How to Assess for Adaptive Automotive Needs

• Jul 01, 2010

Driving does more than get us from here to there; it’s key to being as independent and involved as possible in our communities and with families and friends. No wonder, then, that a study published in Evidence-Based Nursing concluded, “Giving up driving was associated with an increase in depressive symptoms among older non-institutionalised adults.”

While clients with new disabilities, such as spinal cord injuries, usually work with occupational or physical therapists who teach them about automotive accessibility, seniors who notice changes in reflexes or vision too often assume they must drastically reduce or give up driving altogether.

Fortunately, adaptive automotive equipment can make driving safer and more comfortable for consumers with a range of mobilityrelated conditions.

Finding a CRDS

The Association for Driver Rehabilitation Specialists (ADED) maintains a national database of Certified Driver Rehabilitation Specialists (CDRS). The CDRS “plans, develops, coordinates and implements driver rehabilitation services for individuals with disabilities,” ADED says. These professionals usually have backgrounds in occupational or physical therapy, kinesiotherapy or driver education, and work for acute-care or rehab hospitals, clinics or driver education schools.

DME suppliers and complex rehab providers, however, are often better positioned to initially educate consumers about automotive accessibility products. For example, a senior who visits a DME supplier to purchase a rollator may not know how his arthritis impacts his driving or how adaptive automotive devices can help. And as with complex rehab seating & mobility, auto access needs can vary greatly from consumer to consumer based on medical conditions and prognoses, as well as whether the consumer wants to drive or ride as a passenger. DME suppliers and rehab providers have a great opportunity to explain to consumers that driver evaluations can uncover their specific needs and help indicate what sorts of technology could help.

Inside a Driver Evaluation

According to ADED, during a driver rehabilitation evaluation, a consumer can be assessed for the following driving-related skills and abilities:

• Vision
• Cognition (includes being able to control emotions when driving)
• Perception (defined as “How the brain interprets what the eyes see”)
• Motor coordination
• Functional ability
• Reaction time
• Coordination
• Behind-the-wheel evaluation

Because driving involves activities besides steering, accelerating and braking, consumers can also be evaluated on their abilities to:

• Transfer in and out of the vehicle and into a wheelchair or scooter
• Reach and operate standard vehicle controls
• Open and close vehicle doors
• Store and retrieve a wheelchair or scooter

CRDS’s know how a diagnosis can impact a consumer’s ability to drive, and what adaptive equipment may be helpful. For instance, a person with multiple sclerosis typically needs to conserve energy and keep body temperature under control, so part of the CDRS recommendation may be to use air conditioning in the car and try to find assistance when loading the wheelchair. A consumer with cerebral palsy may have a limited range of motion, exaggerated startle reflexes and increased tone. ADED says, “A spinner knob can be attached to the steering wheel to allow controlled steering with the use of one hand. A left gas pedal may be used if a person is unable to use the right-foot gas or brake. Hand controls may be indicated for the person unable to use either foot for gas or brake.”

Enjoying the Total Driving Experience

While driving is the focus of these evaluations, providers can support the overall travel experience by making consumers aware of adaptive automotive products that facilitate safe transfers and positioning in the vehicle.

Shear forces, for instance, can put skin integrity at risk for drivers or passengers who slide across automotive seats instead of completely lifting themselves during transfers. Aftermarket automotive seat systems that swivel, turn and/or raise and lower out of the vehicle can make transfers safer.

Pediatric car seats that offer postural support beyond that of standard car seats can help maintain proper positioning. These are especially helpful for larger children who’ve outgrown the car seats offered by standard retailers.

By combining the right adaptive automotive technology with expert evaluations and consumer training, drivers and passengers alike can continue to enjoy the ride when the open road calls.

This article originally appeared in the July 2010 issue of Mobility Management.