Medicine and Health Sciences Commons^™

Utility Of An Occupational Therapy Driving Intervention For A Combat Veteran, Sherrilene Classen, Miriam Monahan, Maria Canonizado, Sandra Winter

Miriam Monahan

Many combat veterans are injured in motor vehicle crashes shortly after returning to civilian life, yet little evidence exists on effective driving interventions. In this single-subject design study, we compared clinical test results and driving errors in a returning combat veteran before and after an occupational therapy driving intervention. A certified driving rehabilitation specialist administered baseline clinical and simulated driving assessments; conducted three intervention sessions that discussed driving errors, retrained visual search skills, and invited commentary on driving; and administered a postintervention evaluation in conditions resembling those at baseline. Clinical test results were similar pre- and postintervention. Baseline versus postintervention …

Evidence-Based Review Of Interventions For Medically At-Risk Older Drivers, Sherilenne Classen, Miriam Monahan, Beth Auten, Abraham Yarney

Miriam Monahan

OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions.

METHOD. We used the American Occupational Therapy Association’s classification criteria (Levels I–V, I 5 highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A 5 strongly recommend the intervention; B 5 recommend intervention is provided routinely; C 5 weak evidence that the intervention can improve outcomes; D 5 recommend not to provide the intervention; I 5 insufficient evidence to recommend for or against the intervention.

RESULTS. For clients with stroke, we recommend a graded simulator …

Driving Characteristics Of Teens With Attention Deficit Hyperactivity And Autism Spectrum Disorder, Sherrilene Classen, Miriam Monahan, Yanning Wang

Miriam Monahan

Vehicle crashes are a leading cause of death among teens. Teens with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or both (ADHD–ASD) may have a greater crash risk. We examined the between-groups demographic, clinical, and predriving performance differences of 22 teens with ADHD– ASD (mean age 5 15.05, standard deviation [SD] 5 0.95) and 22 healthy control (HC) teens (mean age 5 14.32, SD 5 0.72). Compared with HC teens, the teens with ADHD–ASD performed more poorly on righteye visual acuity, selective attention, visual–motor integration, cognition, and motor performance and made more errors on the driving simulator pertaining …

Driving Errors In Parkinson’S Disease: Moving Closer To Predicting On-Road Outcomes, Sherrilene Classen, Babetter Brumback, Miriam Monahan, Irene I. Malaty, Ramon L. Rodriguez, Michael S. Okun, Nikolaus R. Mcfarland

Miriam Monahan

Age-related medical conditions such as Parkinson’s disease (PD) compromise driver fitness. Results from studies are unclear on the specific driving errors that underlie passing or failing an on-road assessment. In this study, we determined the between-group differences and quantified the on-road driving errors that predicted pass or fail on-road outcomes in 101 drivers with PD (mean age 5 69.38 ± 7.43) and 138 healthy control (HC) drivers (mean age 5 71.76 ± 5.08). Participants with PD had minor differences in demographics and driving habits and history but made more and different driving errors than HC participants. Drivers with PD failed …

Evaluating Driving As A Valued Instrumental Activity Of Daily Living, Anne E. Dickerson, Timothy Reistetter, Elin Schold Davis, Miriam Monahan

Miriam Monahan

The purpose of this translational research article is to illustrate how general practice occupational therapists have the skills and knowledge to address driving as a valued occupation using an algorithm based on the Occupational Therapy Practice Framework: Domain and Process (2nd ed.; American Occupational Therapy Association, 2008b). Evidence to support the model is offered by a research study. Participants were compared on their performance of complex instrumental activities of daily living (IADLs) and a behind-thewheel driving assessment. A significant relationship was found between the process skills from the performance assessment and whether the driver passed, failed, or needed restrictions as …

Indicators Of Simulated Driving Skills In Adolescents With Autism Spectrum Disorder, Sherrilene Classen, Miriam Monahan, Stephanie Hernandez

Miriam Monahan

Adolescents are at high risk for motor vehicle crashes (MVCs). Teens with autism spectrum disorder (ASD) may have an even greater risk for MVCs due to impaired visual, cognitive, and motor skills critical for driving. This prospective two group study demonstrated the demographic, clinical, and simulated driving skill differences of seven adolescents with ASD (mean age = 15.14, SD ±1.22) compared to 22 healthy controls (HC) (mean age = 14.32, SD ±.72) through a comprehensive driving evaluation (CDE) conducted by an occupational therapist certified driving rehabilitation specialist (OT-CDRS). Adolescents with ASD performed poorer on right eye acuity (Fischer’s (F) = …

Indicators Of Simulated Driving Skills In Adolescents With Attention Deficit Hyperactivity Disorder, Sherrilene Classen, Miriam Monahan, Kiah Brown

Miriam Monahan

Adolescents with attention deficit hyperactivity disorder (ADHD) have an increased risk for committing traffic violations, and they are four times more likely than neurotypical peers to be crash involved, making them a potentially high risk group for driving. We used a two-group design to measure differences in demographics, clinical off-road tests, and fitness to drive abilities in a driving simulator with nine adolescents with ADHD (mean age = 15.00, SD ± 1.00) compared to 22 healthy controls (HC) (mean age = 14.32, SD ±..716), as evaluated by an Occupational Therapist Certified Driving Rehabilitation Specialist (OT-CDRS). Despite few demographic differences, the …