Driving Well Occupational Therapy, Author at Driving Well Occupational Therapy

I saw a client recently who had been involved in a car accident, let’s call him Chris. He has autism and anxiety. Chris had worked his way to his green Ps through sheer determination. His mum doesn’t drive, so he’d arranged over 100 standard driving lessons himself to learn to drive and gain his 100 hours. He had no input from any health professionals, and didn’t know that he should. He said he managed to pass his practical driving test on the first go and didn’t think he had any challenges with his driving, although noted often people beeped at him for driving too slowly.

Chris said at the time of the accident, he was a delivery driver and felt really stressed by needing to make the delivery within a set timeframe and his workplace tracking his location. He said he was driving at night, stressed about making the delivery, trying to navigate to the location using maps; and whilst driving up a hill, he ran into the back of another car. Chris said he’d been anxious, overwhelmed and distracted.

Chris’s story had me thinking… Could this have been prevented if he had been referred to a driver trained OT earlier in his driving journey? Of course, we all get stressed, anxious and overwhelmed sometimes. Mistakes do happen. But if Chris had been involved in a Potential to Drive assessment before learning to drive, he could have been taught strategies to reduce this risk. He could have been taught strategies to recognise when he’s starting to feel overwhelmed, and how to manage it when he is. He could have been taught critical items to look out for and how to prioritise these. He could have been taught planning, problem solving, and judgement skills in a safe space, so that maybe navigating to a new place wouldn’t have been as stressful.

In the potential to drive approach, we explore a person’s individual needs and create a specialized driver training plan which can include therapy, specialized lessons, and home practice to help Learner drivers get on the road safely.

If you or someone you know comes to mind when reading this, please reach out to Driving Well team and we can chat through the process.

The journey to finally receiving his customized wheelchair accessible vehicle has taken a little over a year in the making for one of our lovely clients. I first met our client in June 2023. He was a young man living with his parents following an acquired brain injury. Our client experienced some functional decline and could no longer stand to transfer into their existing unmodified van and standard car seat. The transfer into the van was difficult and placed both he and his carers at risk of injury. In turn, this severely limited and restricted his community access and participation.

Fortunately, our client had a manual wheelchair, that was suitable for wheelchair occupant travel as it had been crash tested and had appropriate postural support including backrest and headrest.

We were able to successfully trial a lowered floor conversion Kia Carnival through KM Kite, an experienced vehicle modifier with a tried and tested engineering certification with this type of vehicle modification for wheelchair occupant travel. Our client was able to be positioned in the second row, behind the front seats with his carers or family being able to sit on either side beside him.

Following the successful trial of this vehicle modification, we were able to apply for ‘In principle approval’ of this vehicle modification through the extensive NDIS Assistive Technology Vehicle Modification process. A few months later we were given NDIS approval for this request, pending purchase of a suitable vehicle. The client’s previous van was traded in for a new Kia Carnival, and after a few months wait, the vehicle was able to be taken to the KM Kite Factory where over a period of six weeks was successfully modified with a lowered floor, ramp for wheelchair access that has electronic front retractors and a winch to reduce the manual handling demands on entry and exit of the vehicle. An additional 2 rear folding seats have also been installed to enable our client to travel with other family members as well.

While the journey was a year in the making, the client, his family and carers are exceptionally pleased their modified vehicle which has been completed to a high standard, that not only looks amazing, but is safe and complies with Australian Standards for wheelchair occupant travel. Our client and his family can now travel safely daily in the community to attend appointments, go shopping, church on a weekly basis and get back into swimming and visiting family as well. The options for places to visit are almost endless!

If you or someone you know wants to know more about wheelchair accessible vehicles or wheelchair occupant travel, contact us at Driving Well Occupational Therapy to find out more.

I was absolutely thrilled to be the Inaugural recipient of the OT Australia “Oration” award – for a clinician who has been innovative in their work and significantly contributed to the profession of occupational therapy across Australia. The award involved providing a keynote address at the OT Exchange conference, which was held in Perth in June 2024.

We actually have a recording of the keynote address available through the Drive-Able podcast!

Applying for the award

The application process for the award included writing a personal statement, which I am going to share with you here, as it beautifully sums up my story about how I came to be working and teaching OTs in this Potential to Drive approach.

