Aspergers's / Autism

Attention Deficit Hyperactivity Disorder commonly becomes evident in early childhood and probably will be chronic in nature. The disorder consists of developmental deficiencies that can range from inhibiting behaviors to having high anxiety.. The individual may improve with age. Any level of Asperger's may increase the risk of unsafe driving issues. These issues stem from levels of anxiety, poor problem solving skills, lack of organization and and planning. Performance behind the wheel can be due to poor motor skills and performance can be erratic. Visual skill training is vital since all information is treated equally. . Their ability to learn information for the licensing knowledge test works well when one on one instruction is provided. Learning from their driving mistakes takes extra time. All of the above can result in unsafe driving encounters, unpredictable driving actions or an increased number of "minor" accidents. Medical clearance to drive is encouraged.

If someone you know has Asperger's look for the following warning signs that may interfere with safe driving:

• Doesn't observe sings/signals
• Has high anxiety
• Is a perfectionist and hates making mistakes
• Drifting while driving
• Failure to yield right of way
• Difficulty with interpreting traffic environments / does not anticipate dangerous situations
• Impaired eye/ hand/foot coordination
• Neglects to observe all areas of the vehicle before driving in reverse
• Multiple minor accidents
• Slow to respond to traffic lights
• Speed fluctuation / Inappropriate speeds
• Unable to coordinate distractions and driving

NHTSA site for disabled drivers

Aging and Driving

As we all age, changes occur in physical functioning, vision, perception, and processing abilities that could make driving unsafe. While changes are inevitable, they occur at different rates in each individual, and age alone is not a good indicator of driving skills. Most often these changes occur slowly over a long period of time, and the individual is able to compensate for minor deficits. If several skill areas are affected, or there is a sudden change in abilities due to illness or disease, driving may become impaired. An evaluation is recommended if you, or those who drive with you, notice any of the following warning signs.

Warning Signs:

• Doesn't observe signs, signals, or other traffic
• Needs help or instructions from passengers
• Slow or poor decisions
• Easily frustrated or confused
• Frequently gets lost, even in familiar areas
• Inappropriate driving speeds (too fast or too slow)
• Poor road position, or wide turns
• Accidents or near misses

NHTSA site for disabled drivers

Alzheimer's / Dementia

Deciding if and when its time to stop driving is an extremely difficult and emotional time. When Alzheimer's or dementia occurs, a decision will need to be made as to when an individual is no longer capable of operating an automobile safely. The individuals' independence needs to be measured against the potential hazards to themselves, and the community. An evaluation by the driver rehabilitation specialist can be of great value in helping to make this difficult decision. A driver evaluation will assess the components of driving that may be compromised by this progressive condition. Areas assessed should include: attention, processing speed, visuospatial functioning, decision making, judgment, planning, memory, and behavior.

An evaluation is recommended when a diagnosis or problems first arise. Compensatory strategies can be used to help maintain safe driving, and to set limits in preparation for the inevitable. Discussing the issue, and planning for the future, is important to do while the individual has the insight needed to participate.

Warning signs are listed below.

• Driving too slowly
• Doesn't observe signs or signals
• Difficulty interpreting traffic situations and predicting changes
• Failure to yield
• Easily frustrated or confused
• Frequently gets lost
• Needs instructions from passengers
• Poor road position or driving the wrong way down streets

NHTSA site for disabled drivers

Amputation

After a limb amputation, a person is sometimes unable to drive an automobile in the normal manner. There are, however, several types of adaptive devices that can allow an individual with an amputation to safely resume driving. The site of amputation(s) will determine the degree of difficulty an amputee will have with driving a standard equipped vehicle. In most cases, the adapted equipment will involve compensation for the inability to reach and operate primary and secondary driving controls.

