title: On the road again after traumatic brain injury: driver safety and behaviour following on-road assessment and rehabilitation.
abstract: OBJECTIVE
  To examine pre- and post-injury self-reported driver behaviour and safety in individuals with traumatic brain injury (TBI) who returned to driving after occupational therapy driver assessment and on-road rehabilitation.
  
  
  METHODS
  A self-report questionnaire, administered at an average of 4.5 years after completing an on-road driver assessment, documenting pre- and post-injury crash rates, near-crashes, frequency of driving, distances driven, driving conditions avoided and navigation skills, was completed by 106 participants, who had either passed the initial driver assessment (pass group n = 74), or required driver rehabilitation, prior to subsequent assessments (rehabilitation group n = 32).
  
  
  RESULTS
  No significant difference was found between pre- and post-injury crash rates. Compared to pre-injury, 36.8% of drivers reported limiting driving time, 40.6% drove more slowly, 41.5% reported greater difficulty with navigating and 20.0% reported more near-crashes. The rehabilitation group (with greater injury severity) was significantly more likely to drive less frequently, shorter distances, avoid: driving with passengers, busy traffic, night and freeway driving than the pass group.
  
  
  CONCLUSIONS
  Many drivers with moderate/severe TBI who completed a driver assessment and rehabilitation program at least 3 months post-injury, reported modifying their driving behaviour, and did not report more crashes compared to pre-injury. On-road driver training and training in navigation may be important interventions in driver rehabilitation programs.
  
  
  CONCLUSIONS
  Driver assessment and on-road retraining are important aspects of rehabilitation following traumatic brain injury. Many drivers with moderate/severe TBI, reported modifying their driving behaviour to compensate for ongoing impairment and continued to drive safely in the longer term. Navigational difficulties were commonly experienced following TBI, suggesting that training in navigation may be an important aspect of driver rehabilitation.
authors: a Occupational Therapy Department , Epworth HealthCare , Melbourne , Australia .
authors: Pamela
authors: P
authors: Ross
authors: b School of Psychological Sciences, Monash University , Melbourne , Australia .|c Monash-Epworth Rehabilitation Research Centre , Melbourne , Australia .
authors: Jennie L
authors: JL
authors: Ponsford
authors: d School of Occupational Therapy, La Trobe University , Melbourne , Australia , and.
authors: Marilyn
authors: M
authors: Di Stefano
authors: e Monash University Accident Research Centre , Melbourne , Australia.
authors: Judith
authors: J
authors: Charlton
authors: b School of Psychological Sciences, Monash University , Melbourne , Australia .|c Monash-Epworth Rehabilitation Research Centre , Melbourne , Australia .
authors: Gershon
authors: G
authors: Spitz
mesh_terms: D000328:Adult; D000368:Aged; D001333:Automobile Driver Examination / Q000523:psychology / Q000706:statistics & numerical data; D001334:Automobile Driving / Q000523:psychology* / Q000706:statistics & numerical data; D000070642:Brain Injuries, Traumatic / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis
keywords: Automobile driving; crash risk; head injury; occupational therapy