Driving After Brain Injury
Maria T. Schultheis, PhD – Guest Editor
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Message from the Editor
The rapid evolution of technology has resulted in significant changes to our everyday life activities – including driving an automobile. Computing, communication, and sensor technologies are just some examples of technologies that have already been integrated into automobiles to create new benefits and assistance for drivers. These advances can allow individuals to remain behind the wheel and continue to experience the personal sense of autonomy and independent lifestyle that is often associated with being a driver. For an individual with a neurological compromise, and specifically brain injury, the ability to drive can be compromised by lingering cognitive, physical, sensory or behavioral difficulties resulting from the brain injury. However, many of these individuals retain the desire to maintain the driving privilege. And studies have demonstrated the significant negative impact on their ability to return to work, how they socialize and for many how they define their autonomy. And while the reasons for driving may vary throughout an individual’s lifetime, the importance of maintaining this privilege typically remains.
For clinicians working with these individuals, the task of determining whether they are ready to return to driving can be daunting. This critical decision requires a balance of understanding the potential risk (both to the individual and others) and the impact to that individual’s quality of life. It is this clinical dilemma that has personally fueled over 20+ years of conducting research to understand the very complex behavior. Along the way, it became clear to me that while the literature on examining driving capacity following brain injury continues to evolve, there remains limited sources that weave together the findings from the research literature with direct clinical implications. As such, this special issue of Brain Injury Professional aims to provide a resource for clinicians faced with this challenging clinical dilemma by providing a review of current topics related to driving after brain injury.
The issue begins with a clinician’s “cheat sheet” to provide clinicians with summary of key areas that have been addressed in the driving research literature and offers guidance on domains most relevant to assessment and determining capacity to drive. This is followed by articles addressing three top areas of driving research: aging, community integration and future driving assessment tools. The first of these introduces an important but often overlooked challenge of evaluating individuals who are aging with a brain injury. The issue presents consideration for the concomitant limitations and provides guidance for clinical recommendations. The second article provides a review of the current literature examining the relationship between driving and community re-integration and provide guidance for the role of professionals in assisting individuals with brain injury in navigating these changes. Finally, the third article, provides a glimpse into the future of driving assessment. Specifically sharing a summary of existing research that has focused on the development of clinically relevant driving simulators. These promising tools may provide clinicians with novel approaches to improve both our assessment and rehabilitation of driving related skills. This issue also includes an interview with both a clinical and an expert interview to provide insights into the importance of driving after brain injury.
The issue is designed to synthesize information from the research driving literature, assist the clinician in the translation of current research and provide guidance for clinicians. But most important, it is just one step in the long-term objective of developing evidence-based tools to help inform clinical decision making about driving capacity…because “The road to success is still under construction.”
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About the Editor
Maria T. Schultheis, PhD, is the Vice Provost of Research, within the Office of Research and Innovation at Drexel University in Philadelphia, PA. Dr. Schultheis is a tenured full professor in the Department of Psychology and she is a Clinical Neuropsychologist who received her PhD in Clinical Psychology in 1998. Dr. Schulthies’ clinical and research experience have been focused on the rehabilitation of cognitively impaired populations, including traumatic brain injury, stroke and multiple sclerosis. Specifically, she has specialized in 1) the application of technologies to improve clinical assessment and intervention and 2) studying the demands (physical, cognitive and behavioral) of driving following neurological compromise. This includes research focusing on the application of Virtual Reality (VR) technology and the development of VR as a tool for ecologically valid assessment and rehabilitation. Dr. Schultheis’ approach is interdisciplinary and her work intersects psychology, biomedical engineering, transportation, and rehabilitation medicine. As a researcher, Dr. Schultheis’ work has been supported by more than $5.8 million in public and private grants. She has consulted with the National Institutes of Health and the National Multiple Sclerosis Society, along with various international research agencies. She has published over 100 peer-reviewed articles, presentations and book chapters. In 2008, she published the “Handbook on Driving Assessment” a comprehensive resource for professionals involved in determining the driving capacity of individuals with neurological involvement and integrates clinical work on assessing driving capacity for different clinical populations and conditions.
Articles in this Issue
Driving After Brain Injury: A Clinician’s Cheat Sheet
Maria T. Schultheis, PhD, Elizabeth Whipple, PhD
Clinical Considerations for Older Adult Drivers with a History of Traumatic Brain Injury
Kayci L. Vickers, PhD
Driving, TBI and Community Integration
Monica L. De Iorio, MS , Lisa J. Rapport, PhD
Driving Simulation and the Future of Driving Assessment
Kevin J. Manning, PhD
Driving: A Client’s Perspective
Rebecca Williams, MS
Successful Driving After Brain Injury: A Research Perspective
Luke Miller, BS
Successful Driving after TBI: A Clinical Perspective
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