This equipment may be necessary for:

RIGHT LEG AMPUTATION:

• Left Foot Gas Pedal
• Automatic Transmission
• Power Braking

BOTH LEG AMPUTATION:

• Hand Controls for brake and accelerator Spinner Knob
• Automatic Transmission
• Hand Operated Dimmer Switch
• Emergency Brake Extension
• Chest Strap

UPPER EXTREMITY AMPUTATION:

• Automatic Transmission
• Steering Device
• Reduced Effort Steering
• Modified Gear Shifter
• Modified Secondary Controls (turn signals, dimmers)

TRIPLE OR QUADRUPLE AMPUTATION:

• Additional modifications can be made to car or van
• Reduced effort steering system
• Servo Brake and Accelerator Control
• Joystick Driving Systems

NHTSA site for disabled drivers

Arthritis

Rheumatic disease includes nearly 100 different conditions, which cause pain in the joints and connective tissue throughout the body. The key factor in the most serious forms of rheumatic disease is inflammation evidence by heat, swelling, redness, stiffness, and pain. Depending on the areas affected and functional ability, either a sedan or van may be an appropriate vehicle choice. Loss of joint mobility may result in diminished ability to reach, grasp, manipulate, and release objects. Strength, endurance, and range of motion difficulties may necessitate adaptive devices: such as extra mirrors, key holders, extended gear shift levers, power windows and door locks. More extensive adaptive equipment or vehicle modifications may be needed for persons whose ability to use their arms and legs is severely affected by the disease. The following are considerations for selecting a vehicle:
Driving a sedan: When considering the use of a sedan, the individual must be able to do the following:

• Lock and Unlock the door
• Open and close the door
• Transfer to and from the wheelchair if applicable
• Store and retrieve the wheelchair (either independently or with a wheelchair loading device)

Since characteristics and dimensions of vehicles vary, it is important that the individual performs these functions in the vehicle being considered prior to purchase. A driver rehabilitation specialist can provide recommendations for sedan selection.
Driving a van: If an individual is unable to drive a sedan, there are several options available for driving a van. Specialized modifications can allow a person to transfer to the driver seat or to drive from the wheelchair. There are several levels of driving control technology to compensate for the loss of strength and/or range of motion. Some of these include:

• Reduced effort steering systems to compensate for reduced strength
• Servo brake and accelerator control to compensate for reduced range of motion and strength.
• Joystick driving systems, allowing one hand operation of brake, accelerator and steering.

Adaptive equipment and vehicle modifications for wheelchair access are available for some full-size and mini vans; however, all vans are not suitable for modifications. We can assist in making the correct van choice as well as provide a comprehensive evaluation to determine a persons ability to drive.

The evaluation will include:

• Vision
• visual perception
• functional ability
• reaction time
• behind-the-wheel evaluation

NHTSA site for disabled drivers

Cerebral Palsy

Cerebral Palsy (CP) applies to a number of non-progressive motor disorders present from birth. The involvement varies widely from person to person. The person with CP may or may not be a wheelchair user. Frequently special vehicle adaptations are necessary for independent driving. The person with CP may also have impairments in the areas of vision, perception (how the brain interprets what the eyes see) or learning.

Adaptive equipment is frequently used for physical problems. 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 for gas or brake. Hand controls may be indicated for the person unable to use either foot for gas or brake. Specialized modifications can also allow a person to transfer to the driver seat or drive from the wheelchair in a van or minivan.

Common factors that can affect safe driving:

• Limited range of motion and strength
• Exaggerated startle reflex to loud noise
• Increased muscle tone
• Difficulty in coordinated movements
• Visual impairments (poor acuity)
• Trouble visually scanning or tracking quickly
• Learning difficulties
• Impaired judgment in complex situations
• Slow processing and reaction time

A driver rehabilitation evaluation will examine the strengths and weaknesses of each individual as related to the driving task. The goal is independent, safe drive. No modifications or vehicle selection should be made until the person has completed a driver evaluation.
An assessment should include:

• vision
• perception
• functional ability
• reaction time
• Behind-the-wheel evaluation
  

If you, or someone you drive with is having difficulty, a driver evaluation may be indicated. We can provide a comprehensive evaluation to determine your ability to drive.

