The Driving Advisement System: A Computer-Augmented Quasi-Simulation of the Cognitive Prerequisites for Resumption of Driving after Brain Injury

Abstract

No other activity so starkly pits the needs of the individual recovering from brain injury against the protection of society than does operating a motor vehicle. Cognitive abilities (e.g., response to complex processing demands, impulse control, ability to sustain performance, mental flexibility, and judgment), while evident only indirectly, are essential to performance, yet few are well sampled in currently used assessment procedures, which, instead, emphasize visuo-motor coordination and reaction time. In response to this need, a computerized quasi-simulation, the Driving Advisement System (DAS), was developed and is introduced here. The DAS incorporates a set of computer-based tasks for use by professionals charged with rendering advice concerning cognitive abilities necessary for driving safely. Normative data on DAS measures were obtained from a group of over 60 safe drivers free of significant neurological impairment. Preliminary validation findings are summarized. A sample DAS-generated report for a brain-injury survivor, who sought to resume driving, is used to illustrate the graphic norm-referenced presentation of an individual's performance together with self-appraisal ratings.

Neurologic Conditions: Assessing Medical Fitness to Drive

“…9 Off-road testing may be useful for screening functional ability and determining which patients should proceed to additional on-road testing. 6 These tools are also useful in patients with disabilities for evaluating their need for adaptive equipment prior to proceeding to on-road assessment. 6 The on-road test has proven safe, reliable and valid in assessing driving skills.…”

“…6 These tools are also useful in patients with disabilities for evaluating their need for adaptive equipment prior to proceeding to on-road assessment. 6 The on-road test has proven safe, reliable and valid in assessing driving skills. 7,8 Road test skills measure both the basic operational (handling) and cognitive (decision making) aspects of driving.…”