| 1. |
- Almberg, Maria, et al.
(författare)
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Experiences of facilitators or barriers in driving education from learner and novice drivers with ADHD or ASD and their driving instructors
- 2017
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Ingår i: Developmental Neurorehabilitation. - : Taylor & Francis. - 1751-8423 .- 1751-8431. ; 20:2, s. 59-67
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little is known about whether individuals with autism spectrum disorder (ASD) or attention deficit hyperactive disorder (ADHD) experience any specific facilitators or barriers to driving education.Objective: To explore the facilitators or barriers to driving education experienced by individuals with ASD or ADHD who obtained a learner’s permit, from the perspective of the learner drivers and their driving instructors.Methods: Data were collected from 33 participants with ASD or ADHD, and nine of their driving instructors.Results: Participants with ASD required twice as many driving lessons and more on-road tests than those with ADHD. Participants with ADHD repeated the written tests more than those with ASD. Driving license theory was more challenging for individuals with ADHD, whilst individuals with ASD found translating theory into practice and adjusting to “unfamiliar” driving situations to be the greatest challenges.Conclusion: Obtaining a driving license was associated with stressful training experience.
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| 2. |
- Larsson, Helena, et al.
(författare)
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A Swedish survey of occupational therapists' involvement and performance in driving assessments
- 2007
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 14:4, s. 215-220
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to examine the extent to which occupational therapists (OTs) are involved in driving assessments in Sweden and how these assessments are performed. A questionnaire was sent to 154 geriatric, rehabilitation, and neurological clinics, and additionally directly to 19 OTs who had purchased a test battery specifically used for driving assessments. The response rate was 60%. Of those responding, 57% reported being involved in fitness-to-drive assessments. However, such assessments were carried out in various manners and diverse methods were used, ranging from unstandardized activity assessments to a test developed specifically for driving assessments. Only 19% used on-road driving tests as a complement to the clinical assessments. Apart from the lack of appropriate methods, the respondents said that they did not have sufficient knowledge to perform driving assessments and expressed a need for further education. In the future it seems necessary for OTs in Sweden to undergo specialized training and perform the assessments on a regular basis to maintain a high level of competence as driving assessors.
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| 3. |
- Lee, Hoe C, et al.
(författare)
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Is it reliable to assess visual attention of drivers affected by Parkinson's disease from the backseat? - a simulator study
- 2012
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Ingår i: Emerging Health Threats Journal. - : Informa UK Limited. - 1752-8550. ; 5:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Current methods of determining licence retainment or cancellation is through on-road driving tests. Previous research has shown that occupational therapists frequently assess drivers' visual attention while sitting in the back seat on the opposite side of the driver. Since the eyes of the driver are not always visible, assessment by eye contact becomes problematic. Such procedural drawbacks may challenge validity and reliability of the visual attention assessments. In terms of correctly classified attention, the aim of the study was to establish the accuracy and the inter-rater reliability of driving assessments of visual attention from the back seat. Furthermore, by establishing eye contact between the assessor and the driver through an additional mirror on the wind screen, the present study aimed to establish how much such an intervention would enhance the accuracy of the visual attention assessment.METHODS: Two drivers with Parkinson's disease (PD) and six control drivers drove a fixed route in a driving simulator while wearing a head mounted eye tracker. The eye tracker data showed where the foveal visual attention actually was directed. These data were time stamped and compared with the simultaneous manual scoring of the visual attention of the drivers. In four of the drivers, one with Parkinson's disease, a mirror on the windscreen was set up to arrange for eye contact between the driver and the assessor. Inter-rater reliability was performed with one of the Parkinson drivers driving, but without the mirror.RESULTS: Without mirror, the overall accuracy was 56% when assessing the three control drivers and with mirror 83%. However, for the PD driver without mirror the accuracy was 94%, whereas for the PD driver with a mirror the accuracy was 90%. With respect to the inter-rater reliability, a 73% agreement was found.CONCLUSION: If the final outcome of a driving assessment is dependent on the subcategory of a protocol assessing visual attention, we suggest the use of an additional mirror to establish eye contact between the assessor and the driver. The clinicians' observations on-road should not be a standalone assessment in driving assessments. Instead, eye trackers should be employed for further analyses and correlation in cases where there is doubt about a driver's attention.
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| 4. |
- Selander, Helena, 1975-, et al.
(författare)
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Does Automatic Transmission Improve Driving Behavior in Older Drivers?
- 2012
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Ingår i: Gerontology. - : Karger. - 0304-324X .- 1423-0003. ; 58:2, s. 181-187
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Tidskriftsartikel (refereegranskat)abstract
- Background: Most older drivers continue to drive as they age. To maintain safe and independent transport, mobility is important for all individuals, but especially for older drivers. Objective: The objective of this study was to investigate whether automatic transmission, compared with manual transmission, may improve the driving behavior of older drivers. Method: In total, 31 older drivers (mean age 75.2 years) and 32 younger drivers used as a control group (mean age 39.2 years) were assessed twice on the same fixed route; once in a car with manual transmission and once in a car with automatic transmission. The cars were otherwise identical. The driving behavior was assessed with the Ryd On-Road Assessment driving protocol. Time to completion of left turns (right-hand side driving) and the impact of a distraction task were measured. Results:The older group had more driving errors than the younger group, in both the manual and the automatic transmission car. However, and contrary to the younger drivers, automatic transmission improved the older participants driving behavior as demonstrated by safer speed adjustment in urban areas, greater maneuvering skills, safer lane position and driving in accordance with the speed regulations. Conclusion: Switching to automatic transmission may be recommended for older drivers as a means to maintain safe driving and thereby the quality of their transport mobility.
