Autism-friendly public bus transport: A personal experience–based perspective

Importance of public transport

To feel like a valued member of society, a person takes on different roles with different responsibilities (Arnett, 2007). To fulfill the expectations associated with these roles, one must actively participate in the community (Verdonschot et al., 2009). To this end, independent transportation plays an essential role as it allows a person to participate in social activities and form social relationships that are critical to the quality of life (Backman, 2010; Bigby et al., 2007; Falkmer et al., 2014). How someone travels depends on several factors, including the cost of transportation, parking availability, and proximity to PT (Fearnley et al., 2017; Lunke et al., 2021). Indeed, access to safe and efficient PT is important for independence and participation in many cases (Falkmer et al., 2015; Kenyon et al., 2002; Scott & Horner, 2008). Accessible, safe, and efficient PT can promote quality of life by positively impacting employment, social participation, and healthcare access (Davies et al., 2010). This is especially true in urban areas where PT is one of the most commonly used modes of transportation (Lunke et al., 2021).

Autism

According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V), autism is a neurodiverse condition characterized by difficulties in social-communicative functioning, a preference for repetitive behavior, and sensory sensitivity (American Psychiatric Association, 2013). Recently, however, a growing number of researchers have moved away from this classic view of autism to find the neurodiversity movement (Leadbitter et al., 2021). Rather than focusing on impairments, this movement views variations in neurological development as natural and valuable (Bervoets & Hens, 2020; Nicolaidis et al., 2011). As a result, theories such as the theory of mind, executive functioning, and weak central coherence are increasingly viewed as outdated by some autism researchers. However, they remain relevant in clinical practice (Bervoets & Hens, 2020). The High Inflexible Precision of Prediction Errors in Autism (HIPPEA) theory was introduced as one of the alternatives to the established theories (Bervoets & Hens, 2020; Van de Cruys et al., 2014). It states that autistic individuals create mental models that contain overly narrow predictions. However, they are more sensitive to prediction errors than nonautistic individuals. Meaning that whenever a situation arises in which they are confronted with sensory input that does not correspond to their prior expectations, they are more prone to feelings of disorientation, stress, or anxiety. In this regard, autistic individuals may be more easily thrown off by what nonautistic people may consider as noise or irrelevant input, appearing inflexible in their ability to cope with uncertainties that naturally arise in the social world (Van de Cruys et al., 2014, 2017; Todorova et al., 2021). In Flanders, one in 150 children is diagnosed with autism, with males four times more likely than females (Autisme Vlaanderen, 2021). Similar to the general population, not all autistic individuals are identical. Consequently, the characteristics described above and others related to autism are not always present in all autistic individuals. Their overall level of functioning can differ depending on several factors such as social support, psychiatric comorbidity, context, and intellectual ability of the autistic person (Dworzynski et al., 2012).

Autism and public transport

A study in New Jersey showed that compared to nonautistic peers, fewer autistic persons obtained their driver’s licenses. They also obtained their driver’s license an average of 9.2 months later (Curry et al., 2018). Considering that autistic individuals often have difficulty obtaining a driver’s license, PT is important for their mobility and fulfilling responsibilities (Pfeiffer et al., 2021). It can also complement car use. For example, Dirix et al. (2021) showed that some autistic people who own a driver’s license use PT to avoid stressful traffic situations.

