The Gentle Giants

The Occupational-Therapy-Driving-Assessment

The occupational-therapy-driving-assessment helps people who have health conditions or disabilities that can affect driving abilities. The purpose of the assessment is to determine how these conditions or disabilities can impact on a person’s fitness to drive, and whether this is likely to compromise driver safety and public safety. The assessment is done by an occupational therapist with specialized training in clinical driving evaluation. It consists of an office or clinic-based clinical examination and behind the wheel driving assessment.

The interview data from the study suggested that participants were generally aware of the ethical aspects of their role. They believed that client independence versus safety was the most important element of this aspect of their work and informed all other modes of reasoning. This led them to make decisions and communicate with clients about their rehabilitation programme, based on this overarching ethic of safety.

This theme is consistent with the wider literature on clinical decision making in OT (Fearing & Clark, 2003; Unsworth, 2017). The participants also recognised that their role intersected with other professional groups and therefore needed to remain within their own clinical knowledge and expertise. However, they were also able to ‘mode shift’ between the different modes of reasoning, shifting from one mode to another depending on the situation and the demands of their role.

Some OT’s will use the Katz Activity-Based Disability Scale, to assess their clients for disabilities. This is a standard measurement tool to measure the level of disability and to identify areas for further testing. It is a very useful tool and can be used to determine which occupational therapy interventions are appropriate to support the client to achieve their functional goals.

Alternatively, the Measure (COPM) is used to assist OT’s to assess client outcomes and track progress over time. This model of practice has been developed to enable a more personalized approach to health care and is now being utilized by OT’s globally.

In a clinical driving assessment, an occupational therapist will evaluate the physical and visual skills required for safe driving. They may test a client’s reaction times, how well they respond to traffic signals and how their reactions are affected by certain medications. They will then assess the client’s ability to control their vehicle with their hands, feet, and legs, as well as their range of motion and muscle strength.

The on road driving assessment is a practical component of the clinical assessment and takes place in a dual controlled car with an occupational therapist trained in driver rehabilitation. This part of the assessment allows the therapist to trial equipment and vehicle modifications, as well as specialist driving techniques. The therapist can then determine if the changes are suitable to the client, and can make recommendations for their ongoing rehabilitation.

On road assessments can be done with an adapted vehicle, or with the client driving their own car fitted with adaptive devices. This can include a re-design of the steering column or built-up pedals to allow for easier operation.