I saw another client this week, let’s call him Matt, who has been really impacted by starting driving lessons with a standard driving instructor, and without input from a Driver-Trained Occupational Therapist. After hearing his story, I really think we need to get the word out to help others understand the impact.
Matt’s general OT had been working with him, developing life skills and supporting with readiness for driving (learning road rules, reviewing learner driver education material and Prep Ls). When he got his Learners, they searched for a driving instructor who would suit his needs, and found a driving instructor who’d said they were “specialised” and had lots of experience working with people with autism.
But… all it took was one, single driving lesson with this instructor, and Matt’s confidence, hopes, and motivation to learn to drive was completely shattered. Being neurodivergent, Matt has different learning needs to someone who is neurotypical. Matt was quickly overwhelmed with this instructors’ approach to lessons, and when he didn’t understand something, felt that the driving instructor only got more frustrated, demanding and heated in his communication with him. By the end of the lesson, Matt’s anxiety was through the roof, he didn’t want to do another lesson, and concluded he would never learn to drive. It was devastating.
Over a year later, with a whole heap of support and encouragement from his general OT, Matt agreed to give driving a try again. But this time, he was referred to Driving Well for a Potential to Drive assessment. This assessment is run across two sessions to allow time to explore an individual’s needs and readiness for learning to drive. Matt was so proud of himself in the second session when, despite his high anxiety about driving since his first experience, he was able to manage a driving lesson in a calm and supported environment. The outcome from his assessment was that, yes while his disability may impact his learning to drive, he does have potential to learn to drive with specialised supports in place. He was recommended driving therapy supports and specialised driving lessons, which he was over the moon excited about.
Unfortunately “regular” driving instructors often don’t have the knowledge, skills and experience to train someone who is neurodiverse. As OT Driving Assessors, we are linked in with driving instructors who underwent specialised training with driver trained OTs to understand and support people who are neurodiverse to learn to drive. These instructors are aware of learning preferences of people who are neurodiverse, and adjust their approach to suit their needs. We work closely with the specialised driving instructors throughout the lessons to make sure we are supporting the Learner as best we can to achieve their goals.
If you know a young person who is wanting to explore learning to drive, go to our website for more information or get in touch with our practice manager on 0407 671 621 or on admin@drivingwell.com.au
Driving presents a unique set of challenges for individuals with ADHD. The core characteristics of ADHD—difficulties with attention, impulsivity, and executive function—can directly impact the complex task of operating a vehicle. As an Occupational Therapist, I work with many drivers to develop personalised strategies that turn these challenges into manageable skills, enhancing both safety and confidence on the road.
Our team recently attended professional development with KidsLink, Jacquie and Caitlyn, who unpacked the (UK) National Institute for Health and Care Excellence ADHD guidelines: diagnosis and management.
Understanding the ADHD Brain Behind the Wheel
For a person with ADHD, the car can be an environment of sensory overload and competing demands. Common difficulties include:
– Sustained Attention: Maintaining focus during long or monotonous drives can be draining. The brain may seek out more interesting stimuli, leading to distraction.
– Distractibility: It’s easy to get lost in an internal dialogue or become preoccupied with a worry, causing you to miss a turn or a change in traffic conditions.
– Executive Functioning: Skills like planning a multi-step manoeuvre, sequencing actions for a lane change, and managing mental load are often challenging.
– Under-stimulation: On the other hand, if the driving task isn’t engaging enough, the mind can wander. This is why some drivers with ADHD lose focus on “simple” tasks like just monitoring traffic lights.
Practical Strategies for a Focused Drive
The key is not to “try harder” but to work smarter by using strategies that support the ADHD brain.
Clear the Mental Clutter Before You Drive:
– Before you even turn the key, take a moment to do a “brain dump”. Write down any pressing thoughts, worries, or items on your to-do list. Getting them out of your head and onto paper (or a phone note) frees up cognitive resources so you can dedicate them to driving. If a significant worry pops up mid-drive, it’s safer to pull over, note it down, and then resume your journey.
Use the “Focus Flashlight” Analogy:
-Think of your attention as a flashlight (or a torch). You can learn to control its beam. Are you “zoomed in” and hyper-focusing on one thing, missing the bigger picture? Or is your beam “scattered”, jumping between multiple things at once that may not be important? The goal is to develop a flexible, focused beam. Also, check your “battery level”. If you’re tired, your light will be dim, and your ability to focus will be low. Recognising this helps you make safer decisions about when and how to drive.
