Driving is a key mark of independence in our society. Your family member may be eager to get behind the wheel again.

A trained professional should evaluate the service member or veteran’s ability to drive after a TBI. This evaluation should be done by a specialized driving rehabilitation instructor, such as an occupational therapist or a certified adaptive driving evaluator.

Many skills are required to drive safely, including good vision and good perceptual skills (for example, the ability to judge distances between cars).

A rehabilitation driving evaluation usually consists of two parts: one part in the office or clinic and the other actually driving a car on the road. The evaluation will address the following skills as they relate to driving:

  • Cognitive skills
    • Adequate decision-making, judgment, and planning skills (for example, making left turns and dealing with unexpected situations or emergencies)
    • A healthy self-awareness and an understanding of their own strengths and weaknesses
    • Adequate memory to know where they are going and why
  • Physical skills
    • Ability to get in and out of the car, adjust seat, and fasten seatbelt
    • Ability to physically steer, brake, and control speed
      • An assessment of the need for assistive devices for driving may be required.
  • Visual/spatial skills
    • Assess sharpness of vision and need for corrective lenses
    • Be able to concentrate attention in their central field of vision
    • Adequate visual field and ability to scan the changing environment while also focusing on specific objects
  • Perceptual skills
    • The ability to judge distances between cars on the road and space in parking lots
    • Ability to interpret and respond safely and appropriately to complex visual information, such as following verbal directions to a store
    • Recognize shapes and colors of traffic signs
    • No visual inattention or neglect, which may cause drifting to one side of the road or not seeing the full driving environment
  • Speed of motor responses
    • Reaction time
    • Ability to brake or change lanes safely within a reasonable amount of time
    • Ability to process a lot of information and react quickly

As cognitive skills improve, driving skills may be reevaluated. Many people with TBI do eventually return to driving and drive safely. Driving skills affected by TBI can be improved through training that focuses on visual scanning, attention skills, and spatial perception.

Professionals certified through the Association for Driver Rehabilitation Specialists can provide an evaluation and ongoing driver training. You can find a list of experts in your state at www.driver-ed.org.

Occupational therapists with driving specialty are especially helpful in providing interventions to assist individuals who need ongoing driver skill retraining, modifications, or adaptive equipment.

In some situations, the loss of skills needed to drive safely may prevent the person from driving again. When this occurs, it is important for the driver rehabilitation specialist to ensure that the person with TBI and other family members understand the reasons why cessation of driving is recommended.

The family must be diligent about enforcing the “no driving” rule. For example, you may need to keep close control of the family’s car keys.

If the service member or veteran cannot drive a motor vehicle safely, the driver rehabilitation specialist can help you explore other transportation options. Public transportation (bus, train, subway, taxi, and para-transit options) may be available.

Resources for transportation to medical facilities for appointments, to obtain medications, or other needs may be obtained from a variety of sources, such as the Department of Veterans Affairs, Medicaid, Community Transportation Association of America, or Disabled American Veterans.

Consider transportation assistance from family members, friends, or community groups.