Interventions for resuming driving after traumatic brain injury

Pamela E. Ross, Marilyn Di Stefano, Judith Charlton, Gershon Spitz, Jennie L. Ponsford

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: To describe the goals, processes, resources and outcomes of on-road training lessons provided to drivers with traumatic brain injury (TBI) who failed an initial occupational therapy (OT) driver assessment. Method: Descriptive cohort study using file audit design of 340 drivers with mild to severe TBI. Measures included; number and goals of on-road training lessons and reassessments, time from injury to independent driving, license restrictions, years licensed, physical/visual impairments and injury severity. Results: Initial OT driver assessment was passed by 72% (n = 246) cases. Of the 28% (n = 94) who failed, 93% (n = 87) resumed driving following on-road training; 42 (45%) with an open licence, 45 (48%) with restricted licence and seven (7%) failed to meet licencing standards. Individuals required, on average, 7.0 driving lessons (14 driving instructor hours), and 2.5 on-road reassessments, (9.8 OT and 3.8 driving instructor hours). Lesson goals were recommended to develop compensatory strategies for cognitive impairments (64%), improve previously learned driving skills (57%), improve confidence (53%), and address physical (26%) or visual impairment (16%). Conclusions: Investment in on-road training lessons addressing individual goals, followed by reassessment and use of restricted licenses, can achieve successful return to driving following TBI.Implications for RehabilitationDriver rehabilitation specialists should offer on-road driver training to individuals with moderate to severe TBI who fail an initial driver assessment.Goal directed driving lessons can train individuals with moderate to severe TBI to compensate for cognitive, physical, visual, and psychological barriers to driving, enabling them to pass a reassessment and return to driving.Restricted licences may enable some drivers with TBI to meet their driving needs and achieve safe return to driving.

Original languageEnglish
Pages (from-to)757-764
Number of pages8
JournalDisability and Rehabilitation
Volume40
Issue number7
DOIs
Publication statusPublished - 2018

Keywords

  • automobile driving
  • driver rehabilitation
  • Head injury
  • licence restrictions
  • occupational therapy
  • on-road training

Cite this

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title = "Interventions for resuming driving after traumatic brain injury",
abstract = "Purpose: To describe the goals, processes, resources and outcomes of on-road training lessons provided to drivers with traumatic brain injury (TBI) who failed an initial occupational therapy (OT) driver assessment. Method: Descriptive cohort study using file audit design of 340 drivers with mild to severe TBI. Measures included; number and goals of on-road training lessons and reassessments, time from injury to independent driving, license restrictions, years licensed, physical/visual impairments and injury severity. Results: Initial OT driver assessment was passed by 72{\%} (n = 246) cases. Of the 28{\%} (n = 94) who failed, 93{\%} (n = 87) resumed driving following on-road training; 42 (45{\%}) with an open licence, 45 (48{\%}) with restricted licence and seven (7{\%}) failed to meet licencing standards. Individuals required, on average, 7.0 driving lessons (14 driving instructor hours), and 2.5 on-road reassessments, (9.8 OT and 3.8 driving instructor hours). Lesson goals were recommended to develop compensatory strategies for cognitive impairments (64{\%}), improve previously learned driving skills (57{\%}), improve confidence (53{\%}), and address physical (26{\%}) or visual impairment (16{\%}). Conclusions: Investment in on-road training lessons addressing individual goals, followed by reassessment and use of restricted licenses, can achieve successful return to driving following TBI.Implications for RehabilitationDriver rehabilitation specialists should offer on-road driver training to individuals with moderate to severe TBI who fail an initial driver assessment.Goal directed driving lessons can train individuals with moderate to severe TBI to compensate for cognitive, physical, visual, and psychological barriers to driving, enabling them to pass a reassessment and return to driving.Restricted licences may enable some drivers with TBI to meet their driving needs and achieve safe return to driving.",
keywords = "automobile driving, driver rehabilitation, Head injury, licence restrictions, occupational therapy, on-road training",
author = "Ross, {Pamela E.} and {Di Stefano}, Marilyn and Judith Charlton and Gershon Spitz and Ponsford, {Jennie L.}",
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Interventions for resuming driving after traumatic brain injury. / Ross, Pamela E. ; Di Stefano, Marilyn; Charlton, Judith; Spitz, Gershon; Ponsford, Jennie L.

