OCCUPATIONAL THERAPY DRIVING ASSESSMENTS

The New Zealand Association of Occupational therapists, 2006 gives a detailed explanation of the driving assessments administrated by occupational therapists.

Assessments are conducted by occupational therapists that specialize in driving assessments. These usually begin with an off-road assessment in the therapist's office. This part of the assessment may take up to two hours. After that, the occupational therapist will take the person for an on-road driving assessment.

The Off Road Assessment

The Occupational Therapist needs to know:

1. Is their driver’s license current?

2. Where the client normally drives?

3. Are there any residual physical problems, which may affect driving?

4. What type of car they drive?

-       Hemi paresis

-       Tone

-       Functional Movement

-       Co-ordination

-       Sensation

-       Visual field deficits: If present then a referral is made to an Optometrist for visual testing.

To assess Cognitive Function a computer-based program called the CanDAT (Canterbury Driving Assessment Tool) is typically used.

What does the CanDAT Assess?

• Vision (basic screening)

• Reaction Time

• Memory

• Speed of Information Processing

• Movement Speed

• Visual Spatial Ability

• Divided Attention

• Complex Attention

• Planning

The off road assessment will also look at the client’s knowledge of road rules and signs.

The On Road Assessment

The on road drive is undertaken in the individual’s own car or one of the assessment cars if required. The assessment is undertaken by a driving instructor and the occupational therapist. The driving instructors job is to give directions and risk manage that is intervening in the driving if required.

The drive begins in the individual’s own area and covers places where they would normally drive. Part of the assessment drive will be in less familiar areas and will involve different driving situations such as the local shopping area, suburban and back streets and the motorway or highway if appropriate.

The On Road Assessment is NOT a driving test of the type required to sit or retain a Driver’s License. The assessment focus is on a range of behaviours, which can be associated with cognitive function.

These include:

-       The ability to apply priority rules.

-       The ability to make decision in a reasonable time acting appropriately.

-       Observe and recognise signs (includes knowing you are at a give way or stop sign).

-       Reacting in time to hazards, i.e. late breaking for other vehicles, intersections, bends in the road, pedestrians, including inappropriate stopping for empty pedestrian crossings and intersections.

-       Selecting correct lanes

-       The ability to self navigate from point to point selecting an appropriate route.

The assessment also looks for pre-existing habits such as:

-       Failure to blind spot check when moving off and with lane changes.

-       Stopping too close to the car in front.

-       Following too close- two-second rule.

-       Minor speed limit infringements.

-       Failure to consistently indicate.

-       If a manual car

-       Clutch coasting

-       Neutral coasting

-       Occasional incorrect gear selection

-       Riding the clutch

When both parts of the driving assessment are finished the occupational therapist will write a report outlining their observations and providing a professional recommendation. Occupational therapists have no power to grant or revoke a Driver’s License. The occupational therapist recommendations may be that they can continue to drive however with limitations, such as time of the day, distance and automatic vehicle only.

This report will be sent back to the GP who asked for the assessment to be done. The GP will read the report then decide whether or not they consider the person medically fit to drive the classes or endorsements necessary for a renew of license. If the GP signs the medical certificate confirming that the person is fit to drive, then they can continue with applying for driver licensing application.

References

New Zealand Association of Occupational Therapists (2006). Assessing fitness to drive. Retrieved from http://www.aa.co.nz/assets/about/events/aa-def/pdf/senior-driver-nzaot-assessing-fitness-to-drive.

New Zealand Association of Occupational Therapists (2006). Driving assessments. Retrieved from http://www.nzaot.com/about-occupational-therapy/driving-assessments.php.