Driving Assessment Tools Used by Driver Rehabilitation Specialists: Survey of Use and Implications for Practice

Abstract

OBJECTIVE. This article describes the use of assessment tools by North American driver rehabilitation specialists (DRSs). PARTICIPANTS. Participants were 227 self-identified DRSs from the combined databases of two national associations. MEASURES. Information was solicited through a self-administered survey about the driving evaluation process, assessment tools, and process for making fitness-to-drive recommendations. RESULTS. More than 80% of the DRSs reported testing visual acuity, range of motion, muscle strength, and fine motor coordination. The most consistently used cognitive-perceptual tests were the Trail Making Tests, Motor-Free Visual Perception Test-Revised, and short cognitive screening tests. A client's behind-the-wheel performance was the main factor in making a fitness-to-drive recommendation. Few specialists are using computer-based tests or interactive driving simulators. CONCLUSION. Although use of the Useful Field of View(®) has increased, there continues to be no consistency in cognitive assessments or guidelines for behind-the-wheel assessment. Implications for practice are discussed.

Practices Used by Occupational Therapists and Others in Driving Assessment Centers for Determining Fitness-to-Drive: A Case-Based Approach

“…Using survey data from 277 practitioners in the United States (81% occupational therapists) who evaluated driving fitness, Dickerson (2013) confirmed several of Korner-Bitensky et al's (2006) results, including the wide range of assessment tools being used. Dickerson also examined the assessment tools they might use for clients in general, as well as those with neurological, dementia, spinal cord, developmental disability, and orthopedic diagnoses, and with new drivers.…”

Decision Tool for Clients with Medical Issues: A Framework for Identifying Driving Risk and Potential to Return to Driving

“…However, there is little consistency in guidelines for both predriving and behind-the-wheel components of the comprehensive driving evaluation. While the behind-the-wheel assessment was identified as the determining factor for making a fitness to drive recommendation in a recent study of DRS (Dickerson, 2013), few DRS use computer-based tools or driving simulators, which frequently have greater predictive validity than other individual tools that measure discrete abilities (e.g., divided attention, digit span, strength, and figure ground) (Dickerson et al, in press). Furthermore, there is on-going development of specific tools for driver screening and/or assessment, particularly in the area of driving simulation and this is likely to continue.…”

Consensus Statements for Screening and Assessment Tools

“…An evidence-based framework implies that the proper research activities, from the individual studies to the development of the tool, have taken place (Bédard et al, 2011). The tools currently used by driver rehabilitation specialists to determine fitness-to-drive vary greatly (Dickerson, 2013) and not all tools were developed with the same amount of rigor. Occupational therapists can rely on guidelines to help them select the tools appropriate to their practice (Weaver & Bédard, 2012;Weaver et al, 2014) and all determinations of fitness-to-drive must rely on the combination of full assessment results (triangulation) and using the clinical reasoning process.…”