“In 2019 I advised a 22 year old woman that despite her efforts, she would likely never drive because the challenges of her disability were too severe. She was devastated. It was an awful conversation and I thought “there has to be a better way” to assess and support clients with neurodivergence and psychosocial disabilities wanting to learn to drive.

My curiosity and drive for improvement lead me to finding Dr Monahan in 2020, and with her guidance I pioneered implementation of the “Potential to Drive” approach in Australia. More than 160 driver-trained OTs and rehabilitation driving instructors have attended more than seven workshops transforming clinical practice across the country.

I also collaborated with Dr Monahan to adapt the ‘Drive Focus’ app and bring it to Australia, to date supporting hundreds of young Australians with a disability with their driving goal. I took a leap to then facilitate Drive Focus’ worldwide OT conference debut at OT Exchange in Melbourne 2022 and featured live on the Communities of Practice Facebook group, bringing the app to the attention of thousands of non-driver and driver trained occupational therapists. My work was recognised nationally winning the Australian Road Safety Foundation awards in 2021 and Finalist at Australian Disability Services Awards in 2022.

Innovation never ends: I have also developed a driving therapy program, online toolkit and webinars to support OTs and families. I’m sought after for clinical supervision, inservices, OTA Hot Topic and podcasts, and was recently featured in ABC news stories highlighting updates in licencing guidelines for autism and driving.

My contribution has indeed been outstanding and impactful to the practice of occupational therapy: Australia’s OTs are better prepared to address the question of potential to drive because of my curiosity, leadership and innovation.”

Dr Miriam Monahan

Perhaps the luckiest moment of my career was at the start of COVID, when I discovered Dr Miriam Monahan (OT driver assessor / driving instructor / researcher / lecturer / Drive Focus app developer in the USA) in a US news story online, googled her, reached out through her Drive Focus website, and was on a zoom with her within about 48 hours… our collaboration has led to running the potential to drive training all across Australia, with almost 200 OTDAs and driving instructors having now completed the training and implementing this approach into their practice.

Dr Monahan is an experienced presenter – I have had the pleasure of facilitating nine potential to drive workshops plus other webinars with her, and was ever in awe about her knowledge and how generously she shared her learnings.

Because of these neurological changes and reduced connectivity within the brain, when compared with neuro-typical teens/youth, research has found that learning to drive with autism has common challenges such as[i]:

It is estimated that approximately 62% of the American population with ASD have high functioning ASD, more than half will pursue learning to drive, and one in three teens with ASD will become licenced drivers[ii].
Learner drivers require three times longer to learn to drive
Driving habits are typically that they drive less, and tend to drive more in the local area to defined routes and destinations

Autism characteristics that may impact driving include:

reduced motor coordination: coordination of limbs for physical control (steering, braking, accelerating), and visual motor integration
social challenges: literal interpretation of things, interpreting non-verbal cues eg lights, tailgaters, intentions of other drivers when changing lanes etc
executive functions: often not able to see the big picture and overall understanding of traffic flow through intersections; problem solving; planning ahead; mental flexibility; divided attention
visual search skills: “look but do not see”, focusing on the horizon versus scanning near and far, take longer to find critical information, experience cognitive overload
Anxiety is a very common disorder associated with ASD; learner drivers found anxiety to be a barrier for learning to drive[iii]

The workshops

We aren’t giving away all the secrets in this blog post! The workshop will provide you a deeper dive into understanding the research that has been completed with driving and autism and other conditions (there is a lot that is now known). This will help you to understand how features and challenges of a person’s diagnosis may impact them, and how to best support them.

Models underpinning Potential to Drive approach

Research evidence
Michon’s model of driving performance – operational, tactical and strategic skills, and looking for evidence of these abilities in the young person’s lifeskills.
Information Processing Model for driving: Vision and visual search -> information processing/decision -> execute a motor action
Decision tree for the potential to drive assessment

The workshops

The upcoming potential to drive assessment workshop and implementation workshop, will support you as a driver trained OT to be able to understand these models, and help you to apply them during your assessments with your clients.

