Individualized assessment of driving fitness for older individuals with health, disability, and age-related concerns.
OBJECTIVE
Driver licensing agencies are faced with an increasing population of drivers who are seeking to maintain driving privileges whilst coping with functional changes associated with health, disability, or aging-related issues. Some of these changes impact upon the motor, sensory, and cognitive capacities essential for safe motor vehicle operation. The driver assessment process, as provided by occupational therapists and other professionals trained in the techniques of driver rehabilitation, can provide objective data to identify driver strengths and limitations and options available to increase mobility independence via consideration of adaptive mobility equipment, vehicle choice, driver training, or alternative transportation if necessary. This article provides an overview of the driver rehabilitation specialist's assessment and training process, with an analysis of the key issues related to this form of assessment and the need for further research.


CONCLUSIONS
The basic driver rehabilitation process is outlined including examples of common deficits, assessment considerations, and intervention approaches. The clinical and on-road assessment procedures are described, with illustrations of the reasoning process that leads to a determination of the person's overall driving competence and rehabilitation recommendations. A review of the literature is provided that examines the currently available documentation that supports this assessment and rehabilitation process.


CONCLUSIONS
The article concludes with a review of current literature that examines the claim that detailed clinical and on-road assessment, as provided by driver rehabilitation specialists, is currently the best method for assisting drivers with complex health, disability, or aging-related issues to resume or retain driving privileges.
Wheatley
Carol J
CJ
Maryland Division of Rehabilitation Services, Workforce and Technology Center, Baltimore, Maryland, USA. cwheatley@dors.state.md.us
Di Stefano
Marilyn
M
D000063:Accidents, Traffic / Q000517:prevention & control*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001333:Automobile Driver Examination / Q000706:statistics & numerical data; D001334:Automobile Driving / Q000706:statistics & numerical data*; D003657:Decision Making; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008004:Licensure / Q000706:statistics & numerical data; D008297:Male; D010809:Physical Fitness; D012050:Rehabilitation, Vocational / Q000379:methods*; D018570:Risk Assessment; D017751:Safety Management; D012680:Sensitivity and Specificity