Specific abilities such as vision, flexibility, sensation, reaction time, memory and strength are necessary for safe driving. Often those closest to a driver may have the most difficulty providing guidance and determining if it is time for the person to stop driving. A driving evaluation allows an impartial professional to assist the client, family and physician in determining the best course of action.

Driver Rehabilitation is a growing specialty and is appropriate for the following groups of people:
o Those who may require adaptive equipment to compensate for physical disabilities,
o Those who have cognitive or perceptual disabilities,
o Those who have to transport a mobility device,
o Those who suffer from PTSD symptoms related to a motor vehicle collision;
o Those with advanced age and in early stages of dementia;
o And more.

A comprehensive evaluation consists of two main components, the clinical assessment and the on-road assessment. The exact tests done will vary from client to client depending on the diagnosis and deficits observed. An occupational therapist and certified driver rehabilitation specialist with 13 years of experience in the field performs the evaluations.

The clinical assessment includes:
• History – medical and driving, this includes any secondary conditions that could affect driving
• Vision – includes acuity, color perception, depth perception, peripheral vision, ocular motor control, tracking and scanning
• Hearing
• Strength – upper and lower extremity strength, active and passive range of motion, neck rotation, tone
• Coordination – fine and gross motor coordination, head and trunk control and brake reaction time
• Balance – sitting and standing (static and dynamic)
• Ambulation
• Wheelchair and mobility device use – the type of device, amount of use, ability to load and unload it from the vehicle and the dimensions of the device (this can effect vehicle selection)
• Cognitive screening – knowledge of road rules and signs, processing speed, attention (divided and sustained), memory, visual perceptual skills

The on-road assessment includes:
• Transfer skills – ability to independently enter and exit the vehicle
• Vehicle handling skills- the ability to operate the primary controls (gas, brake and steering) and the secondary controls (turn signals, ignition, gearshift, lights, wipers, etc.)
• Applied road knowledge
• Applied cognitive, language and perceptual skills- this may include the client’s ability to navigate in familiar areas when memory is an issue
• Wheelchair/mobility device loading
• Training with adaptive equipment if needed- the most appropriate equipment is identified and training is initiated. Additional training is often required for proficiency.
• Evaluations may occur in a car or modified van depending on the client’s needs. Equipment ranges from the standard factory equipment to high tech controls that allow the client to control the vehicle through servomotors.
Recommendations are made based on the client’s performance in all aspects of the evaluation. In general, the recommendations fall in one of four categories.
• Pass- Resume driving without restrictions, may include a recommendation for reassessment at a later date if condition/function deteriorates
• Complete training to improve a specific skill or learn to compensate for a deficits, for a new driver this could include training to licensure with or without adaptive equipment
• Compete training with adaptive equipment including a final fitting at the vendor’s shop to check the client off in their personal vehicle
• Fail – not appropriate for driving at this time, may include recommendation for reassessment at a later date if condition improves or may be for driving cessation in situations where improvement cannot be expected
• Recommendations are made for specific adaptive driving equipment, vehicle selection and structural modification as needed and may be given at the end of training

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To learn more about the Outpatient Rehabilitation Services at North Fulton Hospital, please call 770-751-2650.