Driving is an instrumental activity of daily living that allows people to access their communities and participate in meaningful occupations. However, various medical conditions, disabilities, or aging-related declines can impair driving skills and safety. This is where occupational therapists can play a critical role through conducting driving assessments.
Occupational therapists are uniquely qualified to evaluate the physical, cognitive, visual, and perceptual components involved in driving[1]. They use both clinical and on-road assessments to make recommendations about an individual’s fitness to drive[2].
The Role of OT in Driving Assessments
Occupational therapists bring their expertise in analyzing occupations, client factors, performance skills, and patterns to determine if clients can drive safely. They evaluate[3]:
- Cognition – attention, memory, judgement, problem-solving, self-awareness
- Vision – acuity, peripheral vision, glare recovery
- Motor skills – strength, range of motion, coordination
- Reaction time and processing speed
- Ability to operate vehicle controls
- Understanding of road rules and navigation
OTs use validated off-road tests to assess these skills in a clinic setting. The OT-DORA and DriveSafe DriveAware are commonly used in Australia[4].
The on-road driving assessment involves driving on real roads with an OT and driving instructor. This evaluates real-world driving performance[5].
The Importance of OT Driving Assessments
Occupational therapy driving assessments serve many vital purposes:
- Determine if clients can resume driving after an illness or injury
- Assess novice teen drivers with disabilities
- Evaluate aging drivers to promote safety and independence
- Identify needs for rehabilitation or vehicle modifications[6]
- Provide evidence for licensing requirements or restrictions
- Offer recommendations to improve driving ability
- Reduce risk of crashes and injury to self and others
Research shows that standardised OT driving assessments have good inter-rater reliability and validity in predicting pass/fail outcomes[7]. OTs play a key role within interdisciplinary teams and driver licensing authorities to determine fitness to drive[8].
Summary
In summary, occupational therapists have specialised skills in evaluating the complexity of driving function. Their clinical reasoning and assessments are crucial to determining if individuals drive safely for as long as possible. OT enables people to participate in this meaningful occupation while reducing risk on the roads.
Citations:
[1] https://youtube.com/watch?v=fO4RdK2MHu4&t=0
[2] https://www.aota.org/practice/clinical-topics/driving-community-mobility
[3] https://youtube.com/watch?v=vfhdst6nUM4
[4] https://austroads.com.au/drivers-and-vehicles/assessing-fitness-to-drive
[5] https://abilityactionaustralia.com.au/how-ot-driving-assessment-works/
[6] https://otaus.com.au/publicassets/635829df-2503-e911-a2c2-b75c2fd918c5/Occupational%20Therapy%20and%20Driver%20Assessment%20and%20Rehabilitation%20%20Revised%20March%202022.pdf
[7] https://research.aota.org/ajot/article/67/5/564/5759/Driving-Assessment-Tools-Used-by-Driver
[8] https://www.hennepinhealthcare.org/ot-driving-assessment/
[9] https://ot.phhp.ufl.edu/2018/05/10/the-fitness-to-drive-screening-measure-case-studies/
[10] https://www.aota.org/practice/clinical-topics/driving-community-mobility/driving–community-mobility-toolkit-for-professionals
[11] https://www.myotspot.com/occupational-therapys-role-in-driver-rehabilitation/
[12] https://www.bot.ca.gov/forms_pubs/driver_spreadsheet.pdf
[13] https://austroads.com.au/__data/assets/pdf_file/0037/498691/AP-G56-22_Assessing_Fitness_Drive.pdf
[14] https://otaus.com.au/practice-support/areas-of-practice/driving
[15] https://www.nsw.gov.au/driving-boating-and-transport/driver-and-rider-licences/health-conditions-and-disability/driving-or-riding-disability/driving-assessments
[16] https://pubmed.ncbi.nlm.nih.gov/23968795/
[17] https://www.vitalityaus.com/driving-assessments
[18] https://www.simucase.com/case-studies/malbert-driver-evaluation-part-2-237
[19] https://www.thehartford.com/resources/mature-market-excellence/driving-evaluation
[20] https://caot.ca/document/5894/T11%20Occupational%20Therapy%20Process%20Enabling%20Participation%20in%20Driving.pdf
[21] https://adaptivemobility.com/occupational-therapy-education/occupational-therapy-driving-evaluation-process/
[22] https://www.ntc.gov.au/codes-and-guidelines/assessing-fitness-to-drive
[23] https://www.vicroads.vic.gov.au/licences/health-and-driving/information-for-health-professionals/occupational-therapist
[24] https://www.safemobilityfl.com/pdfs/CliniciansGuide/Chapter3CliniciansGuideOlderDrivers4thEdition.pdf
[25] https://ot.phhp.ufl.edu/2018/04/12/case-study-driving-and-parkinsons-disease/