Despite its usefulness, the use of PT is not always that straightforward for autistic individuals (Falkmer et al., 2015; Feeley, 2010; Lubin & Feeley, 2016). Several potential issues make using PT challenging for them (Pfeiffer et al., 2021). Using PT involves physical and intellectual challenges ranging from reading and understanding timetables to managing the route and reaching an unfamiliar destination (Davies et al., 2010; Levinson et al., 2006). In addition, autistic individuals may experience anxiety and stress when using PT (Falkmer et al., 2015; Pfeiffer et al., 2020). They experience difficulties with unexpected situations and are rule-bound (Ross et al., 2018b), making it difficult to cope with delays or cancelations (Falkmer et al., 2015). Autistic individuals may also be hyperreactive, resulting in greater awareness of sensory stimuli (Chien et al., 2019; Grandin & Scariano, 2005). This hyperreactivity sometimes makes it more difficult to process stimuli when it is too crowded at a bus stop or in a vehicle (Falkmer et al., 2015). Proximity to PT also plays a role in its use in autistic individuals (Wasfi et al., 2017). A German study has shown that PT is well organized in large cities, while in rural areas, infrastructure provision can be significantly improved (Sörensen et al., 2021). Logically, the lack of PT nearby may be why an autistic person is less likely to use it even though they want to (Pfeiffer et al., 2021; Wasfi et al., 2017). The absence of autism awareness among PT drivers is also one of the challenges faced by autistic people (Falkmer et al., 2004). There are no data on the use of PT among autistic individuals in Belgium. Nevertheless, several studies have attempted to determine the extent of the use of PT by autistic individuals. Graetz (2010) surveyed caregivers of autistic individuals living in the United States and found that only 31% used PT multiple times per week. These findings are consistent with a study in the United States by Farley et al. (2009), which found that 27% of the autistic population used PT regularly. Autistic individuals also preferred to travel with PT when accompanied by other family members or people they trusted (Falkmer et al., 2001; Farley et al., 2009). Other studies found that autistic individuals often prefer to be transported by people close to them (Feeley, 2010; Lindsay, 2017; Lubin & Feeley, 2016).

This was confirmed in a recent study by Dirix et al. (2021), which examined Belgian autistic drivers’ experiences with the road environment and infrastructure elements. Participants in this study described riding as a passenger as a coping strategy to avoid having to drive themselves.

Public transport in Belgium and Flanders

Belgium is a small European country with a population of about 11.5 million inhabitants (Statbel, 2021). It is divided into three regions: Flanders, Wallonia, and Brussels-Capital (Statbel, 2020). Each region’s government subsidizes its own PT company. In addition, there is one railroad company, the SNCB (National Railway Company of Belgium), which is funded at the national level. Private PT does not exist in Belgium (FOD Mobiliteit en Vervoer, n.d.). Those wishing to use PT in Flanders must rely upon “De Lijn.” Their services consist of fixed trajectories and stops with a prior known timetable (Vlaanderen, n.d.). De Lijn wants to play an inclusive role with accessibility for all (De Lijn, n.d.-a). This includes, for example, displaying more information while driving, adapting platforms for people with disabilities, and actively engaging in accessibility policies (De Lijn, n.d.-b, n.d.-c). This study will focus only on public bus transportation (PBT), as it is the most widely used PT mode in Flanders (De Lijn, 2021).

Aims of the study

Despite increasing attention to inclusive transportation, research on PBT experiences in autistic individuals is sparse. A systematic review on PT and school buses shows that most studies focus on transportation use, cost, access, and PT safety (Lindsay, 2017). The same review also shows that most studies reflect parents’ perceptions of autistic individuals, while few studies focus on the experiences of autistic individuals themselves (Lindsay, 2017). Falkmer et al. (2001) revealed a lack of studies on the experiences and opinions of autistic individuals, while it is crucial to let this target group speak for themselves. Moreover, information about the challenges and needs in PT is insufficiently available. This could impact accessibility policies, which are essential to successfully meeting autistic individuals’ needs when using PT (Lubin & Feeley, 2016). By sharing their experiences with the outside world, autistic individuals are given the opportunity to improve the safety of their journeys and increase their opportunities to participate in daily life (Nicolaidis et al., 2011; Pellicano & Stears, 2011). In addition, a recent study by Leadbitter et al. (2021) argues that all stakeholders need to understand autistic people’s views and neurodiversity as a movement. In doing so, researchers need to move away from the traditional way of thinking about autism and pay more attention to the experiences of autistic people. This study gives autistic people the opportunity to express their issues while traveling with PBT by asking about their opinions and experiences related to traveling with PBT.

Epistemological orientation

This study employed a subtype of phenomenological research, namely, hermeneutic phenomenology (HP). Phenomenological research is described as the study of experiences (Lindseth & Norberg, 2004). The method focuses on a detailed exploration of individuals’ personal opinions and experiences (Smith, 2015). Hermeneutics is the science of interpretation that assumes that the meaning of words is never stable or definitive. The meaning and significance of human activities are examined from the participant’s perspective (Howitt, 2010). Thus, HP seeks to better understand phenomena by asking how they are experienced by a person living or going through them (van Manen, 2016). The data collected with the semistructured interviews were processed based on interpretative phenomenological analysis (IPA). Its main advantage is that it allows the researchers to constantly interact between what is said and what is meant (Lindseth & Norberg, 2004). Howard et al. (2019) recently found that HP is appropriate for capturing the experiences of autistic individuals.

