Becoming safe, independent drivers may require special training, equipment for teens with physical, development impairments&lt

By Annette Maggard Lewer, MOT, OTR, CDRS

Annette Maggard Lewer And husband and daughter

Annette Maggard Lewer and Family

Annette Maggard Lewer, MOT, OTR/L, CDRS, attended Rockhurst University earning a B.A. in Philosophy in 1993 and a Master’s in Occupational Therapy in 1995. She is the Driving Program Coordinator for Rehabilitation Institute of Kansas City/Ability KC, working with patients to address the most challenging, and for many the most critical, milestone of independence–driving. She is frequently requested to speak on driving rehabilitation to various groups such as university OT programs, senior living centers/communities, hospitals, physician’s conferences, education conferences, as well as interviews with the media.

As parents of children with special needs worry about the future, it’s common to be concerned about your child’s ultimate level of independence, especially when you are no longer around. Will my child be able to live on his own? Will she have a job? Will she be able to drive? The answer to this last question often can determine the success of the first two. In our urban-sprawl society with limited public transportation options, the inability to drive makes going to school, work, the grocery store, etc., even more challenging.
It seems the trend is for adolescents of all abilities to be less equipped to learn to drive than in previous decades. Teens have more hesitation and fear surrounding driving, whether they have special needs or not. There is a lack of awareness of driving habits, rules, and routes. Elimination of driver’s education in many school systems contributes to these issues.
So how does a parent decide when a child may be ready to learn to drive? What options are out there for learning? What if the child needs adaptive equipment? Are there things parents can do to facilitate the process?
When to begin
There are minimum ages before states will allow instruction to begin. In Kansas (ksrevenue.org) it’s 14, in Missouri (dor.mo.gov/drivers) it is 15. However, this does not mean that all adolescents will be ready at that time. Among the factors that contribute to readiness are maturity level, physical abilities, cognitive skills, and visual skills. Consider if the child has the time and energy, judgement, and desire to learn. Key indicators are when the teen shows responsibility for homework, medication schedule, and chores. In addition, you should not have safety concerns about your child being on their own for extended periods of time.
According to The National Highway Traffic Safety Administration (nhtsa.gov): “Young drivers, particularly 16- and 17-year-olds, have high fatal crash rates because of limited driving experience and immaturity that often result in high-risk behavior behind the wheel. A more comprehensive program – the graduated driver licensing (GDL) system – gives novice drivers experience under adult scrutiny and protection by gradually introducing more risky driving conditions. In fact, multiple studies report GDL systems reduce the number of 16- and 17-year-old-driver crashes.”
For the child with special needs, he or she may require more time than their peers to reach the milestones required for safe and independent driving. Your physician, educators, or school professionals may be good resources to help you determine when it is appropriate.
How to learn
Online or classroom driver’s education courses can help solidify knowledge of the rules of the road. Some insurance companies and auto safety organizations also provide resources. Practical experience with a parent or trusted adult is a good starting point, but there are also private classes if your school system doesn’t offer driver’s ed.
Driving rehabilitation specialists are an option if the new driver is unable to pass Department of Motor Vehicle testing after several attempts, or has numerous collisions or moving violations, or if parents feel there is a safety concern.
A certified driving rehabilitation specialist (CDRS) is someone who has received specialized training and passed a certification examination to show they are qualified to address driving needs for individuals who have an injury, illness, or development delay that has or may impact their ability to drive. Instruction is tailored to specific needs, such as individuals with stroke, brain or spinal cord injuries; low vision; physical limitations or developmental disabilities; needing to learn to drive from a wheelchair; and the elderly.
Following an evaluation of physical, cognitive, and visual abilities, a plan is developed that may include homework activities, additional therapy, or simply more time to mature. The plan could suggest compensatory techniques or use of specialized equipment to control the vehicle. Unfortunately for some, driving may just be a bad idea. In that case, the DRS can direct you to transportation resources. More information about ADED-The Association for Driver Rehabilitation Specialists can be found at aded.net.
When adaptive equipment is needed
A DRS/CDRS can help determine if adaptive equipment is needed to help control the vehicle or access turn signal, wipers, etc. Training on safe and proficient use of the equipment should be completed prior to any installation in a vehicle. Depending upon the type of equipment recommended the cost can vary from a simple mirror of $5.00 up to a van conversion of $80,000. Vocational rehabilitation services in Kansas and Missouri, and some charitable organizations that advocate for individuals with disabilities offer programs that may help pay for adaptive devices.
In addition, automotive insurance may cover all or part of the cost of adaptive equipment if the need for such equipment is a result of a motor vehicle crash. Most major vehicle manufacturers offer rebates on adaptive equipment, usually up to $1,000, provided you purchase a vehicle less than one year old. Your local car dealer can supply information on these programs.
The National Mobility Equipment Dealers Association (nmeda.com) can help you apply for these rebates and can provide pre-purchase advice about the type of vehicle that will accommodate your adaptive equipment needs. Some states waive the sales tax for adaptive devices if you have a prescription for their use. The cost of adaptive equipment may also be tax deductible.
How parents can facilitate driving skills
I suggest working on pre-driving skills at a young age, which encourage independence, and allow the teen to focus on learning to control the car and integrating rules of the road, when the time comes. For example, my daughter was given the task of locating our car in parking lots as early as age four.
In general, developing motor skills, coordination and body positioning in space through dance, yoga, karate, riding a bike/tricycle, or participating in sports are good to consider. Visual activities to work on scanning skills are also helpful, such as games looking for state license plates, “slug bug”, and car bingo. As the child gets older, activities that encourage reading traffic signs, finding all the cars of a specific color, spotting all the red lights, or looking for addresses improve scanning skills. Work on finding the route finding from home to commonly travelled places such as a friend’s house, favorite restaurant, or school. Ask your child to give you directions as you drive or walk. Many parents assume their children know these routes, but often find it is not the case.
Set a good example in your own driving. A child often spends more time in a vehicle with their parent than other drivers. If we are asking them to be more attentive to driving skills, be prepared for them to watch you. Talk to them about the choices you make when driving. Get a copy of the driving handbook for your state and read it with them. It never hurts to brush up on the rules. Most of these activities will obviously involve transitioning their attention away from electronic devices and onto the road and their environment.
Even with individualized, professional training, some new drivers may require several trials in our driving program at Ability KC over a span of years to achieve safe, independent driving skills. When they are finally successful, the feeling of freedom and possibility is evident. For teens with special needs, sometimes getting behind the wheel puts them on even ground with other drivers because other drivers can’t tell if they are in a wheelchair, using hand controls, or special strategies. With some effort many people with special needs can find their road to independence.
Frequently asked Questions about AbilityKC’s Driving Program
http://www.rehabkc.org/ckfinder/userfiles/files/brochures/DrivingFAQ.pdf

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