“WHERE THE RUBBER MEETS THE ROAD:

THE IMPORTANCE OF BEHIND THE WHEEL EVALUATIONS AND TRAINING”

The Association for Driver Rehabilitation Specialists

Annual ConferenceBuffalo, New York

Presented by: Tommy Crumpton, LOT, MOT, CDI, CDRS

August 3, 2014

ABSTRACT

When preparing to perform a Driving Evaluation, there is often a dilemma as to what should be included and how thorough the evaluation should be. While it is evident that each of us approach a driving evaluation from different perspectives (i.e. range of medical conditions, professional background, level of experience, and available vehicles/equipment), it is the behind-the-wheel component that sets Driver Rehab Specialists apart from others. This presentation will provide insight as to the importance of a behind-the-wheel assessment and training in conjunction with a clinical assessment in determining a person’s risk level for driving. A practical, systematic approach to performing an evaluation and training will be presented with an emphasis on no/low tech drivers via handouts and videotaped sessions.

LEARNING OBJECTIVES

1. The participant will understand the similarities and differences between a Driving Evaluation and a typical Occupational Therapy Evaluation

2. The participant will understand the role of the Driver Rehabilitation Specialist as outlined in the ADED Best Practices for the Delivery of Driver Rehabilitation Services

3. The participant will understand what is assessed in a Behind-the-Wheel Evaluation

4. The participant will understand the process involved in Behind-the-Wheel Training

5. The participant will understand the patient’s legal responsibility when learning to drive or returning to driving with a medical condition

ANATOMY OF AN EVALUATION

As Driver Rehab Specialists, we continually search for the “perfect” clinical evaluation tool that will answer every question about a person’s

functional ability

Raise your hand if you have found the perfect evaluation tool…

Those of us who specialize in the field of Driver

Rehabilitation have not found the clinical

evaluation tool that measures a patient’s true

driving risk potential

STANDARDIZED TESTING

The framework or “skeleton” of an evaluation is a

collection of various clinical assessment tools that we compile to determine if

there is a deviation from a “normal” response

WHAT DO WE DO NEXT?

FUNCTIONAL OBSERVATION

A patient’s functional ability is what we see or observe (the “skin) during an evaluation.

We then correlate the clinical findings with the functional

findings to get the whole picture

A Problem List is based on deficits identified during a

Clinical Assessment

A Treatment Plan is based on what we see through a

Functional Assessment

* WITHOUT OBSERVING THE PATIENT’S

PERFORMANCE OF AN ACTIVITY, THE EVALUATION IS INCOMPLETE *

Definition: “Where the Rubber Meets the Road”

Fig. at the point in a process where there are challenges, issues,

or problems.

McGraw-Hill Dictionary of American Idioms and Phrasal Verbs © 2002 by The McGraw-Hill Companies, Inc.

Additional common uses of the phrase:

Refers to the tire of a vehicle on the surface of a

road

“where it really counts”

* WITHOUT OBSERVING A PATIENT PERFORM THE TASK OF DRIVING,

THE DRIVING EVALUATION IS

INCOMPLETE AS WELL *

ADED BEST PRACTICES ACT

The membership of ADED has developed the “Best Practices for the Delivery of Driver

Rehabilitation Services”

As a Driver Rehabilitation Specialist, when performing a Clinical or Behind-the-Wheel

Evaluation and/or Training, this is the guide that should be used.

It is an invaluable tool to help you develop your documentation form and to progress your

program to a higher level.

ROLE OF THE DRIVER REHABILITATION

SPECIALIST

EvaluatorEducatorTeacher

WHAT DO WE DO IN THE ADAPTIVE DRIVING

PROGRAM?

We evaluate and train both experienced and

inexperienced drivers with physical, cognitive, or a combination of physical and cognitive deficits

WHAT DOES A DRIVING EVALUATION INCLUDE?

The evaluation actually consists of two (2) parts:

The Clinical Evaluation includes:

General Information Medical History Current Status of Driver License Driving History Current physical, visual, and

cognitive status as they relate to driving

The Behind-the-Wheel Evaluation includes:

A performance based assessment

Safely performing a series of maneuvers (Foundation Skills) that every driver must be capable of doing

The setting is determined either by driving experience, or whether adaptive equipment will be needed

For inexperienced drivers or those needing adaptive equipment, a parking lot only evaluation is done

When evaluating a patient’s cognitive status, and/or minor physical deficits, the full evaluation route is 20 miles long, takes over an hour to complete, and is performed in a variety of normal driving settings

FOUNDATION SKILLS OF DRIVING

Steering Braking Accelerating Lane

Positioning Left Turns Right Turns Backing

Use of Turn Signals

Checking the Blind Spot

Reading the Terrain

Changing Lanes Parking Decision

Making

FOUNDATION SKILLS OF DRIVING

Steering Braking Accelerating Lane

Positioning Left Turns Right Turns Backing

Use of Turn Signals

Checking the Blind Spot

Reading the Terrain

Changing Lanes Parking Decision

Making

FOUNDATION SKILLS OF DRIVING

Steering Braking Accelerating Lane

Positioning Left Turns Right Turns Backing

Use of Turn Signals

Checking the Blind Spot

Reading the Terrain

Changing Lanes Parking Decision

Making

FOUNDATION SKILLS OF DRIVING

Steering Braking Accelerating Lane

Positioning Left Turns Right Turns Backing

Use of Turn Signals

Checking the Blind Spot

Reading the Terrain

Changing Lanes Parking Decision

Making

GOOD NEWS / BAD NEWS

When a person successfully demonstrates driving ability, there is :

GOOD NEWS: They are considered by you to be a

safe driver.

BAD NEWS: They may still have to prove it to the

Licensing Agency.

RECOMMENDATION CHOICES BASED ON THE

EVALUATION1. Resume driving after completing

required Department of Public Safety testing

2. Return for follow-up training, then complete required Department of Public Safety testing

3. Driving is not recommended and the patient should retire from driving

FOLLOW-UP TRAINING(THERAPY BEHIND THE WHEEL OF A CAR)

The number of hours will be estimated by the therapist

Training is specific to the needs of the individual patient

If adaptive equipment is needed, training will be recommended

In all cases of Behind-the-Wheel training, the core function of the Adaptive Driving Program

is that we are training the brain to do something it has

never done before or to perform it in a way different

than originally learned

LEGAL RESPONSIBILITY WHEN RETURNING TO

DRIVING WITH A MEDICAL CONDITION

Texas Department of Public Safety and

Texas Department of Health Services Guidelines

DEPARTMENT OF PUBLIC SAFETY TESTING

The Department of Public Safety (DPS) and the Department of Public Health (Medical Advisory Board) guidelines are that when there is a change in a person’s mental or physical condition that could affect his/her ability to operate a vehicle safely, they are responsible for informing the DPS and completing any testing that may be required

The Department of Public Safety is the only legal authority over a person’s Driver License

The Adaptive Driving Program does not substitute for DPS testing

QUESTIONS???

HAVE A GREAT CONFERENCE

WELCOME TO NEW MEMBERS&

GOOD LUCK TO THOSE TAKING THE CERTIFICATION EXAM