2. The Association for Driver Rehabilitation Specialists Annual Conference Buffalo, New York Presented by: Tommy Crumpton, LOT, MOT, CDI, CDRS August 3, 2014

3. 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.

4. 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

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

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

8. 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

9. 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

11. 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

12. 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

13. * WITHOUT OBSERVING THE PATIENT’S PERFORMANCE OF AN ACTIVITY, THE EVALUATION IS INCOMPLETE *

14. 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.

15. Refers to the tire of a vehicle on the surface of a road “where it really counts”

16. * WITHOUT OBSERVING A PATIENT PERFORM THE TASK OF DRIVING, THE DRIVING EVALUATION IS INCOMPLETE AS WELL *

17. 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.

18. Evaluator Educator Teacher

19. We evaluate and train both experienced and inexperienced drivers with physical, cognitive, or a combination of physical and cognitive deficits

20. The evaluation actually consists of two (2) parts:

21. General Information Medical History Current Status of Driver License Driving History Current physical, visual, and cognitive status as they relate to driving

22. 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

23. 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

24.  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

25.  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

26.  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

27.  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

28. 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.

29. 1. 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

30. 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

31. 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

32. Texas Department of Public Safety and Texas Department of Health Services Guidelines

33. 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

34. 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

36. HAVE A GREAT CONFERENCE WELCOME TO NEW MEMBERS & GOOD LUCK TO THOSE TAKING THE CERTIFICATION EXAM