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Industry: Email Alert RSS FeedDriving after brain injury
Journal of Rehabilitation, April-June, 1995 by Barbara S. Handler, Jeanne Boland Patterson
A related issue is accessibility of facilities and/or professionals who can provide assessment and training services. In many areas, people with brain injury who require evaluation or would benefit from an opportunity to return to driving have no options available, unless they are able to travel to larger urban centers where such facilities are located. Even if these individuals can locate and afford such an evaluation, being tested in unfamiliar areas may not accurately predict their capacity to drive safely in well-known territory.
Provisions for issuing restricted licenses were mentioned by only a few of the researchers (i.e., Gastaut & Zifkin, 1987; Hopewell, 1988; Shreve, 1993; Spudis, Penry, & Gibson, 1986; Summers, 1986; Utah State Driver License Medical Advisory Board, 1981). For some individuals this may represent a solution that meets everybody's needs: the needs of the individual to maintain as much independence as possible and the needs of society to protect citizens from potential danger at the hands of drivers trying to perform beyond their capacities. The option of restricted licensure raises additional questions about assessment, enforcement, and liability.
Variations in language also complicate research efforts. It would be helpful if one (or more) national organization of professionals dealing with the treatment and rehabilitation of individuals with brain injury could attempt to reach consensus on language applied to the testing and treatment of the target population.
Another issue that requires further study and discussion at a national level is the qualifications of those who evaluate and teach people with brain injuries to drive or return to driving. Should these individuals be driving instructors (who may or may not have any expertise in working with people with disabilities), occupational therapists (who may or may not have any training in driving skills), or some combination of the two? What standards should be set for evaluators and trainers, and who should set them? Many school districts have dropped driver training from their curricula in the last five years. When students with brain injuries now in the school system reach driving age, who will provide the specialized training they may require to become safe drivers?
Finally, we have established that more people are surviving brain injury than in the past and that a percentage of those people are driving. We have also seen that cognitive capacities diminish with age in people who do not have disabilities. Research is needed on the aging survivor of brain injury. What types of assessments should be made of such individuals, at what intervals in time, and by whom? If we are able to establish guidelines for these individuals, what will the mechanisms of enforcement be and how can they be made uniform across the states?
Rehabilitation professionals, both practitioners and researchers, face numerous challenges in addressing these issues that are critical from both personal and vocational perspectives for individuals who have sustained traumatic brain injuries.
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