Potential to Drive assessment – overview

Dr Monahan has pulled all the research together and outlines an approach to enable OT driver assessors to set-up the assessment environment to minimize anxiety, optimize chance of success, provide a positive experience, and enable best clinical reasoning and decision making about “potential to learn to drive”.[iv]

Clinical assessment:

Clinical assessment is similar to the standard OT driving assessment approach, however will include assessment of visual motor integration, intelligence (where applicable) and an introduction to the “critical items” concept – the critical things we need to pay attention to as a driver.

The workshops

The potential to drive workshops will go through what assessment tools to use and common features/challenges, and clinical reasoning of the outcomes in helping you to make a decision about the outcome of the assessment.

Lifeskills review:

Parent/support worker is asked to complete a lifeskills questionnaire, to look for evidence of operational, tactical and strategic skills.

Where the young person is doing things independently in the community such as catching public transport, organizing themselves for school or a part-time job, doing household tasks such as cooking and washing, and being able to be out in the community, they are showing evidence of tactical and strategic skills which provides a solid foundation for driving.

Where a young person is completely reliant on others and unable to do basic tasks, be a pedestrian and be alone in the community (or even at home), they are not showing sufficient tactical and strategic skills for driving at the moment. Some may benefit from working on these skills with their community OT and waiting until they are a little older and more mature, to re-visit driving then; others will never have the skills for driving and are best supported to learn some community independence

The “$5 test” is a suitable indicator for readiness to drive:

Young person needs to be able to be given a $5 note and told to cross the street to go to the local shop and purchase a loaf of Tiptop multi-grain bread. At the store, they are out of this brand and the person needs to make a reasonable substitution (eg another brand of multi-grain), purchase at the check-out, make change, and return with the bread and change.

If a person cannot independently complete this task, it is likely that they are not ready for learning to drive.

The workshops

You will receive a “Lifeskills checklist” which will help you/your client/parent to rate the client’s current level of performance in a broad range of lifeskills, to help identify readiness to pursue learning to drive. And guess what – there is a brand new electronic version available, making reporting writing so easy!

Passenger activities:

Applying the research, it makes sense that a new learner driver with autism will likely become cognitively overloaded, overwhelmed and anxious, when placed immediately behind-the-wheel. It is too much to expect them to be able to learn to operate the steering wheel, indicators, follow instructions, look at where the car is in space, start to learn driving procedures…. all in a verbal/auditory learning context (when they are visual learners!).

Dr Monahan recommended that to best assess potential to learn to drive, that a series of ‘Passenger activities’ are completed – the specialised driving instructor would be driving their dual-controlled car, young person in the front passenger seat, OT driver assessor and main parent or support worker in the back seat of the car.

The passenger activities look at various components of the driving task ONE-AT-A-TIME in a structured / semi-standardised manner and provides valuable information about the young person’s ability to complete each of these tasks.

Breaking down the underlying tasks required for driving provides the OT Driver Assessor a much better look at the Participant’s ability, without putting them under cognitive overload or too much anxiety. This method also enables assessment of potential to learn, when the young person is a pre-learner and is interested to see if it is worthwhile / feasible for them to pursue obtaining their Learner’s permit.

The workshops will explain:

What the four passenger activities are
How to complete them
How to rate the client’s performance in these
Use case studies to demonstrate these
Develop clinical reasoning skills

Behind-the-wheel

For learner drivers, I usually include a short behind-the-wheel assessment – even if it is the first time, we are able to gauge ability to follow instructions, ability to put a few things together (steering, scanning, following procedures, problem solving and ability to make little improvements).

Decision / outcome of assessment

The decision tree provides a framework for pulling all of your results together, to be able to make a recommendation about your client’s potential to continue with learning to drive. There are four possible outcomes:

Ready now without need for additional supports (mainstream approach)
Ready now but due to challenges from disability needs specialized support (this likely includes a specialised driving instructor and driving therapy with OTDA, as well as input from general OT, and other AHPs, and family/support workers).
Not ready for driving yet: needs to work on all pre-driving skills and try again in the future
Not for driving: challenges from the disability are severe and they need support to develop community mobility independence.

The workshops
The assessment and implementation workshops will help you to develop clinical reasoning skills to work out where your client sits on this decision tree, and make recommendations to the client and family.

Call to action

If you are an OT driver assessor or specialised driving instructor working the disability learner driver space, and you haven’t done this training before, then you need this training!

