Driving and Community Mobility

What neurological aspect should OTs analyze regarding driving?

How neurological deficits impact potential to drive.

What assessments should OTs be able to select related to driving?

Appropriate assessments and interventions to address fitness to drive.

What roles must OTs articulate regarding driving rehabilitation?

Roles of OT generalists and OT Driver Rehabilitation Specialists (DRS).

What is the OT's role in community mobility?

Address barriers and improve person–environment fit for transportation and mobility.

What OTPF category includes driving?

Driving is an Instrumental Activity of Daily Living (IADL).

Why is driving considered an occupational enabler?

It supports access to work, education, shopping, leisure, and social participation.

Is driving a right or privilege?

A privilege.

What systems must integrate for safe driving?

Motor, sensory, visual, perceptual, and executive function systems.

Why is driving high-risk?

It can lead to severe injury or death.

How many people died in traffic crashes in 2024?

40,901.

What percentage of fatal crashes involve drunk driving?

30% (12,429 deaths).

How many fatalities were speeding-related in 2024?

11,775.

What percentage of crashes are due to human error?

94%.

Which groups are the most vulnerable road users?

Teens and older drivers.

What visual-perceptual issue involves ignoring one side of space?

Unilateral neglect.

What is the impact of visual field deficits on driving?

Reduces the ability to detect hazards or other vehicles.

How does paresis affect driving?

Weakness limits ability to steer, brake, or operate pedals.

What pain condition can impair driving?

Complex Regional Pain Syndrome (CRPS).

What cognitive issues affect driving?

Impulsivity, poor inhibition, denial, poor insight, memory deficits.

What communication impairment can affect emergency responses while driving?

Aphasia.

What seizure-related issue affects driving?

Seizure activity may prohibit driving until medically cleared.

Who are primary stakeholders in driving decisions?

Clients and caregivers.

Who makes the final licensing decision?

State licensing agencies.

What is the practitioner’s role among stakeholders?

Evaluate and provide individualized evidence.

Why is communication between stakeholders important?

To ensure effective and safe recommendations.

What entity oversees medical fitness to drive in Texas?

The Medical Advisory Board within the Department of Public Safety.

What events may trigger a referral to the Medical Advisory Board?

Self-report, DPS concern, repeated drug/alcohol convictions, physician/law enforcement concern.

What is medical revocation?

Revoking a license due to medical concerns.

What is required after a TIA in Texas?

1-month driving restriction from last TIA if not on anticoagulants.

What must a stroke survivor demonstrate to drive again in Texas?

Driving ability through DPS evaluation.

Who must clear visual deficits after stroke?

An ophthalmologist.

What is required for moderate–severe movement disorders in Texas?

A driving test and yearly review for progressive disorders.

What evaluation is recommended for drivers with Multiple Sclerosis?

Comprehensive testing by a Driver Rehabilitation Specialist (DRS).

Do licensure reporting requirements vary by state?

Yes.

What does OT evaluate to understand driving ability?

How neurological impairments affect driving performance.

What does OT identify during driver screening?

Potential risks affecting fitness to drive.

What does the OT provide if return to driving isn’t possible?

Recommendations for alternative community mobility.

What AE-related tasks can OT train?

Use of adaptive equipment and transfer techniques.

Who performs driver screening?

General OT practitioner.

Who completes comprehensive driving evaluations?

Driver Rehabilitation Specialist (DRS).

Who conducts on-road driving assessments?

DRS.

Who fits adaptive driving equipment?

DRS.

What extra training does a DRS have?

Specialized education and specialty certification.

What is a clinical driving assessment?

Evaluation of motor, visual, cognitive, and perceptual factors.

Who may perform a clinical assessment?

OT generalist or DRS.

What is a driving simulator assessment?

A computer-controlled environment simulating driving tasks.

What does a driving simulator detect?

Errors such as speeding, lane positioning, yielding mistakes.

What is an on-road assessment?

Behind-the-wheel evaluation of real-world driving ability.

Who performs on-road assessments?

Driver Rehabilitation Specialist (DRS).

What assessment best predicts fitness to drive?

On-road assessment.

Should clients with major screening deficits be referred to DRS?

No, there is no justification if impairment is significant.

How can ADLs affect driving?

Needs like continence or equipment storage may affect safety.

How can IADLs impact driving?

Transporting dependents may be required.

How does fatigue affect driving risk?

Increases crash risk, especially with poor rest or sleep.

How do work and education relate to driving?

Driving may be required for attending classes or commuting.

How do leisure and social activities relate to driving?

Driving increases access to community participation.

What is the goal of driver rehabilitation?

Safe mobility and transportation.

What are the two main intervention types in driving rehab?

Remediation and compensatory strategies.

What is remediation in driving rehab?

Improving underlying impairments related to driving.

What are compensatory strategies?

Adjustments or methods to overcome deficits.

What is the role of vehicle adaptation?

To support safe driving despite impairments.

What skills are addressed in driving interventions?

Motor, cognitive, visual, and perceptual abilities.

How do simulators help OTs?

Identify impairments and driving errors safely and efficiently.

What training progression does OT use?

Train isolated skills, then integrate into complex tasks.

What is a spinner knob used for?

One-handed steering.

What are secondary control extensions?

Adaptations for wipers, headlights, and cruise control.

What is a left-foot accelerator?

Accelerator pedal used by the left foot for clients with right-leg impairment.

What does a panoramic mirror improve?

Visual awareness of rear, sides, and blind spots.

Can panoramic mirrors replace visual field deficits?

No, they do not compensate for visual field loss.

Why are wheelchair/scooter lifts used?

To load mobility devices independently.

What are some alternative transportation methods?

Public transit, taxis, rideshare, caregivers, friends.

What can OTs train for alternative mobility?

Navigation, planning, money management, communication.

What resource can OT create for clients?

A transportation resource guide.

How is community mobility defined?

Moving around the community using public or private transportation.

What factors affect community mobility access?

Availability, accessibility, affordability, acceptability, adaptability.

Why is transportation important for participation?

It enables access to essential and meaningful community activities.

What determines OT assessment for community mobility?

Type of transportation, service model, and individual needs.

What is a Community Mobility Plan (CMP)?

A conceptual framework for mobility intervention.

What skills may OT address for safe community travel?

Pedestrian skills, GPS navigation, transit use, time/money management.

What emotional/behavioral components may OT train?

Impulse control, stress management, social interaction skills.

What emergency-related skills may be included in community mobility intervention?

Handling emergencies and self-care when alone.