Participants and recruitment

Convenience and criterion sampling allowed for a purposive sample of autistic individuals with prior PT user experience. The following inclusion criteria were set:

To recruit autistic persons, a poster was created and distributed via social media. Autisme Limburg, Vlaamse Liga Autisme, Ergotherapie Vlaanderen, Toerisme voor Autisme, ² and some smaller organizations also shared this poster with their members.

Table 1 provides a schematic overview of the included participants.

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Table 1.

Demographics.

	Gender	Age, years	AQ score		Gender	Age, years	AQ-score
1	Male	23	–	10	Male	18	32
2	Female	25	43	11	Male	33	34
3	Male	18	33	12	Male	25	37
4	Female	27	31	13	Female	19	9
5	Female	25	23	14	Male	19	/
6	Male	19	40	15	Male	24	27
7	Female	19	–	16	Male	19	29
8	Female	29	29	17	Female	30	22
9	Female	25	31

Semistructured interview format

The questions in the current study were designed based on a pre-prepared topic list (e.g. use of PT, bus stop, schedule, etc.) and were intended to create structure and predictability in the interview. The topic list was developed based on the available literature and practical experience (see Appendix 1, page 27). In addition, a photo guide was compiled to provide a clearer and better idea of the situation for each question.

Initially, two pilot interviews were conducted to ensure that all questions were clear. The first pilot interview was conducted with a nonautistic person, and the second with an autistic person. This second interview was important to assess whether the semistructured interview was appropriate for autistic individuals and to emphasize the importance of clear communication without suggestive questions.

Procedure

In preparation for the interview, autistic participants were given the topic list for the semistructured interview to create predictability. This approach was adopted after consultation with Autisme Centraal (n.d.). ² In addition, the autistic participants were asked to determine the interview location to ensure a safe and trusting atmosphere. If the participant did not select a location, the researcher chose a quiet environment without distractions.

Data were collected between November 2018 and March 2019. The interview pace was adjusted individually for each participant to allow sufficient time for understanding and answering the questions. All interviews were recorded. They were conducted and analyzed by an occupational therapist. Two research team members, a psychologist/occupational therapist, and a physical therapist reviewed these analyses. Most research team members were part of a research group on transportation with a background in behavioral studies. They conducted the analyses from an occupational therapy perspective, focusing on the person and meaningful activities (Reitz & Scaffa, 2020). In this regard, transportation is an important activity of daily living that allows a person to fully participate in society (Falkmer et al., 2014). Given that IPA is based on the participants’ lived experiences (Lindseth & Norberg, 2004), it was decided not to use existing models or frameworks in transportation. Finally, no external parties or clients were involved in this study, so there was no external involvement while conducting the study.

Ethical considerations

The Social and Societal Ethics Committee (SMEC) of Hasselt University approved this study (reference: REC/SMEC/VRAI/189/109). Before the interview, each participant signed an informed consent form that described their rights and the purpose and outline of the study procedure.

Data analysis and quality criteria

Community involvement

We consulted with patient organizations to create the interview guide (i.e. Autisme Limburg, Vlaamse Liga Autisme, Ergotherapie Vlaanderen, Toerisme voor Autisme, ² and some smaller organizations), and to collect more information about autism and PT in Flanders. Subsequently, these organizations also actively helped to recruit participants. The participants were asked to verify the findings and interpretations after their interview.

Findings

Three main themes emerged that were considered important in making bus travel more comfortable for autistic people (see Table 2 and Figure 1): creating predictability, limiting stimuli, and open and accessible communication. Almost all participants made notice of these three main themes. The interpretive phenomenological analysis revealed that most participants did not express their emotions directly but rather cited experiences instead. The themes were derived from these experiences. It was suggested that when these themes were not addressed during the journey, participants experienced stress, anxiety, and anger. While some experiences frequently recurred among participants, other experiences were less unanimously shared. Interestingly, a few participants indicated that more autism-friendly PBT would improve accessibility for all travelers, not just autistic individuals. A more detailed overview concerning which themes the participants mentioned can be consulted in Appendix 2 (page 28).

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Table 2.

Themes and subthemes derived from analysis.