Make the Invisible, Visible:
– To combat the “look but don’t see” phenomenon, verbalise your actions. When checking mirrors, say the colour of the car you see (“blue car, grey car”). When approaching a green light, say “cars stopped, cars stopped, safe to go”. This forces your brain to process what your eyes are seeing and confirms your comprehension.
Increase Engagement to Beat Boredom:
– If a single task like scanning for traffic lights is not stimulating enough, add another layer. Challenge yourself to scan for traffic lights *and* speed signs. This concept of “gamification,” such as using a tally system for successful scans, can work well for short periods to build a new habit. The tally system allows competition between you and your driving supervisor – who was first to scan the traffic lights when taking off (if you don’t understand why this is important, check out the next point below).
Leverage Visual Learning:
– Dash-cam videos of near-misses or crashes (e.g., someone running a red light) can be a powerful tool to concretely demonstrate *why* safety habits like scanning every intersection are non-negotiable.
Learning to drive with ADHD is about building a toolkit of strategies that work for you. By understanding how your brain works and implementing supportive techniques, you can become a safe, confident, and focused driver.
As a driver-trained occupational therapist, most of my work focuses on helping people learn to drive or return to driving safely after injury, illness, or disability. Recently, I found myself in an unexpected position — not as the professional giving guidance, but as the driver in need of it.
I was on my way to a client appointment when my car began to lose power on a busy road. In those moments, it’s easy to feel flustered or panicked, but the key is to respond calmly and follow safe procedures.
Your primary goal in a breakdown is to protect yourself and others. Panicking can lead to rushed decisions that put you at greater risk. Take a deep breath and focus on the immediate steps you need to take.
If the car is still able to move, carefully steer it to the left-hand side of the road or the nearest safe shoulder. Avoid stopping around bends, at intersections, or in other locations with poor visibility.
Your hazard lights let other drivers know something is wrong and to approach with caution. If you can safely get out, place your reflective warning triangle at least 50–100 metres behind your vehicle (if available) to increase visibility — especially important in low light, poor weather, or high-speed zones.
The safest place in a breakdown often depends on your location:
Contact roadside assistance, a tow truck, or a trusted contact who can help. If you are in a dangerous position (e.g., broken down in a lane with no shoulder), call emergency services (000) and explain your location clearly.
After my breakdown, I reviewed my roadside kit. I realised I was missing a high-visibility vest and a warning triangle — items I now recommend to all my learner drivers. It’s also a great reminder to keep your mobile phone charged, know how to use your emergency brake, and regularly service your vehicle.
Here’s what I did — and what I recommend for anyone, whether you’re a brand-new driver or have decades of experience behind the wheel.
Final Thoughts
A breakdown can happen to anyone — even the most prepared driver. The key is knowing what to do before it happens. As a driver-trained OT, I encourage all my clients to practise these “what if” scenarios during lessons, because safe driving isn’t just about when the car is moving — it’s also about how we respond when it stops unexpectedly.
Stay safe out there, and remember: being calm, visible, and cautious can make all the difference in a roadside emergency.
This week is Queensland Road Safety Week – a time to come together as a community and focus on how we can all make our roads safer.
In 2024, 303 people lost their lives on Queensland roads and another 7,565 people were seriously injured. Tragically, this represents a 4.6% increase in road fatalities compared to the previous year. These numbers are more than just statistics – behind every one is a family, a friend, and a community forever changed.
Just recently, Queensland was reminded of how devastating road trauma can be, with a tragic crash in Logan where a driver was charged with manslaughter following the deaths of two pedestrians. Stories like this highlight why road safety must be a priority for all of us. Read more here.
Road safety isn’t just about rules and regulations – it’s about protecting the people we care about. Whether you’re driving to work, heading out with friends, or taking the kids to sport, every trip matters. Small decisions make a big difference.
Here are some simple but powerful ways we can all contribute:
Slow down – arriving a few minutes later is always better than not arriving at all.
Stay off the phone – distractions can wait until the car is parked.
Don’t drive tired – if you’re yawning or struggling to concentrate, it’s time for a break.
Drive sober – alcohol and drugs affect judgment and reaction time.
Belt up – seatbelts save lives, every time.
This Queensland Road Safety Week, we invite you to make a personal commitment to safer driving. What’s one thing you will change to keep yourself and others safe on the road?
I’ll take a breath – and won’t rush!
I won’t weave in and out of traffic.
If someone else is being reckless – I will “let them”.
I will pay attention!
I won’t drive tired.