We would love you to join us, and we would love to support you with your learning as you implement this approach into your practice, and provide the best support that you can for your clients.

Online Potential to Drive assessment workshop

Details: Wednesday 30^th October AND Friday 1^st November, 2024, 9am – 1pm BOTH days.

It will not be recorded!

Sydney – in person – Potential to Drive implementation workshop

Best to have attended the assessment workshop.

Details: Friday 22^nd November, 2024, 9am – 1pm

Location: Oatlands Golf Club, Oatlands NSW 2117

(Minimum 10 participants – otherwise the workshop will be rescheduled!)

It will not be recorded!

[i] Curry, A. E., Yerys, B. E., Huang, P., & Metzger, K. B. (2017). Longitudinal study of driver licensing rates among adolescents and young adults with autism spectrum disorder. Autism, 1-10. doi:10.1177/1362361317699586

[ii] Autism and Developmental Disabilities Monitoring Network 2012, Huang et al 2012, Curry et al 2017.

[iii] Chee, D., Lee, H., Patomella, A., & Falkmer, T. (2017). Driving Behaviour Profile of Drivers with Autism Spectrum Disorder (ASD). Journal Of Autism And Developmental Disorders, 47(9), 2658-2670. doi: 10.1007/s10803-017-3178-1

[iv] Monahan, M., Classen, S., & Helsel, P. (2013). Pre-driving evaluation of a teen with attention deficit hyperactivity disorder and autism spectrum disorder. Canadian Journal Of Occupational Therapy, 80(1), 35-41. doi: 10.1177/0008417412474221

I have recently had the pleasure of working with several clients who have had a lower limb amputation who were wanting to return to driving. People often ask “what is the best vehicle modification for a person who wishes to return to driving with a lower limb amputation?”

For some people, a lower limb amputation may occur from a traumatic injury such as motor vehicle accident whereby they may also have other associated conditions such as a head injury or spinal cord injury. For other people, their lower limb amputation may occur because of poor circulation due diabetes or other cardiovascular condition.

Driving a motor vehicle is a complex task involved perception, appropriate judgement, adequate response time and appropriate physical capability (Austroads, 2022). As an occupational therapy driving assessor, there are many components to our assessment:

The Person
Individual performance component skill level, the type of amputation (below or above knee), co-morbidities, their functional capacity in daily life as well as their mobility (prosthesis and/or wheelchair user).
The Environment
Where do they live, work, etc, as well as the social environment/context. Goals for driving and does the environment support this?
The Occupation (Driving)
Individual driving history, habits, where they would like to drive to, any specific vehicle modifications or preferences they have looked into?
There are a range of vehicle modifications options that could be considered – left foot accelerator is common for people who have a right lower limb amputation, hand controls (hand accelerator and brake, of which there are several types) are also common, and many people report they have found this easier to learn to drive with compared to a left foot accelerator.

There are a small number of people who have a well-fitting and tolerated prosthesis (usually with a below knee amputation) and have good sensation (superficial and proprioception) who can drive with their prosthesis.

This and other vehicle modifications can be trialled in an on-road assessment with the occupational therapy driving and specialist driving instructor. This is undertaken in dual controlled vehicle to ensure safety for everyone involved in the assessment process.

I have discovered that no two clients are the same, and there is not a one size fits all approach that works for everyone. It all comes down to individual assessment of clients and their needs. An occupational therapy driving assessment can help individuals to trial and test a range of vehicle modification options to find the best fit for them based on their needs and preferences.

As driver-trained OTs, we’ve worked with many individuals who need to fine-tune their driving skills to maintain independence. While urban driving comes with its own set of challenges, rural roads are areas that often require special attention, especially for those unaccustomed to these environments.

The ARSF’s Rural Road Safety Month is a crucial campaign that brings attention to the heightened risks associated with driving on rural and remote roads in Australia.

A Closer Look at the 2023 Road Toll

In 2023, Australia saw 1,273 lives lost on its roads—a 7.9% increase from the previous year. Despite the common perception that rural areas are safer due to lower traffic volumes, almost two-thirds of these fatalities occurred on rural or remote roads.

Who is most at risk?

