Sherrilene Classen, Orit Shechtman, Kezia D. Awadzi, Yongsung Joo, Desiree N. Lanford; Traffic Violations Versus Driving Errors of Older Adults: Informing Clinical Practice. Am J Occup Ther 2010;64(2):233–241. https://doi.org/10.5014/ajot.64.2.233
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© 2020 American Occupational Therapy Association
Certain driving errors are predictive of crashes, but whether the type of errors evaluated during on-road assessment is similar to traffic violations that are associated with crashes is unknown. Using the crash data of 5,345 older drivers and expert reviewers, we constructed a violation-to-error classification based on rater agreement. We examined the effects of predictor variables on crash-related injuries by risk probability using logistic regression. Drivers’ mean age was 76.08 (standard deviation = 7.10); 45.7% were women. Of drivers, 44.6% sustained crash-related injuries, and female drivers had a higher injury probability (44%) than male drivers (29%). Lane maintenance, yielding, and gap acceptance errors predicted crash-related injuries with almost 50% probability; speed regulation (34%), vehicle positioning (25%), and adjustment-to-stimuli (21%) errors predicted crash-related injuries to a lesser degree. We suggest injury prevention strategies for clinicians and researchers to consider for older drivers, especially older women.
Vehicle position: the position of the vehicle (anterior or posterior) in relation to other vehicles or objects and pavement markings, including following distance during forward movement and vehicle spacing during lane changes and merges. An example of such an error is inadequate space cushion during merge or lane change.
Lane maintenance: the lateral positioning of the vehicle during driving maneuvers (turns, straight driving, lane changes) and while stopped, indicating the ability to maintain steering control. An example of such an error is drifting out of the driving lane.
Speed regulation: the ability to follow and maintain speed limits and maintain adequate control of the vehicle’s acceleration and braking features. An example of such an error is traveling too slow or too fast.
Yielding: giving the right of way when appropriate, indicating the ability to recognize common rules of road safety. Yielding is assessed at four-way or two-way stop intersections, right turns on red, and merges.
Signaling: the proper use of turn signals. An example of such an error is leaving the turn signal on or not using the turn signal when turning.
Adjustment to stimuli and traffic signs: the ability to appropriately respond to driving situations such as changing road sign information, vehicle movements, pedestrian movements, or potential hazards. An example of an error is choosing an improper lane from posted signage or an improper response to traffic or pedestrian movement.
Gap acceptance: choosing an appropriately safe time, spacing distance, or both to cross in front of oncoming traffic, such as during an unprotected turn. An example of such an error is faulty driver judgment in estimating distances that are either too short or too long for the given speed and distance to be traveled.
Visual scanning: demonstrating visual scanning of the driving environment. An example is not checking the blind spot or not looking left and right before proceeding through intersection.
DRSs need to pay special attention to high-probability errors resulting in injury, that is, lane maintenance, yielding, and gap acceptance errors. These errors must be carefully evaluated as a high-risk category during on-road assessments and be noted as such.
Client factors (such as body structures, e.g., frailty), performance skills (such as motor skills, e.g., response time), process skills (e.g., processing speed), and contextual characteristics (e.g., demands of the physical roadway environment) underlying these errors must be evaluated, identified, and remediated.
DRSs should weight their on-road assessment scoring system to account appropriately for errors with a high probability of injury.
Drivers who make errors that fall within this category, and their family members and physicians, need to be educated on the potential risks associated with such errors.
Drivers prone to making these errors must be referred to a driving rehabilitation program for remediation of client factors (e.g., behind-the-wheel training), adaptation to the vehicle (e.g., adjustment to seat height for proper positioning), or referral to other specialists providing interventions (e.g., ophthalmologist).
If the errors are irremediable, as determined in follow-up evaluations, more rigorous steps should be taken, such as recommending the use of alternative forms of transportation or driving cessation.
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