I will avoid driving if I am drinking (even one glass).
We’re one team, Queensland – what is your action to drive like it?
💛 #oneteamqld
As an OT driving assessor, I am acutely aware of the complex interplay between medical conditions, medications, and driving safety. Medicinal cannabis is a growing area of interest—and concern—especially as more people access it to manage chronic conditions. Recently, we’ve been seeing an increasing number of people being prescribed medicinal cannabis. So what’s the impact on driving?
The Queensland Government maintains a strict zero-tolerance policy regarding driving with any detectable amount of THC in the system, regardless of whether the cannabis is used medicinally. This policy applies to all drivers, including those with a valid prescription for medicinal cannabis. A positive roadside drug test can result in immediate suspension, fines, or further legal action.
Many medicinal cannabis products contain THC, the psychoactive compound that can impair driving. Research consistently shows that THC impairs critical driving functions—judgment, motor coordination, and reaction time. Multiple studies link cannabis use to increased crash risk, with some showing the risk more than doubles.
THC’s effects can vary depending on dose, frequency of use, and individual metabolism, which makes setting a “safe” limit nearly impossible. This variability is a key reason behind Queensland’s continued zero-tolerance stance. Even if prescribed for legitimate medical reasons, THC may still impair driving. Importantly, roadside tests cannot distinguish between prescribed and recreational use. This means medicinal cannabis users are subject to the same legal penalties.
Recommendations for Medicinal Cannabis Users
As a driver-trained OT, my primary concern is the safety and well-being of all road users. While medicinal cannabis plays a crucial role in managing certain health conditions, its impact on driving ability must be carefully considered. Until further research provides clearer guidelines, it is imperative that individuals using medicinal cannabis exercise caution and adhere to current laws to ensure road safety.
For more information on drug driving laws and medicinal cannabis in Queensland, visit the Queensland Government’s Transport and Motoring website.
Today, I assessed Steve.
Steve is a professional heavy vehicle driver who was hit with a sudden and unexplained medical episode back in February. For about six weeks, he was unable to work — very unwell, undergoing tests and specialist reviews, including a neurologist. Thankfully, his symptoms gradually resolved, and he’s been feeling completely back to normal for several months.
But like many employers and workers in this situation, Steve and his employer didn’t know how to safely and officially return him to driving.
His doctors weren’t sure what was required for a heavy vehicle medical clearance. That’s where Driving Well OT comes in.
🚦Our Role in Returning Drivers to Work
At Driving Well, we specialise in supporting workers with medical conditions to safely return to driving, with governance under the Austroads Assessing Fitness to Drive guidelines.
For many health conditions, these national medical standards recommend an occupational therapy driver assessment to determine whether the driver’s medical condition affects their ability to drive — especially when the driver holds a commercial or heavy vehicle licence.
We provide comprehensive assessments and case management for return to work:
C-class (private licence) OT driving assessment
– Clinical review of medical history, vision, physical and cognitive function, and road law knowledge
– On-road driving assessment with an OT driver assessor and driving instructor – if this is all ok, we can then proceed to the next stage of heavy vehicle assessment
Heavy vehicle (MR/HR/MC etc.) practical assessment
– Conducted with a qualified OT driver assessor and heavy vehicle instructor
– Delivered in conjunction with Brisbane Truck School at Hemmant
Steve completed his C-class assessment a few weeks ago, and MC assessment today — and passed with flying colours.
He is cleared and ready to return to driving multi-combination vehicles professionally (after the paperwork is done of course). If this process had been started just three months earlier, both Steve and his employer would have avoided substantial financial loss.
Now if you weren’t already excited that Steve gets to have some normality back, and that his boss gets his truckie back on the road, and the circle of transportation continues, then hold onto your hats, cause this is about to get really exciting..
Thanks to the magic of ChatGPT, I was able to crunch some numbers about the average revenue and operational expenses involved in running a truck and transportation business. Here is the maths:
When a professional driver has a medical condition, the path back to work can be unclear — for the worker, the doctor, and the employer.
But waiting can be extremely costly.
A timely occupational therapy driving assessment not only ensures safety — it can significantly reduce downtime and loss. At Driving Well, we bridge the gap between recovery and return to work with clinical insight, functional assessment, and practical road testing tailored for commercial drivers.
Need help navigating this process for your worker or client?
Parkinson’s disease is a progressive brain disorder that affects movement and coordination. It occurs when nerve cells in a part of the brain called the substantia nigra become damaged or die. These cells produce dopamine, a chemical that helps control smooth and purposeful muscle movements.