The data reveals that more than half of the lives lost were not drivers. Among the fatalities:

611 were drivers
251 were motorcyclists
210 were passengers
159 were pedestrians
35 were cyclists
7 were other road users

The toll was particularly high among specific demographics and during certain times:

3 in 4 deaths were male, highlighting a significant gender disparity in road fatalities.
Most deaths occurred during the day (62%) and on weekdays (63%), contradicting the assumption that night-time or weekend driving is inherently more dangerous.
By age group, those aged 40-64 years were most affected, accounting for 389 fatalities, followed by the 65+ age group with 293 fatalities, and 26-39 years with 284 fatalities.

What is the Cost?

The human cost of road fatalities is immeasurable, but the economic impact is also staggering. In 2023, the annual economic cost of road trauma in Australia was estimated at almost $30 billion.

But What Can We Do?

1. Adapt Your Speed to the Conditions

Rural roads can be deceptive. While they may seem quiet and open, they can quickly turn treacherous if you’re driving too fast. The lack of street lighting, sharp curves, and potential for loose gravel or potholes means that you need to adjust your speed to match the conditions.

2. Stay Alert for Wildlife and Farm Equipment

Wildlife is a common hazard on rural roads, especially at dawn and dusk when animals are more active. Hitting an animal can not only be tragic but also cause significant damage to your vehicle and put you in danger. Likewise, farm equipment is often slow-moving and can take up much of the road. Approach these situations with patience and care.

3. Understand the Importance of Defensive Driving

On rural roads, defensive driving is critical. This means being aware of your surroundings, anticipating potential hazards, and maintaining a safe following distance. Because rural roads are often narrower, you’ll need to be especially careful when passing other vehicles.

4. Plan Ahead for Emergencies

One of the most important aspects of rural driving is preparation. Before heading out, ensure your vehicle is in good condition—check your tire pressure, oil levels, and make sure you have a full tank of gas. Keep a roadside emergency kit in your car, and make sure your phone is fully charged. Remember, help may not be readily available in rural areas, so it’s crucial to be self-sufficient.

5. Managing Fatigue

Rural driving can be monotonous, which may lead to fatigue—a serious safety risk. To combat this, take regular breaks to stretch and rest. If you start to feel drowsy, it’s better to pull over in a safe location than to push on.

The data from 2023 paints a clear picture: rural and remote road safety remains a critical issue in Australia. With almost two-thirds of road deaths occurring in these areas, it’s more important than ever for all of us to take responsibility and make a concerted effort to reduce road trauma. By staying vigilant and adhering to road safety guidelines, we can work together to make our roads safer for everyone.

Let’s #ChooseRoadSafety and commit to making a difference—because every life lost on our roads is one too many.

Hello everyone! I’m Chloe, the new Practice Manager at Driving Well. With three months under my belt, I’m excited to share my journey into the world of allied health business, occupational therapy, driving, and the NDIS.

The Journey to Driving Well
My background in biomedical science and my mother’s influence as a nurse sparked my interest in healthcare. However, my role as a sleep scientist left me feeling unsatisfied. The listing for a Practice Manager at Driving Well caught my eye, offering a way to help people achieve their goals of driving. The fantastic team culture and opportunities have made my transition rewarding and fulfilling.

A Day in the Life of a Practice Manager
My role as Practice Manager keeps me on my toes, with each day bringing new clients, questions, and projects. I’m the one to greet you on the phone and help you book your appointments to get back on the road. However, there is much more to my role than just scheduling. I handle finances, send reports, and work on various projects and developments within the business. There’s no such thing as a typical day or week here!

Top Three Learnings
My first three months have been a whirlwind, filled with valuable lessons:

Patience:
Navigating the NDIS can be tricky, slow, and sometimes frustrating. I’ve learned the importance of patience, understanding that good things take time. Working through the many processes and hoops required to help clients get back to driving or start their journey has been a significant learning curve.

Diversity:
With over 130 clients in just a few months, I’ve witnessed incredible diversity in conditions, cases, and goals. This experience has highlighted that there’s no “one size fits all” in occupational therapy. The endless possibilities in helping people have been a heartwarming revelation.

Organisation:
Organisation is key in my role. Ensuring all paperwork is in order before assessment day can be stressful, but I’ve developed effective methods to ensure smooth sailing for everyone involved. My advice: have your paperwork ready on time to avoid unnecessary stress.

