Occupational Therapy Driving Assessments can be divided into 2 sections; the off-road section and the on-road section. All Driving Assessments, regardless of the person’s medical condition, follow this format. The aim of this article is to focus on what is specifically involved in the off-road component of the assessment.
The off-road assessment consists of various screens and assessments that aim to detect any deficits with an individual’s vision, cognition and physical capacity. All Driver Trained Occupational Therapist follow the same therapeutic process to ensure consistency and validity with each assessment. Other additional information is also obtained e.g. need for driving, medication history and medical history.
One of the three screening areas is vision. The Occupational Therapist will complete a functional screening test. The purpose of this screen is to ensure that the person’s visual acuity meets RMS standards, and determine if the person’s vision has the potential to impact on their driving. It is to be noted that no formal diagnosis will be made from this screen. The aim is to detect any deficits. If deficits are detected, the Occupational Therapist will refer the client to an Optometrist, Ophthalmologist or appropriate specialist. The visual assessment consists of the following
Questions about vison history
Visual acuity test (using a Snellen vision chart)
Visual field test (testing peripheral vision)
Cover test (to detect any present of strabismus)
Physical and functional test
The physical function test assesses an individual’s entire body and physical capacity. Again, the assessment remains the same regardless of the person’s medical condition. The aim of the assessment is to determine if the person has any deficits that may impact on their ability to physically control the vehicle. The entire assessment is completed with the person seated. The assessment involves the following areas:
Active range of motion
Passive range of motion
The third and final screen assesses a person’s cognitive functioning. Various or multiple assessments can be used for this section. The most commonly used and recommended test is the DriveSafe DriveAware (DSDA) assessment. This assessment is considered to be the gold standard of assessing a person’s cognitive fitness to drive. The assessment has high validity and is one of the few assessments that is specific to driving. The assessment is able to assess a person’s concentration, attention, ability to follow instructions and road knowledge. However, for clients who have cognitive specific conditions e.g. brain injury the DSDA, as well as a second assessment, will often be used. Examples of other cognitive assessments that may be utilized include:
Mini Mental State Examination
Trail Making Test
Motor-free Visual Perception Test
Clock Drawing Test
Cognitive Behavioral Driver’s Inventory
Stroke Drivers Screening Assessment
Gross Impairment Screening Battery of General Physical and Mental Abilities
Computerized Sensory-Motor and Cognitive Test
Once these 3 assessments are completed the Occupational Therapist will notify the individual of any deficits that were detected. These deficits will be monitored during the on-road component of the assessment.