All occupational therapy practitioners play a role with addressing driving. It is the role of the generalist OT to address driving risk and the role of the OT driver rehab specialist to look at fitness to drive.
If we think about this in simple terms, the primary (or generalist) OT is screening. It is the role of this OT to identify risk, help to recover, rehab, & remindate as much as possible, and then refer to the OT driver rehab specialist (OT DRS). It is then the role of the OT DRS to evaluate fitness to drive. Specifically the OT DRS is looking at the impact of a medical condition or injury on driving performance. If we take this one step further, the OT generalist can work on anything and everything leading up to turning on the engine of the vehicle. Once we turn on the engine, this becomes a speciality area of practice and the domain of the OT DRS. I like using the engine as a dividing point because an OT can help with transfers, seat belt application, seating and positioning. These are all tasks needed to prepare for driving and within the scope of occupational therapy. Furthermore, all of the skills worked on by the OT, as defined in OTPF III include reimbursable services. When the OT generalist addresses driving risk they help to problem solve pre driving challenges and ensure that the client is referred to the OT DRS at the right time. This is imperative for appropriate access to resources, being judiciary with financial resources, and occupational justice.
- The OT generalist can perform a driving risk assessment. This includes review of vision, cognition, motor skills, & other IADLs. A great resource for learning how to do this is the Generalist Resource to Integrate Driving (GRID). https://
adaptivemobility.thinkific. com/courses/GRID. As a footnote, some clinics are using the term "pre-driving" or "clinical assessments" for this type of testing. It is important that we move away from this language and start calling this activity a driving risk assessment. This assessment is completed as part of the plan of care, it is reimbursement, and should be included as an intervention for any patient being discharged to home how was previously a driver. It is also important to note that the OT completing clinic based assessments is not an OT DRS. The OT DRS is an individual who has obtained advanced training in driver rehabilitation and has had experience/training in a moving vehicle. The OT DRS understands the connection between the clinic and the vehicle.
I encourage all OTs to take Occupational Therapy for Driving & Community Mobility. https://
After you take this free course, and become excited about your role as an OT, I recommend taking both the Generalist Resource to Integrate Driving and Part 1 In the Clinic: Building Blocks. Part 1 gives you 25 hours of online education focused on sharpening your clinical assessment skills needed to complete a driving risk assessment. This course bundle will strengthen your skills and confidence. I strongly encourage this bundle for OTs in outpatient clinics, acute rehab, and long term rehab.
Then, if you are called to become an OT Driver Rehab Specialist, the next step is to take Part 2 In the Car: Take the Wheel. This dynamic, interactive course, is for the OT practitioner preparing to expand into the field of driving rehabilitation. Take the Wheel includes online preparation work, plus 3 days of hands-on training, with experienced occupational therapy driver rehabilitation specialists, in a driving rehabilitation vehicle. This course is one of a kind & a must for any occupational therapy practitioner preparing to participate in behind-the-wheel driving evaluations & treatment. Be prepared for the field of driver rehabilitation! Practice your skills before getting into the car with a patient! Benefit from online coursework to maximize your time in the rehab vehicle. Gain valuable hands-on time by practicing as the driver rehabilitation specialist in the passenger seat, as the driver with adaptive equipment, and as an observer.
A funny little known fact, you actually have to become an OT DRS before you become certified. In the world of driver rehabilitation, certification is offered to a range of medical & non-medical professionals who have gained experience (~840 -1600 hours) as a driver rehab specialist. You must complete your advanced education and gain hands-on experience with clients before you apply and sit for your certification exam. In addition, as an OT DRS you will need to follow any state specific requirements outlined by your state driver's licensing administration. As many OTs hesitate to start in a field without obtaining their certification, ADED has added a 'driver rehab professional' (DRP) badging option. This badge may be obtained by any OT who has completed Part 1 & Part 2 of Adaptive Mobility Services education (as noted above) and completes the application & quiz process as outlined by ADED. Adaptive Mobility is proud to support this new process and many of the new DRP are Adaptive Mobility graduates.
I think the biggest challenge I face is mindset. Mindset around the idea that I, as an occupational therapist, can and should carve my own path. When I was in school, our program focused on training us to be exceptional OTs who worked in larger systems - healthcare or the school system. While many OT DRS work for hospital systems, I have found true joy in starting and running my own private practice. This is something I never imagined for myself and something I regret not doing sooner. I truly believe that it was my own mindset that held me back. I never considered myself someone who might be a business owner, or who could do this on her own. Stepping into this has expanded my limiting mindset and is helping me to create an incredible future.
Another challenge we face is that we, as OTs, are often bleeding hearts. We can be overly empathetic with our patients, and worry too much about finances and resources. As a result, we often devalue our own role. This is a huge problem. OTs are worth their weight in GOLD. We need to be proud of the services we offer and proud of our unique clinical reasoning and problem solving skills. This limiting mindset around money and value has impacted our ability to market ourselves and spread the word about our important work. So, when I work with new OT DRS, confidence & marketing are often a big challenge. It takes a little work, but with some good coaching, we find that our innate OT skills actually make use natural at marketing!
Helping someone achieve freedom and mobility by being able to drive independently. Many of us are lucky enough to have friends and family ready to lend a hand, run an errand, and give us a ride, but let's face it. There is NOTHING, and I mean NOTHING like being able to drive yourself somewhere alone. This feeling never gets old and it is humbling and exhilarating with each client.