Driver’s Rehabilitation and the Role of OT, Continued from Page 3
We also complete lessons with clients that are either new
drivers learning the rules of the road and defensive driving
skills for the first time – some using adaptive driving aids – or
previous drivers trying to get back on the road. Occasionally,
we’ll complete lessons with elderly clients if the deficits we
observe during the evaluation are something we think can
be corrected. Each lesson is typically 60 minutes long.
What do you find most difficult about working in this
setting?
The most difficult thing about working in this setting is
attempting to manage expectations of parents and clients.
Driving and independence go hand in hand. As a result,
emotions are always high in situations where we may have
to deliver bad news. Ultimately, driving is a privilege, not
a right. We do our best to give these teens the best shot at
being a safe and independent driver; however, there’s no
guarantee lessons will lead to independent driving. Having
to tell a teen and their family they should wait a few years
until they continue to mature or that driving may not be
possible can be difficult. Similarly, recommending driving
retirement to an older adult that lives in an area with subpar
public transport or limited family support can be difficult
as well. As occupational therapists, we want all our clients
to succeed as we know driving is closely correlated with
overall health, independence, and quality of life. We do our
best to connect these clients with alternative transportation
resources as well as our Marianjoy chaplains for additional
support.
Most beneficial/rewarding?
The most beneficial part about driver rehab is getting a
client on the road as an independent driver. The reward is the
same whether it’s: the 18-year-old on the autism spectrum
that practiced regularly and took a year to complete all of
his lessons; the man in his 20’s with osteogenesis imperfecta
that has suffered over 50 broken bones in his life; the 50+
year old female with a rare form of muscular dystrophy that
can now go to the store without her caregiver for the first
time in years; or, the man with post-polio that can now
drive the 45 minutes directly to work instead of spending
2+ hours taking three buses and a train. They all remind us
of why we got into this field and allow us to briefly forget
any stress or anguish we were feeling.
What are the most significant safety concerns that you
see with an individual and his/her car or driving abil-
ity?
With all the other distracted drivers out there, it’s
imperative the clients we see become defensive drivers if
they’re going to be successful. Studies suggest that simply
talking on the phone or having an in-vehicle conversation,
whether hands free or not, can impair an individual’s driving
ability the same or worse than driving while intoxicated.
Little things like using your rearview mirror regularly,
checking blindspots, and watching for red-light runners
before proceeding through a fresh green light can save a
life.
What advice would you give a new therapist who is
interested in working or completing a fieldwork in the
area of driver rehab?
We need more occupational therapists in driver rehab!
Unfortunately, it’s difficult to start a program on your own.
I highly recommend giving us a call and observing us if
interested. We’ve helped other programs get started and we
are happy to answer questions or offer advice on complex
patients. We’ve got a great education team that’s always
willing to help make the fieldwork process go smoothly. The
Association for Driver Rehabilitation Specialists (ADED)
can describe the process for becoming a certified driver rehab
specialist as well as provide contact information for driver
rehab specialists nationwide (www.aded.net). AOTA also
has great information on driving and community mobility
as well as resources that focus on elderly drivers.
We are always willing to talk any therapist through
what it takes to place a medical hold on a license with the
help of a supporting physician or to provide alternative
transportation resources. In terms of pediatric clients, aim
to get them moving through the environment and having
to process that information at a young age. For most of us,
we grew up riding our bikes in the neighborhood learning
the rules of the road and interacting with traffic on a regular
basis. For the little guy in a wheelchair or using forearm
crutches, this may be more difficult but with the right
support it’s possible.
Is there any other information about the driver rehab
program that you would like to share?
You don’t have to be a certified driver rehab specialist
to address driving needs. Driving and community mobility
is well within the scope of the generalist occupational
therapist. One of our favorite sayings in the department
is, “If they can’t drive the stove, they probably shouldn’t be
driving a car.” This is more applicable to adults that have
suffered a stroke or brain injury or even elderly drivers that
Continued on Page 5
Page