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Monday, August 12, 2013

Driving Safely with Autism: Beth Israel's DriveWise and DriveAdvise Programs

From Beth Israel Deaconess Medical Center's "Human First" Program

August 8, 2013

The goal of DriveWise at Beth Israel Deaconess Medical Center is to provide objective information about driving safety while supporting individuals and their families.

For more information, please call (617) 667-4074.

 What is DriveWise?

Recognized as a national model, DriveWise offers an objective evaluation of driving safety for people of all ages who have experienced neurological, psychological and/or physical impairments. Because driving is important to one's independence, health care providers and family members are careful not to end driving privileges prematurely. On the other hand, delaying this decision can jeopardize safety.

DriveWise was developed by the divisions of Cognitive Neurology and Occupational Therapy at Beth Israel Deaconess Medical Center to help with this difficult decision making process. The program is comprised of a multidisciplinary team, including social workers, occupational therapists, and neuropsychologists. This unique team approach results in a thorough examination of driving performance.

What steps does the DriveWise evaluation include?

1.) Social Work Assessment - The participant is introduced to the program by a clinical social worker who takes a careful history and reviews the role of driving in the individual's life. Support for the individual and family members is provided.

2.) Occupational Therapy Assessment - The participant's physical, visual and cognitive abilities are assessed by the Occupational Therapist prior to the on-road evaluation. Standardized tests based on research and reflecting best practice are used to assess function.

3.) On-Road Evaluation - The Occupational Therapist and a certified driving instructor assess actual driving performance and safety during a standardized on-road evaluation using the driving instructor's car. This vehicle can be adapted to meet the needs of people with disabilities.

4.) Follow-up with Social Worker - A detailed written summary with recommendations from the team is reviewed with the participant at the follow up meeting. A copy of the report is sent to the referring physician. The social worker can provide educational materials on driving, arrange transportation alternatives, and/or refer participants to training programs to improve driving skills.


What happens if it is not safe for a participant to continue driving?

If driving cessation is recommended as a result of the evaluation, practical and emotional support is provided by the clinical social worker and alternative methods of transportation are identified.

What is the relationship between DriveWise and the Registry of Motor Vehicles?

If the participant is not safe to drive and does not follow the recommendation to stop driving, the DriveWise team may report findings to the Registry of Motor Vehicles.

Who can benefit from DriveWise?

Individuals of any age who have cognitive or motor problems that compromise driving safety may benefit from DriveWise.

How are referrals made?

Family members, primary care physicians, or specialists may make referrals by calling Beth Israel Deaconess Medical Center's Division of Cognitive Neurology at (617) 667-4074.

What is the cost of the program?

This program is primarily fee-for-service. However, some insurers may cover a portion of the driving evaluation. Due to wide variations in coverage, all participants are strongly urged to check with their own insurance plans.

How can I help pay for others in the community who cannot afford this service?

We welcome your donations to our scholarship fund, which covers the cost of this important service for those unable to pay. Please call (617) 667-4074.


DriveAdvise is a new pre-driving assessment program offered as part of DriveWise. Similar to DriveWise, DriveAdvise utilizes the multidisciplinary team approach to assess driving readiness and capacity. DriveAdvise is targeted for people who have never driven and are considering learning to drive, or for those who had driven but have stopped driving for a number of years due to a medical or neuropsychiatric illness.

The assessment begins with an interview with a clinical social worker. This meeting focuses on motivations for learning or returning to driving as well as current lifestyle adjustments related to transportation needs.

The patient will then meet with an Occupational Therapist, experienced in evaluating driving safety. The OT will test cognitive functions such as attention, memory and processing speed and also physical functioning, such as brake reaction time, strength and range of motion. A computer based test that measures visual functions critical to driving will be used.

Following the assessment the team will meet and write a letter summarizing findings and recommendations. These recommendations will be shared with the patient and family in a meeting with the social worker. The goal of DriveAdvise is to promote maximum independence while balancing safety needs for those patients who are trying to decide if learning or relearning how to drive is feasible and safe.

DriveWise has been featured on television and in the press:

DriveWise Research Publications
  1. Lee, A.K., Phillips L.K., Wolkin J.R., Hollis, A., Kapust L. & O'Connor M. (2011). The 90 Year Old Driver: The "Oldest Old" is the new "Old". Poster presented at the International Neuropsychology Society 39th Annual Meeting. Feb 2-5 2011
  2. O'Connor, M.G., Kapust, L.R., Lin B., Hollis A.M. & Jones R.N. (2010). The 4C's (Crash History, Family Concerns, Clinical Condition and Cognitive Functions): A Screening Tool for the Evaluation of the At Risk Driver. Journal of the American Geriatrics Society, 58(6), 1104-1108. 
  3. O'Connor M & Kapust L (2009): Are Parkinson's patients safe to drive? How can the clinician decide. Poster presented at the 9th international AD/PD conference March 11-15 2009. 
  4. O'Connor, M.G., Kapust, L.R. & Hollis, A.M. (2008). DriveWise: An Interdisciplinary Hospital Based Driving Assessment Program. Gerontology & Geriatrics Education, 29(4), 351-362. 
  5. Elkin-Frankston, S., Lebowitz, B.K., Kapust, L.R., Hollis, A.M. & O'Connor, M.G. (2007). The use of the Color Trails Test in the assessment of driver competence: Preliminary report for a culture-fair instrument. Archives of Clinical Neuropsychology, 22(5), 631-635. 
  6. Deveney C.M., Namji S, Kapust L.R., Hollis A.M. & O'Connor M.G. (2006). Neuropsychological predictors of on road driving performance. Journal of the International Neuropsychological Society, 12(S1), 26. 
  7. Kapust L.R., & Weintraub (1992). To drive or not to drive: preliminary results from road testing of patients with dementia. Journal of Geriatric Psychiatry and Neurology, 1992 Oct-Dec;5(4):210-6.

NESCA (Neuropsychology and Education Services for Children and Adolescents) is a pediatric neuropsychology group practice in Newton, MA whose senior clinicians and allied staff evaluate and treat a wide range of complex learning, developmental and emotional disorders. Seeking to identify and empower the best in each child, they also address special education issues and school placements, often observing children in their classrooms and participating in TEAM meetings. NESCA has served clients from throughout the U.S. and more than twenty other countries.

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