Printer friendlyDriving Evaluations
What is included in a driving evaluation?
What if physical problems exist?
What if a person is fearful of driving?
What if cognition for driving is affected?
What if the person is a senior driver?
Are driving tests mandatory after you turn 80?
How do I know that this is a valid evaluation?
Driving Evaluations
Driving is a skill of daily living that most people value. When injury, disease, illness or aging potentially affect your ability to drive, a comprehensive driving evaluation should be taken. These are different than screening tests to renew your licence. This type of evaluation helps to determine if your medical condition or age may be affecting your driving ability.
What is included in a driving evaluation?
There are two parts of the evaluation. One is done in a driving clinic and the second is done on the road.
The occupational therapist begins the evaluation by determining the effects that the client’s medical condition, medications and functional limitations may have on the driving task.
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Visual screening is completed. This is a check to see that your eyes meet the minimum standards for driving in your province. As well, how you move your eyes, your ability to judge distance and how well you see out to the side when you keep your eyes straight ahead.
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The occupational therapist will also look at your arms and legs to see that you have enough movement and strength to control all of the features of the car. If you have some difficulties, adaptive equipment will be recommended to help you.
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Perceptual and cognitive abilities are evaluated by measuring your reaction time, seeing how you can pay attention to more than one thing at a time and completing some thinking skill tests to check your memory, problem solving abilities and how well your brain can interpret what you see.
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The occupational therapist also takes a driving history, notes the type of vehicle driven, and discusses potential adaptive driving equipment.
In this part all aspects of the driving task are assessed and include:
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Physical ability and endurance to handle the vehicle.
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Cognitive/behavioural skills. For example, ability to be aware of potential hazards, being aware of the full traffic environment.
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Visual/perceptual skills. For example, how effectively you use your eyes, look around when you are driving and be able to take in the information you see correctly, make sense of it and act appropriately.
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All responses to the traffic environments. For example, your ability to handle unusual situations, how you handle pedestrians, ability to cope with busy traffic areas or even the expressway.
Based on all the information gathered during both parts of the evaluation, the occupational therapist, usually in collaboration with a driver instructor, interprets results and makes recommendations based on performance strengths and limitations as well as on driving potential.
What if physical problems exist?
Different vehicles offer different space behind the wheel, and very simple positioning or a cushion may provide an easy solution to a presenting problem. However, some clients may need to drive with adaptive driving equipment, and training would thus be recommended prior to installation of driving aids in their own car. In some instances, such as people who use a wheelchair or scooter, a modified van will be necessary. Occupational therapists are aware of state-of-the-art and safety-tested equipment. They know the width of lifts to accommodate specific wheelchair sizes, the benefits and limitations of full size vans versus minivans, lifts versus ramps, about power seat-bases, different types of hand controls, wheelchair securement, etc.
What if a person is fearful of driving?
There are some clients who have phobias and anxiety about driving. Occupational therapists have training in emotional and mental health issues, however most who specialize in this field also have extra training for working with persons with driving anxiety. Occupational therapists assist clients using a systematic desensitization and graded treatment plan to return the person to driving comfortably and safely. Sometimes, the occupational therapist works collaboratively with a psychologist.
What if cognition for driving is affected?
Often after brain injury or stroke, reflexes and mental functions (attention, concentration, decision-making, speed of information processing, etc.) are affected. This may result in the person being unsafe to drive either temporarily, or in some cases, permanently. Potential to benefit from driver training would be determined at the time of assessment, or re-assessment may be recommended at a later date.
What if the person is a senior driver?
Age alone does not stop a person from driving. When family members, family doctors or even the person himself/herself are unsure of driving ability, they are often referred for an evaluation. The occupational therapist is knowledgeable about age-related changes that may affect driving ability. Through a comprehensive assessment, fitness to drive is determined. Adaptive equipment, altered driving techniques and self-restriction are often very helpful to keep seniors driving longer and safely.
Are driving tests mandatory after you turn 80?
Driving licence assessments are more of a screening tool and not the same as what is described here. To renew your license, some provinces do require that people at age 75, 80, and so on, have a medical examination to confirm they are physically able to drive safely. These assessments are not the same as a comprehensive evaluation described above which can pin point difficulties and hopefully offer solutions other than taking your licence away.
How do I know that this is a valid evaluation?
Driving evaluations differ across the country and steps are being taken to standardize the testing. For example, the Canadian Driving Research Initiative for Vehicular Safety in the Elderly (CanDRIVE), led by Dr. Malcolm Hing and Dr. Shawn Marshall, is an interdisciplinary health related research program dedicated to improving the safety of older drivers.
In the meantime, if you are referred to a driver evaluation program the evaluation should be as detailed as possible to ensure that all the information is available to make recommendations regarding retraining, equipment purchases and adaptations. In Ontario, the Ministry of Transportation requires that all evaluations be completed by a registered occupational therapist and all driving programs must be approved by the ministry. For those outside of Ontario, please check with your provincial Ministry of Transportation.
You may also look at the Association for Driver Rehabilitation Specialists (ADED) for more detailed information. The ADED web site details codes of ethics, contents of evaluations and much more. There are also several occupational therapists who also hold the ADED qualifications who can be found on this web site.
Many thanks to registered occupational therapists Wendy Nieuwland, Lynn Hunt and Margaret Young who prepared this information for us.