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| 5. |
- Selander, Helena
(författare)
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Driving assessment and driving behaviour
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionDriving is an important part of everyday life and represents independence. Activities, both productive and social, may be affected if a person can no longer drive. Older drivers, as a group, have a low crash rate. On the other hand, driving may be affected by medical conditions in this group, for example dementia or stroke, which often call into question a person’s fitness to drive. However, there are older drivers who may benefit from compensatory strategies to prevent driving cessation.AimThe aim of the thesis was to examine driving assessments methods, both off-and on-road tests, and if an intervention may improve driving behaviour for older adults.The specific aims were to:examine how occupational therapists (OTs) are involved in driving assessments in Sweden, what methods are used and how these assessments are performed;determine whether the commonly used cognitive test battery, the NorSDSA, could predict an on-road test results for stroke and cognitive deficits/dementia participants;investigate driving errors characteristic in older drivers without cognitive impairments and identify relationships between off-road and on-road tests results;investigate whether automatic transmission, compared with manual transmission, may improve driving behaviour of older and younger drivers.MethodsIn Study I, a questionnaire was sent to 154 geriatric, rehabilitation and neurological clinics and additionally directly to 19 OTs. In Study II, data consisted of test results from 195 clients who had completed a fitness to drive assessment. In Study III, 85 older volunteer drivers were assessed regarding their vision, cognition and driving behaviour. In Study IV, 31 older drivers and 32 younger drivers were assessed twice on the same fixed route; once in a car with manual transmission and once in a car with automatic transmission.ResultsDriving assessments were carried out by OTs in various manners and diverse methods were used. Most OTs used off-road tests; tests developed specifically for driving assessments or un-standardised activity assessments. Even though few off-road tests can predict driving performance, only 19 % of the OTs used on-road test. The off-road test NorSDSA could neither predict an outcome of an on-road test for stroke clients, nor for cognitive deficits/dementia clients. Some of the older volunteer drivers displayed questionable driving behaviour, although they were fit to drive and a total of 21 % failed the on-road test. Using automatic instead of manual transmission was shown to improve older, but not younger drivers’ driving behaviour.ConclusionsFor OTs in Sweden, driving assessments are challenging, since there are no specified guidelines regarding the appropriate assessment tools. Assessors often solely rely on cognitive test(s) when assessing their clients. NorSDSA should not be used as a stand-alone test when determining fitness to drive. The lack of guidelines can be problematic for OTs, but also for the clients, since there is a risk that they do not receive a valid and reliable assessment. To perform these kinds of assessments there is a need for specialised training. On-road assessments are seen as the gold standard but that standard needs to encompass driving problems or errors that are “normal” driving behaviours in older persons. To switch from manual to automatic transmission may be a way to assist older drivers to continue driving and maintain the quality of their transport mobility.
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| 6. |
- Selander, Helena, 1975-, et al.
(författare)
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Older drivers: On-road and off-road test results
- 2011
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Ingår i: Accident Analysis and Prevention. - : Elsevier Science B.V., Amsterdam.. - 0001-4575 .- 1879-2057. ; 43:4, s. 1348-1354
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Tidskriftsartikel (refereegranskat)abstract
- Eighty-five volunteer drivers, 65-85 years old, without cognitive impairments impacting on their driving were examined, in order to investigate driving errors characteristic for older drivers. In addition, any relationships between cognitive off-road and on-road tests results, the latter being the gold standard, were identified. Performance measurements included Trail Making Test (TMT), Nordic Stroke Driver Screening Assessment (NorSDSA), Useful Field of View (UFOV), self-rating driving performance and the two on-road protocols P-Drive and ROA. Some of the older drivers displayed questionable driving behaviour. In total, 21% of the participants failed the on-road assessment. Some of the specific errors were more serious than others. The most common driving errors embraced speed: exceeding the speed limit or not controlling the speed. Correlations with the P-Drive protocol were established for NorSDSA total score (weak), UFOV subtest 2 (weak), and UFOV subtest 3 (moderate). Correlations with the ROA protocol were established for UFOV subtest 2 (weak) and UFOV subtest 3 (weak). P-Drive and self ratings correlated weakly, whereas no correlation between self ratings and the ROA protocol was found. The results suggest that specific problems or errors seen in an older persons driving can actually be "normal driving behaviours".
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| 7. |
- Selander, Helena, et al.
(författare)
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The Nordic Stroke Driver Screening Assessment as predictor for the outcome of an on-road test.
- 2010
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 17:1, s. 10-17
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Tidskriftsartikel (refereegranskat)abstract
- The use of the cognitive test battery Nordic Stroke Driver Screening Assessment (NorSDSA) has increased, sometimes as a stand-alone test to evaluate fitness to drive, also for non-stroke patients such as patients suffering from cognitive deficits/dementia, approaches that may be questioned. The objective of the study was to determine whether the NorSDSA could predict an on-road test result, for large sets of stroke ( n=74) and cognitive deficits/dementia participants ( n=116), respectively. The percentage of correctly classified was 62% for the stroke group and 50% for the cognitive deficits/dementia group. A discriminant analysis with pass/fail on the on-road test as grouping variable could classify 62% of the stroke participants and the cognitive deficit/dementia participants. Hence, the NorSDSA could not predict the outcome of the on-road test. Therefore, NorSDSA should not be used as a stand-alone test to determine the fitness to drive of individual participants. Also, its use with participants suffering from cognitive deficits/dementia appears to be less successful than for clients with stroke.
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