NHTSA site for disabled drivers

Multiple Sclerosis

Multiple Sclerosis can affect individuals in varying ways including tingling, numbness, slurred speech, blurred or double vision, muscle weakness, poor coordination, unusual fatigue, muscle cramps, bowel and bladder problems and paralysis. Due to these symptoms, special equipment or accommodations may need to be made to aid a person in safely maintaining their mobility independence for as long as possible.

Physical Considerations: The following are considerations for selecting a vehicle:

Driving a sedan: The Individual must be able to do the following:

• Open and close the Door
• Transfer in and out of the vehicle
• A wheelchair/scooter must be able to be stored and retrieved. Special equipment is available to aid with storage.

Driving a Van: Options may include a mini-van with a lowered floor and a ramp or a full size van with a lift. Specialized modifications allow a person to transfer to the driver's seat or drive from a wheelchair. Technology may be able to compensate for the loss of strength or range of motion such as:

• Reduced effort steering and/or brake systems to compensate for reduced strength.
• Mechanical hand controls allow for operation of the gas and brake using upper extremities.
• Servo brake/ accelerator systems compensate for reduced strength/range of motion of arms.
• If spasticity is difficult to manage, it may lead to an inability to drive.

Visual Changes:

• May be severe enough that driving is precluded or night driving is prohibited.
• If double vision is intermittent and can be monitored independently, then driving may be limited to avoid driving during an exacerbation.
• Sunglasses may help with glare sensitivity.
• Compensate for loss of peripheral vision with special mirrors and head turning.
• Learn order of traffic signals to aid with color vision impairment.

Cognitive Issues:

• Need to regulate emotions and avoid driving when upset, angry or overly emotional.
• May be limited to familiar routes if some loss of memory or problem solving but still enough judgment to drive.

Decreased Energy:

• Energy conservation is vital.
• May require assistance with wheelchair loading to save energy for driving.
• Air conditioning aids with managing warm climates.

Medications:

• Seek the physician's input regarding side effects which may impair driving.
• Monitor when medications are taken. Don't drive when sleepy or just
  before or after medicating

We can provide a comprehensive evaluation to determine a person's ability to drive.

The evaluation will include:

• Vision
• visual perception
• functional ability
• reaction time
• Behind-the-wheel evaluation

NHTSA site for disabled drivers

Spina Bifida

Spina Bifida is a congenital defect in which part of one or more vertebrae (the bone structure that surrounds the spinal column), fail, to develop completely, leaving part of the spinal cord exposed. It can occur anywhere on the spine but is most common in the lower back. The severity of the condition depends on how much nerve tissue is exposed. Frequently special adaptations on a vehicle are necessary for independent driving. The person with spina bifida may also have impairments in the ~areas of vision, perception (how the brain interprets what the eyes see) or learning. Adaptive driving equipment is frequently used for physical problems. A spinner knob and hand controls can be used if a person is unable to use either foot for gas or brake. Specialized modifications can also allow a person to transfer to the driver's seat or drive from the wheelchair in a van or minivan.

Common factors that can affect safe driving:

• Limited range of motion and strength
• Difficulty with coordinated movements
• Visual impairments (poor acuity)
• Trouble visually scanning or tracking quickly
• Learning difficulties
• Impaired judgment in complex situations
• Slow processing and reaction time

A driver rehabilitation evaluation will examine the strengths and weaknesses of each individual as related to the driving task. The goal is independent, safe driving. No modifications or vehicle selection should be made until the person has completed a driver evaluation.

The evaluation will include:

• visual perception
• functional ability
• reaction time
• Behind-the-wheel evaluation

NHTSA site for disabled drivers

Spinal Cord Injury

After a spinal cord injury has occurred, a person is no longer able to drive an automobile in the normal manner. However, there are several types of adaptive equipment and vehicle modifications that can allow an individual with a spinal cord injury to drive. Depending on the level of injury and functional ability, either a sedan or van may be an appropriate vehicle choice.

