OT Driving Assessors: policies skills, tacit knowledge… + modifying vehicles

Michelle Turnbull Occupational Therapy Driving Assessor, MT Rehab., NSW Introduced by Carol Jewell OTA, Professional Practice and Development

In Australia, Occupational Therapists play a unique role in driving assessment and rehabilitation – providing a thorough assessment and insight of an individual’s medical condition, injury or disability, and the impact on their ability to drive safely and within licensing authority standards.

To work in this area of practice, Occupational Therapists complete postgraduate training to develop skills and tacit knowledge in assessing an individual’s physical, visual, cognitive and behavioral capacity of our clients to drive safely, consistently and independently. This involves complex assessments on and off the road.

Occupational Therapists who have completed this training are generally referred to as Occupational Therapy Driving Assessors (OTDAs). They have complete complex off and on road assessments of their clients before making recommendations about their ability to drive safely.

Working in this complex area of practice requires a thorough knowledge of several documents that direct clinical practice; these are:

• Assessing Fitness to Drive (2022): the national driver medical standards set out the considerations and medical criteria for safe driving and management of drivers with health conditions.

• Australian Competency Standards for Occupational Therapy Driver Assessors (2018): this important document outlines the knowledge and skills required to practice as an OTDA, and essentially guides their clinical assessment of client’s individual driving performance.

• Australian Standards: including, but not limited to, “AS3954:2019 Motor vehicle driver controls – Adaptive systems for people with disabilities”; and “AS/NZS3696.19:2009 Wheelchairs

Part 19: Wheeled mobility devices for use as seats in motor vehicles”.

Who do OTDAs work with?

OTDA’s area of expertise could possibly be perceived as only working with adults, and/or only working with clients who already drive. On the surface that’s how it may look, but in reality, it is very different. When working in this field, OTDA clients can include working with teenagers with disability who need an assessment and rehabilitation to support their desire and ability to learn to drive; or working with experienced drivers who need assessment of their ability to return to driving after an accident or injury; as well as working with older drivers to support them to continue to drive for as long as it is safe, or facilitating cessation of driving where that is the safest option.

OTDAs work across a spectrum of diagnostic groups, from physical injuries and disability to cognitive impairment and mental illness, but even within this niche area of practice, some OTDA’s focus on specific groups based on their expertise.

Michelle Turnbull

Teamwork makes the dream work!

Although many OTDAs work alone in private practice, teamwork is still extremely important in this area of practice. On any given day, an OTDA may find themselves working with driving instructors, vehicle modifiers, licensing authorities, other Occupational Therapists (seating and wheelchairs), medical specialists, physiotherapists (transfers) or psychologists (driving anxiety, neuropsychological testing).

Vehicle modifications and OTDAs

Many OTDAs work with clients with physical impairments that require modifications to their vehicle access, or driving controls, to allow them to drive safely, consistently, and independently. Working in this area of practice requires close working relationships with vehicle modifiers and an in-depth knowledge of Australian Standards that relate to driving controls and vehicle access. Vehicle modifications are constantly changing and evolving and OTDAs working in this area work with both modifiers and driving instructors, to ensure their knowledge is current to achieve optimal outcomes for their clients. Although it’s not imperative to be an OTDA to make

Steering wheel Modifications recommendations about modifications for vehicle passengers, it is important to note that any change to a vehicle that affects the driver should be reviewed by an OTDA on road, to ensure that the changes do not negatively impact on the individual’s driving performance.

Lessons I’ve learnt as an OTDA

As an OTDA, I learnt that when working in a driver assessment service linked to a dementia and aged-care service, you will recommend licence cancellation more often than you will recommend if someone is fit to drive.

I became exceptionally skilled at delivering bad news.

I discovered the significant impact of no longer being able to drive – and how public transport and community transport are not great alternatives for an elderly population with cognitive decline.

I discovered a love of helping people with physical impairments and assisting them to return to driving using modified vehicle controls. I particularly enjoy working alongside vehicle modifiers and engineers to devise custom solutions for clients with more challenging injuries and functional limitations.

I discovered that debriefing support after a particularly difficult assessment was important – but having that support from other OTDAs who were also driver-trained, was essential.

I discovered the relationship with your driving instructor was extremely important, and at times could mean life and death!

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