Themes	Subthemes
1. Creating predictability	1.1 Providing overview throughout the journey
	1.2 Consistency
	1.3 Information accuracy
2. Limiting stimuli
3. Open and accessible communication

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Figure 1.

Schematic overview of themes and subthemes.

Theme 1: predictability

Three subthemes were identified that could contribute to the creation of predictability: (1) overview throughout the journey, (2) consistency, and (3) accuracy of information. If these criteria were not met, this often led to experiences of frustration, stress, anger, and anxiety by the participants

I find that it is less predictable when they (i.e. the buses) arrive. Sometimes there is a traffic jam, or sometimes there is no traffic jam at all, and not many people get on, so in that case, it goes faster. . . then it would be convenient if I could check where we are at any time. . . . As I said, that’s actually the main thing that stresses me out; now, with the app, it’s already better, but yeah, still, so yeah. (Female, 30 years)

Theme 2: limiting sensory stimuli

Most participants clearly described hypersensitivity to sensory stimuli. They stated that it takes a lot of energy to process all the stimuli they encounter during a bus ride, resulting in fatigue. A trip becomes even more exhausting if one has to sit on the bus for a long time or if the connections between different bus lines do not align. The majority indicated that it would be more comfortable if the connections between buses and trains were shorter. Now the journey often takes a long time, creating many sensory stimuli that could have been avoided. Furthermore, crowding is also a stressful and exhausting factor when participants use PT. The majority of participants indicated that they found it difficult to cope with crowding because it made them feel oppressed, stressed, and angry. Minor adjustments could remedy this. For example, the PT company can ensure that timetables are visible from different perspectives, so travelers do not have to face the crowd to check them. It is considered positive if a bus stop has a shelter to sit in because it protects travelers from unnecessary stimuli. However, some autistic people quickly became overstimulated when others are in the shelter.

I never sit in that shelter, because you know, people are standing there or there are people next to you who can talk to you or get too close, or in your personal space. . . in terms of touching and so on. That triggers me, and yeah. . . therefore, I am always standing outside. (Male, 18 years)

Few autistic individuals indicated that it would be more convenient if larger buses were used at peak times. An indication of bus occupancy would also be helpful and have a calming effect. In addition, some participants mentioned that they find it more comfortable to ride new vehicles than older buses because they are less noisy.

It depends again on where I ride the bus. . . Sometimes when it are old buses but sometimes also, if I’m lucky, then it are new buses. If it’s an old bus, then the sounds of the people and the bus itself bother me more. If it’s a new bus, then I notice this less quickly or something like that. (Male, 33 years)

Some participants specifically indicated that they purposely looked for a single seat or put their backpack on the seat next to them to prevent anyone from sitting next to them. If someone did sit next to them, participants often used coping strategies to avoid stimuli as much as possible (e.g. noise-canceling headphones). In this regard, most participants reported listening to music or using noise-canceling headphones or earplugs while traveling. When they fail to use these strategies, it can cause sensory overload and stress. Finally, regular use of the bus or other PT modes creates a certain routine that is helpful in better processing sensory stimuli during the trip.

I also recently had custom earplugs made, and I intend to start using those more because sometimes I do, then I’m sitting there with one finger in my ear like that . . . But that’s something I should use, not just on the bus but in multiple situations. (Female, 29 years)

Theme 3: open and accessible communication

Many respondents indicated that there is little communication with the bus driver. When participants do not know where to get off, it can cause stress because they often feel they are not allowed to talk to the driver. When a problem arises during the ride (e.g. not knowing where they are), most approach the bus driver, but communication with the driver does not always go smoothly. In addition, participants indicated they mainly asked to be warned to get off at the correct stop.

You always have to keep an eye on where you are, and on long distances, especially if you have never taken the bus, the only thing you can rely on is the bus driver. You can ask the driver, ‘will you tell me when to get off?,’ but otherwise, you know nothing. So, actually, the most idiotic thing is the advertising of De Lijn. I don’t even understand, they are so, so wrong, they say ‘stress-free’ on the bus, but if you don’t know where you are, you can’t be stress-free, you can’t be calm on the bus, alright, because you have to monitor where you are constantly . . . (Male, 24 years)

Some participants also indicated that there used to be more communication with other PT staff (e.g. cashier, customer service staff, etc.), but that this has become less frequent in recent years due to digitalization (e.g. mobile apps, the disappearance of paper tickets and membership subscriptions, etc.). Given the low level of contact, participants indicated that it is not always easy for them to approach an employee. When they have no choice but to approach someone, it can cause stress and anxiety.

