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OVERVIEW OF SERVICES
Driver Rehabilitation Services, P.A. is a North Carolina Agency Licensed Driving School and a member of the Association of Driver Rehabilitation Specialists. Driver Rehabilitation Services, P.A. offers a complete clinical assessment of a person’s visual, perceptual, cognitive, physical and behavioral abilities. This assessment is conducted by a registered and licensed occupational therapist who is also a certified driver rehabilitation specialist and certified North Carolina driver instructor. A behind the wheel assessment to determine a person’s potential to return to driving following an illness or injury is completed with the occupational therapist. Those persons with a congenital or acquired disability wanting to learn to drive for the first time may also be assessed and trained.
All participants must sign a contract for services, release of information and waiver of agreement that releases Driver Rehabilitation Services, P.A., their physician(s), and therapist(s) from being held liable for the disclosure of information released to the Division of Motor Vehicles and other necessary parties regarding the ability of the participant to drive a motor vehicle.
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TYPES OF EVALUATION / TRAINING
- Clinical evaluation for component skills needed to drive
- Wheelchair and/or seating and positioning evaluation as it relates to driving
- Behind the wheel evaluation including car evaluation or low tech van evaluation
- Behind the wheel training.
EQUIPMENT PRESRIPTION
Prescriptions for vehicle modifications expressing the client's preferred brands and detailing justification will be made. Final prescriptions are generally not written until the Department of Motor Vehicles behind the wheel test has been successfully passed and the client has secured a valid license with the appropriate restrictions. Rare exceptions are made when the vehicle modification is extremely unique for that individual and not readily achievable in the driving school’s vehicle.
SCOPES OF SERVICE
We provide clinical assessment for component skills related to driving and the need for special equipment and driver evaluation and training services to persons with physical, visual, cognitive or perceptual conditions that may affect their driving capacity. All participants will be asked to fill out a history information sheet relating to their medical and driving history. This will be reviewed with the person to determine the type of vehicle the patient plans to drive, the amount they will drive, the medications they are taking, and their driving record. The person will also be interviewed regarding their ability to perform their activities of daily living. The clinical assessment will consist of the following tests:
1. Physical status of functional movement, strength, tone, coordination, sensation and use of equipment or prosthetics/orthotics. A reaction time test, which simulates the ability to move from gas pedal to brake, will be administered.
2. Visual tests related to eye movements, efficient use of vision in a dynamic driving situation, general eye sight and the ability to visually attend to more than one stimulus will be assessed.
3. Perceptual tests for recognition of signs, right and left ability, and accurate perception of the driving environment are completed.
4. Cognitive skills related to attention, concentration, reasoning, judgment, impulsivity control, planning traffic situation interpretation, and driver’s knowledge.
5. Language abilities related to sign recognition, number recognition, and ability to follow directions
BEHIND THE WHEEL EVALUATION:
The behind-the-wheel assessment consists of a person’s ability to transfer in and out of the vehicle, manipulate the controls (with or without adaptive equipment), and operate the vehicle safely and in accordance with traffic laws. When appropriate, the Miller Road Test is used to objectively rate the driver on his/her performance. The on the road portion of the evaluation consists of initially driving in light traffic areas and then progressing to more dense traffic including city and highway driving if appropriate.
Specific skills evaluated include smooth operation of the controls especially related to steering, accelerating and braking; ability to change lanes, merging into traffic, entering and exiting the highway, consistent ability to check for the blind spots including use of mirrors and head turning, proper signaling ability, ability to follow traffic lights and signs. Additionally each person is evaluated on their ability to make correct judgments throughout the evaluation in negotiating intersections and construction areas. These are often the areas which those unable to make safe judgment decisions have greatest difficulty.
Fatigue and concentration are evaluated to determine if the person is capable of driving safely during the 45 minute to 1-hour on the road testing. If adaptive equipment is used, it is determined if the person needs further training in the use of the equipment and/or if they are safe to use it.
RESULTS
Following the clinical and on-the-road testing the results are discussed at length with the patient and appropriate family member(s) / Caregiver(s). Recommendations are made at this time. Recommendations will be made based on the findings but final approval to drive will be made by the Department of Motor Vehicles and the Physician. Further training may be indicated to help a person return to driving. This may include further training with adaptive equipment or more training for on the road safety related to other deficits, including cognitive and visual impairments. If vehicle modifications or equipment is required the client will be provided with contact information for appropriate vendors and the therapist will continue to be involved in assuring the participant’s needs are fully and appropriately met. Other recommendations may include: the need to see an optometrist or ophthalmologist if there are visual problems, no night driving, speed or traffic environment restrictions, or the need to cease driving.
GOAL OF SERVICES
Driver rehabilitation is typically the final stage of recovery that affects a client's ability to return to work, participate in educational activities and live as independently as possible. Therefore, the primary goal of these services is to determine the client's capacity to operate a vehicle independently, in their environment. Further behind the wheel training is provided as needed.
WHO QUALIFIES?
Services are provided to individuals with, but not limited to:
- Traumatic brain injury (TBI)
- Cerebral Vascular Accident (CVA)
- Spinal cord injuries
- Amputation
- Psychiatric conditions
- Diabetes
- Normal effects of aging
- Neuro muscular conditions
- Orthopedic conditions
- Congenital Disabilities
OUTCOMES
Results will be sent to the North Carolina Department of Motor Vehicles only if the person should not drive or has impairments which warrant further training or restrictions. This has been discussed with the Department of Motor Vehicles Medical Review Board and this is their request. All results are sent to the referral source and other valid team members. A report is always sent to the client.
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