Transportation
Occupational Therapy for Drivers with Disabilities
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What is Occupational Therapy (OT)?
We are health professionals that look at people, their roles, daily activities, wellness and illness, and access and barriers to services and resources for independence and skills of living. One of these skills is community mobility and driving.
What settings does Occupational Therapy work in?
Hospital based: inpatient, outpatient, home care
Skilled nursing facilities (extended rehabilitation with medical management)
Senior living and community outreach
What education is required?
Therapist level requires bachelor, master, or doctorate
(post baccalaureate after 2007)
Assistant level 2 year associate degree
Fieldwork /certification exam/state licensing required
Driving rehab as a specialty requires regular skill maintenance
Why does OT have a key role in evaluation, treatment and recommendations for Older Drivers?
Medical knowledge, evidence based practice, close working relationship with physicians and other health professionals. OT theory focuses on community reintegration, safety, mobility and compensation for impairments. By individually selecting proper assessment methods, the occupational therapist can set guidelines for treatment, modify as needed, and determine potential for recovery of skills. When looking at driving, a background in cognition and vision are particularly relevant, along with activity analysis and use of compensatory strategies and adaptive equipment. An occupational therapist certified as a Driver Rehab Specialist (CDRS) by the Association of Driver Rehab Specialists (ADED) has advanced training and specialized skills in the area of driving. Occupational therapy views driving and community mobility as a key to engagement in life roles and community.
What is the role of driving schools, driving educators/ instructors, equipment vendors, physical therapists(PT) and kinesiologists involved with the Older Driver?
Non-medical professionals can educate as to safe driving practices and habits. They generally do not have the extensive training in medical conditions and the changes with aging that OT receives in school and as a clinician. PT and kinesiologists typically have medical training, but less focus in cognition, vision and community access / mobility.
Occupational therapy goes beyond the evaluation, and looks at the whole person, and needs for mobility, be it driving or an alternate means of transportation.
Why is the physician reporting law difficult to enforce?
Lapse of consciousness is highlighted in the Health and Safety code, but there are many other conditions which could potentially affect driving safety. Many physicians either do not understand the law, are afraid of affecting rapport with the patient, or breaching HIPAA privacy laws. The result is no one reports. Often it is a family member or caregiver that voice concerns. Ironically, the law and the DMV do not specifically have a standard for reaction time, and visual abilities such as adequate depth perception or scanning(vision in motion) to obtain a license.
Older Driver Issues to Consider
Currently there are a limited number of qualified Occupational Therapists with specialized training in driver assessment; however all occupational therapists have the skill set to address the changes associated with physical disabilities and changes associated with aging.
- Reimbursement for Occupational Therapy Driver assessment and treatment is often not paid by medical insurance.
- Lack of public awareness of Older Driver services in the community.
- Scarcity of qualified Driver Rehab programs/ lack of effective mass transit to locations.
- Lack of viable transport options encourages the unsafe Older Driver to drive without a license or drive despite lack of skill.
- The Older Driver population will grow dramatically in the next decade.
- Alzheimer’s dementia will also be on the rise, along with longer life expectancy, challenging the DMV license renewal process.
Farrell Sheffield, OTR/L, HTC, CDRS is an Occupational Therapist, certified as a Driving Rehab Specialist, with advanced practice in hand therapy. A graduate from University of Southern California with a degree in Occupational Therapy, she has been a clinician for more than 25 years in hospital, outpatient, and home health settings, working with children and adults with physical disabilities. She has a passion for Visual Rehabilitation and is a member of the Neuro–Optometric Rehabilitation Association. Mrs. Sheffield is the founder and coordinator of a Driving Rehabilitation hospital based program in San Diego County, and received driving instructor training in 2002 from the California Driving School Inc. She was appointed 2004 Association of Occupational Therapy Driver/ Driving Network Coordinator.