Exciting Projects Ahead
I’m working on several exciting projects at Driving Well:

Digital Get Driving Toolkit:

Enhancing the toolkit with new content and making it more accessible for clients who can’t visit the clinic.

Physical Get Driving Toolkit:
Developing a tangible toolkit to send to clients, complementing the digital version.

Theratrak:
An online tool to aid clients in their therapy exercises from home. This tool allows assigning exercises and maintaining contact with clients between appointments to develop their pre-driving skills further.

Practice Manager’s Academy (PMA):
A personal project where I am developing my skills as a practice manager, thanks to the opportunity provided by Jenny.

Top Tips for Booking a Driving Assessment

Here are my top three tips for clients preparing for a driving assessment:

Breathe:
It’s normal to be nervous. The Driving Well team is supportive and ready to answer all your questions. Remember to take deep breaths and stay calm.

Be Patient and Kind:
Organising driving assessments involves coordinating with multiple people. While the team works efficiently, sometimes things don’t go as planned. Patience and kindness go a long way in making the process smoother.

Read What We Send You:
Ensure you read all the information we send you. This will cover everything you need to know about your appointment, from the location to what to expect before, during, and after the assessment. Being well-informed will save you from potential headaches.

I’m excited to thrive in my role and look forward to the positive impact I’ll continue to make at Driving Well!

Brisbane OT driver assessors were recently provided the opportunity to practice driving with vehicle mods with Total Ability and our specialised driving instructors, at the RACQ Mobility Centre at Mount Cotton.

Driving OTs frequently work with clients with physical injuries, conditions and disabilities which may impact their ability to use conventional vehicle controls independently and may need modifications to enable them to drive. There are a multitude of driving modifications available, including various types of spinner knobs, hand controls, left foot accelerator pedals, through to higher level / advanced modifications such as the mini wheel and joystick steering, and driving from wheelchair.

Driving OTs are skilled at assessing clients’ functional abilities and work together with the client and a suitable driving instructor, to work out what driving modification will best suit the client and their situation. The driving OT will also guide the client on the process that is required for them and support them with applying for funding for driving lessons and funding of the modifications, guide them through the licensing process, and explaining the engineering and compliance process.

What we are not necessarily skilled at, is actually driving with the modifications themselves!

Having a professional development day offline, in the company of our friends and colleagues, in a safe and supported environment to practice driving with the various vehicle mods on a closed track (no traffic!) was just invaluable.

Myself, Zoe and Amanda were all able to attend and between us, we practiced driving with:

Fadiel e-radial hand control and spinner knob
Fadiel trigger hand control and Lodgesons lollipop spinner knob
Basic push-pat mechanical hand control and spinner knob
Left satellite accelerator and right brake lever
Left satellite accelerator and left Fadiel easy drive brake (I didn’t think this would be do-able, but after a client demonstrated this with ease, I was up to the challenge and yes it certainly can be done!)
Left mini-wheel advanced electronic steering and right two-way joystick (brake/accelerator) drive from wheelchair
Left foot accelerator (for me, this is still the hardest way to drive – I am not coordinated with my feet at all)
Four-way joystick (brake, accelerator and steering all-in-one) drive from wheelchair – I was not game to test this one out… kudos to the driving OTs that did.

Biggest takeaways for our team were:

it was useful to remember the functional components required to drive with each of the modification types
“unlearning” of our standard recommendation – the technology and techniques have advanced and grown, so our previous go-to (which still works) might not be the only option.
There are so many options, that it is really up to what suits the client best, and that they may need several trials to settle on the right modification for them.

Sharing a huge congratulations again to Paul Crake and his team at Total Ability once again for their efforts which were rewarded at the May ATSA conference in Brisbane, with Paul taking out not one, but three awards for:

Commitment to Excellence (shout out too to Ali Akbarian at Mobility Engineering – sponsor of the Drive-Able podcast
2024 Industry Person of the Year
2024 Supplier / Manufacturer of the year

Total Ability have dedicated time and resources to supporting the driving and disability industry and have developed several resources to assist clients and OTs understand the vehicle mods process.