You are probably familiar with the common motor symptoms of including tremors, muscle stiffness or rigidity, slowness of movement (bradykinesia) and impaired balance and coordination. But did you know that Parkinson’s can include “non-motor” symptoms too? These may include:
Each person’s with Parkinson’s disease is different. The “non-motor” changes vary can be subtle initially but may progress over time. Some individuals experience mild cognitive impairment (MCI) without significant impact on daily activities, while others may develop Parkinson’s disease dementia (PDD), characterized by more pronounced cognitive decline
What does this mean for driving?
Driving is a complex interaction between attention and perception, planning and judgement and motor coordination. Non-motor symptoms that affect executive functioning and visual-spatial processing may slow reaction speeds, slow planning and decision making, make multitasking more difficult and affect sustained attention. Motor symptoms may hinder make it more difficult to produce powerful and fast motor movements on the steering wheel and brake and accelerator pedals. This may hinder a person’s ability to rapidly scan a traffic situation, identify critical information, plan and make a decision and then execute that using the vehicle.
I’m concerned about my driving. What should I do?
Your first port of call is always to speak with your doctor – whether that be your GP, Neurologist or Geriatrician. The presentation and progression of Parkinson’s disease can vary between individuals and your doctor can complete a clinical review of symptoms, a medication review to screen for side effects and response, and recommend adjunct therapies such as Physiotherapy, cognitive therapies and lifestyle modifications that may help manage motor and non-motor symptoms. They can also refer you for a comprehensive occupational therapy driving assessment that will provide a practical assessment any impact the diagnosis may be having on your driving skill areas and make recommendations around driving to maximise your ability continue driving safely. Recommendations may include regular onroad review, restrictions around driving radius, times of day and vehicle type.
If you or someone you know requires an occupational therapy driving assessment, please feel free to contact Driving Well Occupational Therapy to arrange an assessment.
Imagine this: you’re behind the wheel, cruising down the highway, but your brain is battling a fog of fatigue. Your reactions are slower, your concentration slips, and your eyelids feel like they weigh a ton. This isn’t just a bad night’s sleep — it could be a symptom of obstructive sleep apnoea (OSA), a common yet underdiagnosed condition that has serious implications for driving safety.
What Is Obstructive Sleep Apnoea?
Obstructive sleep apnoea is a sleep disorder where a person’s airway becomes partially or completely blocked during sleep, causing breathing to stop and start repeatedly. Each pause can last from a few seconds to over a minute and may happen dozens or even hundreds of times a night.
The Anatomy Behind OSA
OSA occurs when the muscles supporting the soft palate, tongue, and throat walls relax during sleep. This can cause the airway to narrow or close, especially in people with:
Each time breathing stops, the brain briefly wakes the sleeper to reopen the airway — but these awakenings are so short, the person may not even be aware it’s happening. Over time, this disrupts restorative sleep and leads to chronic fatigue and poor concentration during the day.
Oxygen Loss to the Brain: The Silent Threat
One of the most serious effects of OSA is intermittent hypoxia — periods during sleep when the brain gets less oxygen than it needs.
Why Does This Happen?
When the airway is blocked, breathing temporarily stops or becomes shallow. This leads to a drop in blood oxygen levels (sometimes significantly), depriving the brain of a steady supply of oxygen. These oxygen dips can occur dozens or hundreds of times per night, often without the person waking fully.
What Are the Consequences?
How does this Affect Driving?
Driving safely relies on alertness, quick reflexes, and good decision-making — all of which are compromised in someone with untreated OSA.
Medical Fitness to Drive: What the Guidelines Say
According to Austroads medical standards for licensing, a person is not considered fit to hold an unconditional licence if any of the following apply:
Conditional Licensing
A conditional licence may be granted if:
If you or someone you know requires an occupational therapy driving assessment, please feel free to contact Driving Well Occupational Therapy to arrange an assessment.
How Sleepy Are You? Try the Epworth Sleepiness Scale (ESS)
The Epworth Sleepiness Scale (ESS) is a simple, self-reported questionnaire used to assess daytime sleepiness — a key symptom of obstructive sleep apnoea. It asks you to rate your likelihood of falling asleep in common situations on a scale from 0 (would never doze) to 3 (high chance of dozing).