In: Disability and Rehabilitation, Vol. 40, No. 7, 2018, p. 757-764.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Interventions for resuming driving after traumatic brain injury

AU - Ross, Pamela E.

AU - Di Stefano, Marilyn

AU - Charlton, Judith

AU - Spitz, Gershon

AU - Ponsford, Jennie L.

PY - 2018

Y1 - 2018

N2 - Purpose: To describe the goals, processes, resources and outcomes of on-road training lessons provided to drivers with traumatic brain injury (TBI) who failed an initial occupational therapy (OT) driver assessment. Method: Descriptive cohort study using file audit design of 340 drivers with mild to severe TBI. Measures included; number and goals of on-road training lessons and reassessments, time from injury to independent driving, license restrictions, years licensed, physical/visual impairments and injury severity. Results: Initial OT driver assessment was passed by 72% (n = 246) cases. Of the 28% (n = 94) who failed, 93% (n = 87) resumed driving following on-road training; 42 (45%) with an open licence, 45 (48%) with restricted licence and seven (7%) failed to meet licencing standards. Individuals required, on average, 7.0 driving lessons (14 driving instructor hours), and 2.5 on-road reassessments, (9.8 OT and 3.8 driving instructor hours). Lesson goals were recommended to develop compensatory strategies for cognitive impairments (64%), improve previously learned driving skills (57%), improve confidence (53%), and address physical (26%) or visual impairment (16%). Conclusions: Investment in on-road training lessons addressing individual goals, followed by reassessment and use of restricted licenses, can achieve successful return to driving following TBI.Implications for RehabilitationDriver rehabilitation specialists should offer on-road driver training to individuals with moderate to severe TBI who fail an initial driver assessment.Goal directed driving lessons can train individuals with moderate to severe TBI to compensate for cognitive, physical, visual, and psychological barriers to driving, enabling them to pass a reassessment and return to driving.Restricted licences may enable some drivers with TBI to meet their driving needs and achieve safe return to driving.

AB - Purpose: To describe the goals, processes, resources and outcomes of on-road training lessons provided to drivers with traumatic brain injury (TBI) who failed an initial occupational therapy (OT) driver assessment. Method: Descriptive cohort study using file audit design of 340 drivers with mild to severe TBI. Measures included; number and goals of on-road training lessons and reassessments, time from injury to independent driving, license restrictions, years licensed, physical/visual impairments and injury severity. Results: Initial OT driver assessment was passed by 72% (n = 246) cases. Of the 28% (n = 94) who failed, 93% (n = 87) resumed driving following on-road training; 42 (45%) with an open licence, 45 (48%) with restricted licence and seven (7%) failed to meet licencing standards. Individuals required, on average, 7.0 driving lessons (14 driving instructor hours), and 2.5 on-road reassessments, (9.8 OT and 3.8 driving instructor hours). Lesson goals were recommended to develop compensatory strategies for cognitive impairments (64%), improve previously learned driving skills (57%), improve confidence (53%), and address physical (26%) or visual impairment (16%). Conclusions: Investment in on-road training lessons addressing individual goals, followed by reassessment and use of restricted licenses, can achieve successful return to driving following TBI.Implications for RehabilitationDriver rehabilitation specialists should offer on-road driver training to individuals with moderate to severe TBI who fail an initial driver assessment.Goal directed driving lessons can train individuals with moderate to severe TBI to compensate for cognitive, physical, visual, and psychological barriers to driving, enabling them to pass a reassessment and return to driving.Restricted licences may enable some drivers with TBI to meet their driving needs and achieve safe return to driving.

KW - automobile driving

KW - driver rehabilitation

KW - Head injury

KW - licence restrictions

KW - occupational therapy

KW - on-road training

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DO - 10.1080/09638288.2016.1274341

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JO - Disability and Rehabilitation

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