And then it’s, alright, I mean, it used to be one of those paper cards, and then that’s changed, and now it’s one of those cards that makes me talk to others a lot less. Sometimes you have to, but yeah, not that often. (Male, 33 years)

Discussion of the different themes

A lack of predictability was often seen as a barrier to PBT use. Therefore, the first theme derived is the need for predictability, which has been previously associated with autism (Goris et al., 2020; Ogawa & Watanabe, 2011; Trapp et al., 2015). However, the results indicate that there may be much room for improvement in Flanders. For example, most participants relied on the bus schedule during their bus trips. Yet, buses were often late or did not show up, causing stress, anger, and frustration among the target group. The results showed that the most problematic issues for the current study’s participants were: no up-to-date timetable, unclear bus number, inconsistencies in the planned route, unclear visible timetable, inconsistencies in the displayed schedule, and lengthy transfers. This is in line with Pfeiffer et al. (2021), who found that timetable planning, navigation, anxiety, and waiting time are often barriers for autistic individuals to use PT. In terms of coping strategies, participants in both this study and Pfeiffer et al.’s (2021) study mentioned preparing the bus route in advance, asking the bus driver to warn them, and personally checking each stop on the bus route to ensure where they could get off and press the stop signal button in time. Predictability reduces tension and allows one to remain independent and flexible (Degrieck, 2009). However, an important prerequisite is that the information provided is clear and accurate, which is also in line with a previous study by Falkmer et al. (2015).

The results revealed that many participants are sensitive to sensory overload while traveling by bus, which constitutes our second theme. Moreover, the current study shows that crowded buses or bus stops may create an oppressive and tense feeling. Indeed, many autistic individuals face hyperreactivity, that is, when incoming sensory stimuli are experienced overly strongly (Chien et al., 2019; Grandin & Scariano, 2005). Participants’ coping strategies include noise-reducing headphones, avoiding crowded buses, or deliberately choosing a specific seat to avoid someone sitting next to them. This is confirmed by previous research on autistic people’s use of PT, which also found that crowded situations are experienced as oppressive and tense (Falkmer et al., 2015; Lubin & Feeley, 2016). The use of noise-reducing headphones and avoidance of crowded places are coping strategies used by autistic individuals that have also been found in studies outside the field of transportation (Ikuta et al., 2016; Kerns et al., 2016). Results showed that routine was important for most participants because it made the bus ride more pleasant. This was also found in a study by Lubin and Feeley (2016), in which autistic individuals and their caregivers expressed the need for a reliable and consistent PT service. A more recent study by Pfeiffer et al. (2021) also found that one of the main disadvantages of using PT for autistic individuals is its crowdedness. Interconnectivity (i.e. better coordination between and with other forms of PT) was also raised as an important issue, which is supported by the available literature (Falkmer et al., 2004; Falkmer & Gregersen, 2002; Pfeiffer et al., 2021).

As a third theme, open and accessible communication is considered important by participants when taking PBT. Clear catchphrases when notifying travelers make participants feel safer and less stressed. Consistent use of such catchphrases can create a routine and a sense of security, which makes riding the bus more enjoyable. These findings align with those of Lubin and Feeley (2016), who used focus groups to identify transportation issues for autistic individuals. They found that traveling an unfamiliar route was not considered a significant barrier by most participants as long as they could adequately prepare and the information they received was accurate. Trip-related information also had to be accurate and up-to-date. Furthermore, it is not only autistic people who benefit from open and accessible communication. Other travelers will also have a more pleasant travel experience. Some participants in the present study also indicated this. These findings align with a study by Galetzka et al. (2008) on transparent communication at the Dutch railroads. The study showed that transparency and clarity in communication are considered very important, but this was often not sufficiently present, leading to frustration and confusion among passengers and staff.

