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Research Article  |   May 1993
Prediction of Behind-the-Wheel Driving Performance in Patients With Cerebral Brain Damage: A Discriminant Function Analysis
Author Affiliations
  • Thomas Galski, PhD, is Director of Psychology and Neuropsychology, Kessler Institute for Rehabilitation, East Orange, New Jersey, and Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey/New Jersey Medical School, Newark, New Jersey. (Mailing address: Kessler Institute for Rehabilitation, 240 Central Avenue, East Orange, New Jersey 07018)
  • Richard L. Bruno, PhD, is Staff Psychologist and Psychophysiologist, Kessler Institute for Rehabilitation, East Orange, New Jersey, and Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey/New Jersey Medical School, Newark, New Jersey
  • Holly T. Ehle, OTR, is Associate Director of Occupational Therapy, Kessler Institute for Rehabilitation, East Orange, New Jersey
Article Information
Community Mobility and Driving / Neurologic Conditions / Traumatic Brain Injury / Research
Research Article   |   May 1993
Prediction of Behind-the-Wheel Driving Performance in Patients With Cerebral Brain Damage: A Discriminant Function Analysis
American Journal of Occupational Therapy, May 1993, Vol. 47, 391-396. doi:10.5014/ajot.47.5.391
American Journal of Occupational Therapy, May 1993, Vol. 47, 391-396. doi:10.5014/ajot.47.5.391
Abstract

Rehabilitation specialists, particularly occupational therapists, are often involved in evaluating clients’ fitness to resume driving after cerebral damage due to head injury or stroke. Their available methods include separate or combined administration of predriver, simulator, and behind-the-wheel evaluations. However, use of these methods without a theoretical model on which to base test selection has yielded some criticism and little research about the effectiveness of these methods in predicting driving performance.

Using the authors’ Cybernetic Model of Driving as the basis for assessing abilities and behaviors relevant to driving outcome, this study sought to determine the effectiveness of the evaluation methods by discriminant analysis and measurements of sensitivity in predicting behind-the-wheel failures. Comprehensive evaluations of 106 patients revealed that residual deficits in cognition per se did not render a person unfit to drive and underscored the importance of considering behaviors in determining fitness. The methods of evaluation were shown to be relatively sensitive in predicting outcome; off-road and on-road evaluation reached sensitivities of 90% and 92% with the inclusion of behavioral measures. Formulae for predicting outcome based on methods of evaluation are provided and reasons for failures in behind-the-wheel evaluations are discussed.