Transportation
Driving Evaluations
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A comprehensive driving evaluation by a certified driver rehabilitation specialist (CDRS), unlike the standard state driver’s exam, is not a pass/fail test. The results generally fall into one of three categories: clearance to resume unrestricted driving, a plan for driver training, or the recommendation that driving is not appropriate for the client at this time. Training sessions may be used to improve driving technique or to train the client to use adaptive driving equipment.
A clinical evaluation is done first to identify problem areas. It includes assessments of physical skills such as strength, range of motion, spasticity and coordination. The driving specialist will also test vision, attention, reaction time and other cognitive and perceptual skills. A driving simulator or a brake reaction timer may be used. Medical records from the OT, PT, speech pathologist, neuro-ophthamologist and neuropsychologist may also be reviewed.
The second portion of the evaluation occurs on the road in a vehicle provided by the facility. Should any adaptive equipment be required because of a client’s physical deficits such as paralysis or impaired coordination, the evaluator will instruct the client in its use. It is not recommended that a client practice driving prior to the evaluation.
The on-road portion of the evaluation is primarily a functional assessment. The evaluator assesses the client’s vehicle operation skills such as the ability to maintain lane position, speed control, following distance etc. Cognitive issues are also assessed as they relate to safety. The evaluation may examine judgment and decision making in traffic situations, identification and reaction to hazardous situations, and how easily the person is distracted by conversation or by the driving environment.
Fear can affect the individual’s performance during the assessment. He or she may be nervous about the test itself or may be afraid to be behind the wheel again. Motor vehicle accidents are a primary cause of brain injury so this is not surprising. In some cases, supervised practice will be recommended to help the individual regain confidence in their driving abilities.
Funding for a driving evaluation may come from private medical insurance, worker’s comp insurance, or from the state vocational rehabilitation agency. Medical insurance may cover the evaluation if it is done by an occupational therapist. Training and adaptive equipment is not often covered by private medical insurance but may be covered by worker’s comp or vocational rehabilitation.
Beth Anderson is an occupational therapist, a certified driver rehabilitation specialist and a state licensed driving instructor. She has worked at Shepherd Center in Atlanta, Georgia for 15 years. Beth has presented on various driving topics at local and national conferences and is the author of a chapter on driving assessments in the textbook Spinal Cord Injury Medicine.