Limitations and suggestions for future research

First, semistructured interviews can steer the conversation in a certain direction. Topics and accompanying questions were predetermined to ensure that all participants were asked about the same topics, allowing for an in-depth understanding of a topic and comparisons (Kallio et al., 2016). However, this may have resulted in participants sticking to the given topics during the interview instead of spontaneously naming new topics. Nevertheless, the interviewer always addressed the participants’ responses and allowed them to discuss additional topics, and participants were provided with the topic list prior to the interviews. Second, autistic individuals may have difficulties in answering open-ended questions (Frith & Happé, 1994). Our brain constantly predicts what might happen based on the environment, previously acquired knowledge, etc. If that prediction turns out not to be correct, a person learns from it and adjusts their response (Friston et al., 2014). However, autistic individuals can experience difficulties with violations of their expectations (Van de Cruys et al., 2014). Therefore, it may be more difficult for autistic individuals to respond to open-ended questions, as they leave the expectation for an answer implicit, which is at odds with their preference for explicit expectations, minimizing the risk of prediction errors. Although it is likely that some interviewees also experienced problems with the open-ended questions, attempts were made to avoid these problems, for example, by using accompanying photographs. These photographs were intended to help autistic individuals visualize specific situations. Using photographs to clarify the question can add value by supporting the thinking pattern and making abstract concepts more concrete (Rao & Gagie, 2006). In a recent study by Dirix et al. (2021), accompanying photographs were also used to clarify questions when interviewing autistic individuals, which participants found inspiring. In addition to the photographs, pilot interviews were conducted to ensure that the questions were clear. Third, the current study identified reasons for using PBT in autistic individuals with recent PBT experience. However, reasons for not using PBT were not explored in this sample. The literature on transportation shows that many autistic individuals prefer to rely on people from their environment (Farley et al., 2009; Lindsay, 2017; Lubin & Feeley, 2016). Therefore, a study including non-PBT users would be useful. Fourth, using purposive and convenience sampling may have resulted in a sample that is not fully representative of the general autistic population. However, this is not the primary aim of the IPA method. Consequently, this study identified participants’ experiences on which follow-up research can be based. In addition, other autistic individuals may benefit from the coping strategies or recommendations of the participants in the current study. Fifth, it was more difficult for participants to name tangible emotions during the interviews. They often translated these into situations without specifically naming their underlying feelings. As a result, we had to slightly deviate from the analysis method in which we identified the experiences that may have impacted the most common underlying emotions (anxiety, stress, and anger). Difficulties in identifying and describing emotions (i.e. alexithymia) are closely linked to autism and may explain why participants did so to a lesser extent during the interview (Daou, 2014; Ross et al., 2018a). Sixth, we did not check for comorbidity. Previous research shows high comorbidity between autism and other conditions such as Attention Deficit Hyperactivity Disorder (ADHD), Obsessive Compulsive Disorder (OCD) and social anxiety (Bögels & Perrin, 2011). These comorbidities may have influenced the results of this study. For example, participants with anxiety might perceive taking PBT as more negative. It is advisable to ask participants about comorbidities in future studies. Seventh, young adults aged 18–40 years old participated in the current study. This is consistent with most studies regarding PT and autism, which commonly include younger adults up to 30–35 years of age (Haas et al., 2020; Pfeiffer et al., 2021). However, it is unclear to what extent the results can be generalized to other age groups, as age may play a role in individual experiences (Daher, 2009). Follow-up studies with different age groups are recommended. Eighth, this study was conducted in a Flemish context. Therefore, the applicability of the results to persons and/or groups in other countries and regions is unclear as there may be cultural and social differences (Sasidharan et al., 2005; Linnenbrink-Garcia et al., 2012). Again, future research is recommended. Importantly, the interview guide and accompanying pictures must match the setting and culture. Finally, due to the rural context of the study, the current study focused only on PBT and not on other PT modes. However, it is very likely that some of the current study’s findings may also apply to other modes of PT. For example: removing large advertisement boards that block visibility, real-time information, etc. This is also supported by previous research by Lubin and Deka (2012), Haas et al. (2020), and Pfeiffer et al. (2021), who studied the role of PT for autistic people and their experiences with PT. In their studies, they found similarities between the different modes of transportation. In addition, the current study did not focus on practices that are already common in other forms of public transportation, which may also alleviate some of the issues with PBT that the current study’s participants highlighted. However, certain things may be extended to PBT, such as providing real-time information on vehicle information boards (Pfeiffer et al., 2021). Further research is recommended to ensure that the current study’s results apply to other PT modes and to examine practices of other modes that can be extended to PBT.