Occupational Therapy in a Driving Assessment Centre

Hi, I’m Natalie, the SPOTeurope blogger and this week I’ll share with you my first placement experience! I have just finished my first year at Worcester University in the UK, where we have five placements over three years of study. This placement was part time 2.5 days a week for 10 weeks, with lectures and seminars the other 2 days of the week. 

What is a Regional Driving Assessment Centre?

The Regional Driving Assessment Centre (RDAC) is a charity that provides driving and access assessments for anyone looking to maintain or regain their independence with driving. I was able to get involved with assessments both at the Head Office in Birmingham, and at two outreach centres in Worcester and Leamington Spa. 

Driving is an essential occupation for many people and when it is lost it can prevent us from being independent and doing some of the activities we enjoy! Occupational Therapists have an important role working with Approved Driving Advisors (ADA’s) to enable people to drive comfortably and safely.

What is the driving assessment process?

The process begins with an initial interview to find out more about the clients situation and how it is affecting their driving. If appropriate, paper based cognitive tests will be completed and any available adaptations (such as hand controls) may be tested in the centre before the in-car assessment.

Next a practical on-road driving assessment will take place, and both the Occupational Therapist and the Approved Driving Advisor will observe the drive and discuss the safest outcome in the best interests of the client. This may include recommendations to retire from driving or to continue practicing driving, with or without adaptations to maintain or develop existing skills. In either case, practical advice will be given to allow the client to retain their independence safely and for as long as possible.

The image below shows the basic steps in the process, although this appears simple, finding driving solutions specific to each individual made every day slightly different.

Some of you may recognise these images from my ‘Day in the Life’ on SPOTeurope’s Instagram! If you haven’t seen them check them out @SPOTeurope!

*Thanks to all at RDAC for permission to use the photos*

What adaptations are available?

Hand controls and steering aids were the most commonly recommended adaptation throughout my placement. These included a steering ball, push pull hand brake & accelerator, under ring and Lodgesons wireless keypad control. These were commonly used for clients with limited or no movement in their lower limbs, and also clients with limited upper limb movement for example post stroke. Less common hand controls I was able to see on assessments included a joystick control and a mini steering wheel.

There were other adaptations including left foot accelerators, easy release handbrakes and swivel chairs to aid in vehicle transfers.

Luckily I had a couple of chances to try some adaptations myself, this was challenging as I am not usually a confident driver! But looking back I can really see how it helped me to appreciate how difficult it can be for someone to adjust to a new way of driving in order to retain their independence.

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What other services are there?

At my placement I had the chance to observe different types of assessments and discovered services that I wasn’t aware existed! These included:

• A Car Seat Clinic: Here, different child car seats would be at hand for the client to try and the one with the best seating position would be recommended.  

• A Tryb4uFly Assessment: Using real aeroplane cabin seats, the OT  would demonstrate a range of seating and transfer equipment and recommend the one with the most suitable postural support. 

• Access Assessment: Home visits are made to offer different transfer options between a wheelchair and a vehicle and the most appropriate would be recommended. 

• Bugzi Assessment: A MERU Bugzi is a powered indoor wheelchair for children aged one to six. They are available to loan and enable children with disabilities to experience independent mobility. An assessment includes the chance to try a Bugzi and the OT will offer advice on completing a loan application. 

During my placement I was able to visit SIRUS, an automotive specialist that manufactured many wheelchair accessible vehicles and fitted car adaptations. As someone who doesn’t know much about cars this was really useful for me to see what adaptations are possible and how they can enable a client’s independence! 

I then attended NAIDEX, a disability and independent living event where I got the chance to visit the Motability stand and learn more about the options around leasing a new car, scooter or powered wheelchair. This was my first time at NAIDEX and as a first-year student the number of different stands was both overwhelming and exciting, and showed such diversity in the areas an OT can become involved in!

Overall this was a great first placement experience, I had the chance to meet a wide range of people of all ages and saw many different conditions! Every assessment was unique, and I soon came to realise even the most experienced Occupational Therapists and Approved Driving Advisors still came across conditions they hadn’t heard of before! This helped improve my confidence when interviewing clients about how they felt their condition impacted their driving. This highlighted how meaningful driving can be, both as an enjoyable activity and a way of maintaining independence.

Thanks to this placement I have now gained an awareness of what services are available to support peoples independent mobility that I can pass on to anyone who will benefit!