated struggles. But from where Gary stood, it was one continuous chain.
His disability check was his only income, and it left little room to address even basic needs. Gary mentioned that he had lost access to his Medicare benefits due to a complicated situation in another state—something that felt overwhelming and unresolved. At times, it was difficult to understand the full picture. (If you’re wondering why I wasn’t able to help him more, Gary was often secretive, evasive, and difficult to work with, which I came to understand as a form of self-protection shaped by past experiences.) But he did seem overwhelmed with trying to get things back on track.
He agreed to let me help where I could, and we made a simple plan. Through my nonprofit’s Autism Angel Fund, I arranged for a few foundational supports to get him started. It wasn’t everything he needed—not even close—but it was something.
After Gary left the restaurant, I watched him carefully cross the busy road, peering around cautiously and shuffling with awkward steps. I knew he desperately needed a developmental optometry evaluation and new glasses just for safety in navigating his community. I was ready to cover the cost through our Autism Angel Fund, but without reliable transportation or support navigating the trip—an hour away in another county—it simply wasn’t feasible.
I was sad and frustrated that I could never seem to help him much. Gary shared that he often didn’t feel well enough—or think clearly enough—to take the many steps needed to improve his situation on his own without the support of a loving family. His voice was wistful when he said he wished I could be his mom. Moments like that stayed with me. I wanted to do more, but the gaps were often too wide for any one person or program to bridge.
Gary moved frequently, often staying in situations that didn’t feel safe, where safeguards were missing and he felt vulnerable. At one point, he explained why he was reluctant to seek help with housing, all while adamantly refusing to let me interfere in his behalf: “This is unstable housing. I’m here illegally and at the mercy of not being found out. I’m not on the family’s lease and if Hud finds out I’m here, I’m on the street again.”
Basically, the families renting him the room were doing so in violation of their HUD lease so they could have some extra cash. And they blackmailed him to remain silent about any abuses they doled out, so he was very insecure about losing the roof over his head. I was so frustrated!
I called around and found some affordable housing for him, yet he refused it because it didn’t allow pets. I think part of the reason he always accepted such poor housing choices was because above all else, he wanted to keep his beloved emotional support dog with him, and I get that. This dog was the one bright spot of love in his life. He eventually moved again to a different state for yet another “housing opportunity”, but we stayed in touch on Facebook.
When I was preparing to write this book, I messaged him: Hi Gary, I hope this finds you well. I’m writing a book about overcoming barriers to driving for autistic teens and adults. Would you mind sharing with me what barriers to driving that you have (vision, money, no car, anxiety, etc.), and your thoughts on how not driving has impacted your life? Perhaps how it has affected employment opportunities, social outings, or just getting errands done? I would appreciate any input you would care to share. Thank you, Janet
Gary responded immediately, “You basically wrote everything I’m thinking”.
Gary had moved several times again since we last spoke, yet his living situation was no better. His story is sad and filled with tales of being taken advantage of by the families who agree to rent him a room and board.
I closed my eyes in helplessness and frustration. He couldn’t catch a break.
He told me he could never organize his foggy thoughts enough to actually do something about his situation, and sadly, it hasn’t improved to this day.
There are often many layers to experiences like Gary’s. But one piece that comes up again and again with my teenaged and adult patients is the brain fog they have to power through each day. I think of all the medical conditions that create brain fog in the autistic brain, and about how hard it can be to move forward when your thoughts feel cloudy and disorganized. Well, you say, what do mean by that? What medical conditions?
Let’s look at Figure 2.1 below to see some of the things you might be trying to power through all day, every day. (and this isn’t even a complete list)
This is why I’m hammering home the message in Chapter 2 that the invisible health challenges of the autism spectrum MUST be addressed before proceeding further with preparing to drive.
Join me next time to hear “Jason’s” story, a reader who contacted me with heart-warming results that he gained after just a few weeks of trying my basic support protocols. For him, the dominoes lined up and the improvements just kept coming. It even helped his driving!
You CAN make a difference with your health and experience wonderful improvements in how you feel and function each day.