What is an occupational therapy driving assessment?

Occupational therapy (OT) is an allied health discipline that focuses on helping people become as independent as possible. OT encompasses all areas of life – from basic self-care skills, gross and fine motor skills and meal preparation, to social skills and employment and vocational interests. One activity that people may take for granted is driving. For many Australians, driving is an important skill that enables people freedom and independence to access their community, engage in leisure and social activities and fulfil employment duties.

Four qualified driver trained occupational therapist
In NSW, when a person has a medical condition or disability that potentially affects their driving capacity, it is essential for them to inform the Roads and Maritime Service (RMS). By law, it is the primary responsibility of the driver to declare his/her medical condition to the RMS, however the person’s family members or friends may also perform this duty. Often, the individual’s doctor (often GP or specialist) or other health professional will express their concern to the RMS about the person’s driving ability. Because practical observation is required to assess a person’s fitness to drive (it may be difficult to sufficiently determine how a person is affected by their medical condition in regard to driving), the RMS will then direct the person to undergo an OT driving assessment. The sole purpose of the assessment is to ascertain how the person’s medical condition or disability is impacting on their driving skills, to ensure that the driver is meeting safety and RMS standards.

Who needs an OT driving assessment?

Lady happy after she completes an occupational therapy driving assessment

Any individual with a diagnosed medical condition that may affect their driving performance is mandated to have an assessment. The following conditions are examples of medical diagnoses that OT driving assessors commonly work with:

  • Various physical impairments or disabilities
  • Limb amputations
  • Alzheimer’s disease or dementia
  • Brain injury
  • Stroke
  • Epilepsy
  • Cerebral palsy
  • Multiple sclerosis
  • Serious/chronic mental health conditions
  • Autism spectrum disorder (ASD)
  • Intellectual disability or developmental delay

How much does an OT driving assessment cost?

OT driving assessment costs can vary from one service to another and often depends on the person’s medical condition, needs and location (in relation to the service). Clients often need to bear these costs themselves. However, participants of the National Disability Insurance Scheme (NDIS) may use appropriate funding towards the assessment, and insurance may cover costs in instances where the individual became injured at work. For specific costs, it is best to enquire at OT driving assessment service near you.

What happens during an OT driving assessment?

It may be easiest consider the assessment as being separated into two main sections: the off-road testing and the on-road testing. Each part has a specific focus and the results are combined to make a judgment about the person’s driving competence. The OT often visits the person at home, although some services require the person to attend their center.
The off-road assessment involves the OT evaluating the three physical components necessary for driving: vision, cognition and physical capacity. In the physical screen, the OT looks for any obvious impairments or issues in these areas that may potentially affect the driver’s performance.
After the off-road test, the client will then drive with the OT and driving instructor. The driving instructor is a rehabilitation driving instructor, as he/she has specialized training to work with drivers with medical conditions. The client will drive the instructor’s vehicle, as the vehicle will have dual-control brakes that the instructor can apply at any time. The client will drive around the local area for approximately 1 hour, encountering all types of traffic conditions. The OT is surveying how the person’s diagnosis is influencing their driving capacity. As such, minor usually do not affect the outcome of the assessment, such as mistakes due to poor driving habits or the driver being unfamiliar with the car. However, critical mistakes (which occur when the driving instructor must physically intervene to prevent an accident), will lead to an assessment failure.

What happens after the OT driving assessment?

Following the assessment, the OT and driving instructor will inform the client of the outcome. There are three potential results:

  • The person’s medical condition was not assessed to impact on their driving and the OT will recommend that they continue with their licence.
  • The person’s medical condition was assessed to impact on their driving and they are not driving safely and to RMS standards. The OT believes that driving lessons will not benefit the driver, and it is recommended that their licence is cancelled.
  • The person made some minor errors during the assessment, or the OT has some concerns about some aspects of their driving skills. In these instances, the OT may recommend some lessons to improve in the areas of concern, and an OT driving re-assessment may be required after lessons. If the driver has been prescribed new vehicle modifications, the OT will recommend lessons with a rehabilitation driving instructor to learn how to use the modification safely.

The OT will send the driving report to the client, the RMS and their referring doctor.