For anyone needing vehicle modifications to return to driving, there will be an involved process that will likely include:

OT driving assessment (including a clinical and practical on-road assessment; multiple trials may be necessary to find the best option)
OT driving assessment report and recommendations for funding
Driving lessons with the driving instructor to develop competency and safety – “is this consistent and reliable?”
Applying for vehicle modifications funding (eg to the NDIS, NIISQ, i-Care, TAC, HCP)
Completing an on-road re-assessment / handover assessment upon completion of the modifications, and a post-modification report.

Helping drivers return to driving or learn to drive with vehicle mods is one of our favourite things to do – that handover day to see a client driving away with their vehicle and regaining their independence, is absolutely magical to us.

If you need assistance with returning to driving, please check out our website or make a referral!

People with Motor Neurone Disease go through huge changes in their daily life, incredibly quickly. All of a sudden they are unable to stand up by themselves, walk to the bathroom, go out to the shops as they previously did. All of a sudden they are unable to do the things we take for granted every day.

One man I worked with recently had this same story.

The problem…

All of a sudden he was having black outs and couldn’t walk any more. He was quickly provided with a hire wheelchair to get him by until he could get a scripted power wheelchair more suitable to his needs. When I met him in September he was still transferring into a standard car, but I knew this could change really fast. It is so important to think about the future – for MND, things can keep changing really quickly and we need to plan for the worst case scenario, and any vehicle mods solution that we recommend needs to be safe, consistent and reliable, and sustainable. It also needs to meet the insurers “reasonable and necessary” requirements.

I explained the options to to this fellow and his family, and showed a few options on vehicle modifier websites.

The lowered floor conversion to a Kia Carnival is a really effective, popular, and affordable solution, and many Australians use this option. The other options that are also equally effective include the Hyundai Staria and Volkswagen Multivan.

The trial…

The Kia Carnival looked like the way to go in this case, so I quickly commenced the process of trialling and applying to NDIS for vehicle modifications to his Kia Carnival to enable him to transport in his power wheelchair.

The trial was at the client’s home, and allowed him the opportunity to drive up into the car in his electric crashtested wheelchair, see how the restraints work, and go for a test drive. It was all smooth sailing. I gathered all the paperwork needed (there is a lot), and submitted an application to the NDIS to have the modifications funded. The client is responsible for purchasing the actual car.

The approval…

By the end of February 2024, we received approval from NDIS to proceed with vehicle modifications. This is a pretty quick turn-around time in the NDIS world. But, within this time he had lost his ability to transfer into a standard car seat. By the time the approval came through, he’d been stuck at home for 2-3 months, unable to go anywhere over the Christmas period. His hire wheelchair was not suitable for transport, and he couldn’t transfer out of it. Imagine that – being stuck in your own home over Christmas, not being able to take your kids out to celebrate the school holidays, not able to go Christmas shopping, not being able to visit family.

So, the NDIS approval came through at the end of February. Blair and his team at KM Kite on the Gold Coast bent over backwards to schedule the modifications and make it happen as quickly as possible. A job that usually takes 6-8 weeks minimum, they got sorted in less than 4 weeks. They also managed to get him a hire car NDIS had approved funding for so he could transport in the meantime. By the end of March, he had his Kia Carnival with passenger modifications for wheelchair occupant travel.

The solution!

Have a look at the smile on his face!

Lowered floor Kia Carnival delivered with a big blue bow!

He was stoked he could finally, again: be a part of taking his kids to school, going to the shops, going out to watch the footy. All the activities we take for granted every day.

His story really highlights the need for supports to be quickly accessible for people with MND, and the need for increased awareness around the challenges they face.

Zoe Wagner-Jordan, OT Driver Assessor, Driving Well Occupational Therapy

Need to get out and about?

If someone you know is needing support with vehicle modifications –
please get in touch or have a look at our website for more information!

Click Here

Learning to drive is an exciting rite of passage for young people. It can be the beginning of their life as a young adult, independence, trips with their friends – no more pick up and drops off for parents!

As exciting as it may be for the young person, it’s often a daunting prospect for parents.

Are they ready?
Will they be safe?
How will I survive giving them lessons?
What if they don’t pass?

Learning to drive requires a massive energy, time and monetary commitment. It takes time and practice to learn road law theory, courage to sit the exam (once or twice!) and even more courage to sit in the passenger seat as your child takes the wheel. Add to the mix, a learning disability, autism, ADHD, anxiety or physical impairment and it can seem an unclimbable mountain.