Situation | Score (0–3) |
1. Sitting and reading | |
2. Watching TV | |
3. Sitting inactive in a public place (e.g., a theatre or meeting) | |
4. As a passenger in a car for an hour without a break | |
5. Lying down to rest in the afternoon when circumstances permit | |
6. Sitting and talking to someone | |
7. Sitting quietly after a lunch without alcohol | |
8. In a car, while stopped for a few minutes in traffic |
ESS Score | Interpretation |
0–7 | Normal sleepiness |
8–9 | Mild sleepiness |
10–15 | Moderate sleepiness (may require medical attention) |
16–24 | Severe sleepiness (strongly consider evaluation for a sleep disorder) |
A high score doesn’t diagnose sleep apnoea, but it does signal a need for further investigation — especially if you’re experiencing other symptoms such as loud snoring, gasping during sleep, or frequent morning headaches.
Obstructive sleep apnoea can deprive the brain of oxygen, disrupt concentration, and cause extreme drowsiness — all of which pose a serious risk to road safety. But with proper diagnosis, treatment, and support from professionals like OTs, people with OSA can continue to drive safely and responsibly.
If you’re experiencing signs of fatigue, poor concentration, or excessive daytime sleepiness — especially if you score high on the Epworth Sleepiness Scale — please reach out to your doctor. Early diagnosis and treatment can dramatically improve your quality of life and reduce the risk of a serious crash.
If you or someone you know requires an occupational therapy driving assessment, please feel free to contact Driving Well Occupational Therapy to arrange an assessment.
I have had the opportunity and pleasure to be able to provide clinical supervision about driving and vehicle modifications to my team, and also multiple driving OTs across the country.
It is really wonderful to hear their stories about how they were able to reflect, implement suggestions, and get great results with their clients.
Common questions and discussion points:
Often the OTDA already knows what to do and just needs to reflect this and talk it through.
Top 3 feedbacks:
I love supporting OTs with their development in this space. Together we achieve some pretty amazing things.
If you are a driving OT or a general OT working with clients in this space, and need a hand – please reach out and we can book a session together.
I am so grateful I have the pleasure of working with so many wonderful young people who are so motivated to learn to drive, excited about driving, and engaged in our “Get Driving” therapy sessions.
Every Wednesday at the moment I run clinic-based therapy sessions working with young people who are on the path of learning to drive. The “Get Driving” therapy sessions generally are designed to support learner drivers and returning drivers with developing underlying motor, visual and processing skills necessary for driving. Often we work through these sessions to develop skills, to prepare someone for specialised driving lessons with a driving instructor.
The sessions are one-on-one sessions that go for an hour and half, with a combination of activities that are completed in the clinic and out on the road with the client as a passenger in the car.
A session will typically look like this:
Please see this link here to get a handout which explains a bit more about what the Get Driving sessions involve.
This week was such a great reminder to me how privileged I am to be a part of this learning to drive process with young people. Each young person who walked into the clinic came in with a smile on their face, excited to tell me about the work they’d been doing at home to practice and develop their readiness for driving skills. They were all eager to engage in the session, actively asking questions and reflecting on their learnings. I’ve seen such growth in these young people, and it’s so exciting to me to be actively seeing and being a part of this journey with them.
Clients who do well with this program are:
Just last month I heard back from a client who had previously gone through this “Get Driving” support program with me, and then specialised driving lessons, and has now successfully gained her provisional license. Go Tara! What an achievement! We are so proud of you and wish you all the best with your driving career. Please drive safely and remember everything you’ve learned through this program!
If you would like more information about the potential to drive assessment approach, Get Driving supports or other services we provide you can check out our website!
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Driving Well Occupational Therapy is a busy practice that provides OT driving assessment and vehicle modification services for people with medical conditions and injuries in Brisbane, Ipswich and northern Gold Coast. We service clients who are self-funding, NDIS and other compensable (WorkCover, NIISQ, TAC, iCare).
On behalf of the team at Driving Well Occupational Therapy and in the spirit of reconciliation, I acknowledge the Traditional Custodians of Turrbul and Yuggera country, where our team live and serve the majority of our clients, as well as to all Traditional Custodians of country throughout Australia and their connections to the land, sea and community. I pay my respects to Elders past and present, and extend that respect to all First Nations people today.
On behalf of the team at Driving Well Occupational Therapy and in the spirit of reconciliation, I acknowledge the Traditional Custodians of Turrbul and Yuggera country, where our team live and serve the majority of our clients, as well as to all Traditional Custodians of country throughout Australia and their connections to the land, sea and community. I pay my respects to Elders past and present, and extend that respect to all First Nations people today.
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