Date of Award

2007

Document Type

Scholarly Project

Degree Name

Master of Occupational Therapy (MOT)

Department

Occupational Therapy

First Advisor

Jan Stube

Keywords

Activities of Daily Living; Automobile Driving

Abstract

Driving is an integral part of daily life. Discontinuing driving due to decreasing function can have serious effects on a person's life. Occupational therapists work to enhance or maintain a persons independence when they are faced with illness, disease or natural declines associated with aging. Driving is listed as an Instrumental Activity of Daily Living (IADL) by the American Occupational Therapy Association (2002). Occupational therapists have special training and skills which assist them to understand the person from a holistic perspective. The decision to discontinue driving should be made after careful consideration of the many aspects of cognitive, visual-perceptual, and physical performance. Using evidence based assessments with proven validity is essential to assisting drivers and the interdisciplinary team to make this important decision.

Reviewing the current professional literature and research was a key element in accomplishing the goal of identifying an evidence based method of assessing driver related skills in the author's current clinical setting. This literature review clearly identified the need for a battery of assessments to accomplish this task rather than relying upon any single tool. Ball (2006) states" ... licensing decisions with far-reaching ramifications for personal autonomy should be based upon a preponderance of the evidence. Impaired performance on more than one measure affords ... a greater degree of confidence that its recommendations are grounded in hard evidence (p. 82)."

The need to establish a method to perform driver skills evaluations based upon clinical evidence is growing rapidly as the aging population grows. Lee, Lee, and Cameron (2003) projected that the number of drivers over the age of 65 will increase from 13% in 1990 to 25% in the year 2020. This project was undertaken to produce an assessment battery capable of clearly identifying those individuals who present with skills sets insufficient to safely drive an automobile. The assessment battery produced is supported sufficiently by the evidence presented to accomplish this goal. Successful completion of the assessment battery however, is not able to clearly identify those who will be able to drive safely. This ability needs to be determined through performance of an on-road driving evaluation and successful completion of testing required by the local motor vehicle department.

The assessment battery developed in this project consists of four assessments:

• Assessment of Driver Related Skills (ADReS)

• Motor Free Visual Perception Test (MVPT)

• Dynavision Performance Assessment Battery (DPAB)

• Mini Mental State Examination (MMSE)

Each of these assessments is supported in the literature to be used as a valid measure of driver related skills. This battery of assessment is designed to be performed in the clinic in 2-1 hour sessions. The findings which result from performing this assessment battery can be used to direct occupational therapy aimed at remediation of skills to help patients regain or maintain their independence.

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