The following are considerations for selecting a vehicle:

Driving a sedan: When considering the use of a sedan, the individual must be able to do the following:

• Lock and Unlock the door
• Open and close the door
• Transfer to and from the wheelchair
• Store and retrieve the wheelchair (either independently or with a wheelchair loading device)

Since characteristics and dimensions of vehicles vary, it is important that the individual performs these functions in the vehicle being considered prior to purchase. A driver rehabilitation specialist can provide recommendations for sedan selection.

Driving a van: If an individual is unable to drive a sedan, there are several options available for driving a van. Specialized modifications can allow a person to transfer to the driver seat or to drive from the wheelchair.

There are several levels of driving control technology to compensate for the loss of strength and/or range of motion. Some of these include:

• Reduced effort steering systems to compensate for reduced strength
• Servo brake and accelerator control to compensate for reduced range of motion and strength.
• Joystick driving systems, allowing one hand operation of brake, accelerator and steering.
  

Adaptive equipment and vehicle modifications for wheelchair access are available for some full-size and mini vans; however, all vans are not suitable for modifications. We can assist in making the correct van choice and can provide a comprehensive evaluation to determine a persons ability to drive.

The evaluation will include:

• visual perception
• functional ability
• reaction time
• Behind-the-wheel evaluation

NHTSA site for disabled drivers

Stroke

Driving is viewed not just as a 'privilege' but also as a necessity. When a stroke occurs it can affect the skills necessary for independent driving. A majority of stroke survivors can return to independent driving. The goal is to maintain safe and independent driving for as long as possible.

Adaptive equipment is frequently used for physical problems. 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 you are unable to use your right foot to gas or brake. Training is essential with any equipment to be safe with your new adapted driving method.

Warning signs to look for are:

• Inappropriate driving speeds (too fast or too slow)
• Needs help or instructions from passengers
• Doesn't observe signs or signals
• Slow or poor decisions (poor judge of distances, too close to other cars)
• Easily frustrated or confused
• Pattern of getting lost, even in familiar areas
• Accidents or near misses
• Drifting across lane markings, into other lanes
  

If you, or those who drive with you, notice any of the above warning signs, you may need a driver evaluation.

This evaluation will include:

• visual perception
• functional ability
• reaction time
• Behind-the-wheel evaluation

NHTSA site for disabled drivers

Traumatic Brain Injury

Traumatic Brain Injury and Closed Head Injury commonly occur due to motor vehicle collisions. Injuries can range from a loss of consciousness of less than five minutes to being comatose for many months. Any level of injury can cause an increase in pre-injury bad driving behaviors or create new, unsafe driving issues. These issues can stem from problems with vision, accuracy and speed of eye movements, speed of response, attention, memory, problem solving, judgment and/or loss of physical skills. It can spare one skill and wipe another skill completely from memory. It commonly makes learning new information difficult and may keep a survivor from quickly learning from their mistakes. All of the above can result in unsafe driving encounters, unpredictable driving actions or repeat collisions for the survivor.

If someone you know has been in an accident or has had a TBI, look for the following warning signs:

• Inappropriate driving speeds
• Is slow to identify and avoid potentially hazardous situations
• Needs help or instruction from passengers
• Doesn't observe signs or signals or speed limits
• Leaves out important road, traffic or warning information
• Slow or poor decisions to traffic or road changes
• Easily frustrated or confused
• Pattern of getting lost, even in familiar areas
• Collisions or near misses
• Blames their driving mistakes on the behavior of other drivers

If you or those that drive with you notice any of the above warning signs, you may need a driving evaluation. We can, with knowledge about your medical conditions, can provide a comprehensive evaluation and determine your ability to drive.

This evaluation will include:

• visual perception
• functional ability
• reaction time
• Behind-the-wheel evaluation

NHTSA site for disabled drivers