At Driving Well, we’re here to help you through this process.

Our Potential to Drive Program provides a starting point for learner drivers with additional needs who may be thinking of getting their learner’s permit or starting driving lessons. We provide comprehensive assessment to uncover the learner’s/your child’s learning needs based on their disability and work closely with specialised driving instructors to put together a learning package just for them.

We can also provide you with advice on what you can do in day-to-day life to build the skills they need to be a successful driver and support linking with formal therapies that may help. We also offer support for parents and caregivers to learn how to practice skills on-road skills with the individual and to learn the techniques used by their driving instructors to minimise lesson stress!

We can support you through the process of seeing if learning to drive can be supported by your NDIS Plan and walk you through the process form start to finish.

This is a huge undertaking and not a simple process. It is really important that we have a partnership between Driving Well OT and the client and their family.

Read more about the OT “potential to drive” process here.

Approval for driving training program

When a driving program (lessons) are recommended, the OT driver assessor will submit the OT driving assessment report and quote for the number of recommended lessons from the driving instructor provider, to the NDIA

“specialised driving training” is a quote required item, which needs to be approved by NDIA and added as a line item to your NDIA plan under Capacity Building: improved daily living (Specialised driver training 15_046_0129_1_3) this applies even if you have a goal regarding driving / community access, and even if you have sufficient budget in improved daily living.

Once you have written approval from the NDIA (and the line item is added to your NDIS plan), you are able to book your lessons directly with the driving instructor. (Note – as at February 2022, this is taking months to gain approval).

If you are with another insurer, a quote and report is provided, and the insurer must approve the quote to commence lessons.

Drive Focus App

Drive Focus is a tablet based app (ipad/android tablet) designed to develop visual search, reaction time/processing/decision and motor execution skills (the information processing model) required for driving.

It has interactive video taken from the driver’s perspective, which is coded with tap-able “hotspots” of the critical items: brake lights, stop signs, traffic lights, speed signs, pedestrians, cars entering from left/right, objects on the road). The user must tap on the critical items as quickly as possible in the correct order.
The app has Australian “tours” of Brisbane and Melbourne available and costs approximately $20AUD; there are seven drives within each tour, each of increasing difficulty.
Visual cues for critical items can be turned on and off, and the videos can be slowed down to allow more processing time.
The user’s score is presented at the end of each practice, and android users can email their results to their OT.
A university study identified that six one-hour sessions of Drive Focus significantly reduce driving errors among already licenced drivers. The subjects also rated Drive Focus as valuable for improving their driving skills.
There are other studies taking place in the USA and Canada presently to examine the efficacy of Drive Focus with populations including older adults post stroke, traumatic brain injury, and combat veterans with post-traumatic stress.

Our learner drivers are recommended to practice the app three to four times per week for about 15 minutes each session; they can level up through the drives, and review their score and re-attempt to improve their score (number of critical items and average response time).

The app is a Finalist for Best Assistive Technology product at the upcoming Australian Disability Service Awards, and winner of the Technology Award for Australian Road Safety Foundation 2021!

Image: Jenny OT driver assessor working with Jacob using the Drive Focus app on his ipad.

Why should I purchase the Get Driving toolkit?

Driving lessons are full-on – there is a lot to take in, especially in the early phases.

We know for conditions including ASD and ADHD that focusing on one task at a time and building this up (eg developing visual searching skills when outside of the car or when in the front passenger seat) will then make it easier to integrate skills when behind-the-wheel on driving lessons.

Driving Well has developed a therapy program (face to face clinic and passenger activities) and this online therapy toolkit for clients to purchase access at home with their parents / support workers, to work on fundamental skills needed for driving – and build these up so they will get more out of their driving lessons with the driving instructor.

Therapy program sessions at our new clinic space!

We are renting a clinic space at Takes Care Specialist Centre, 11 Cleveland St, Stones Corner on Wednesdays, commencing 16th November. We are so excited to be able to provide “Get Driving” therapy programs to our learner driver clients at this beautiful and accessible clinic space. This will reduce costs to our clients, and allow us to be so much more efficient in providing services.

Need support with driving and vehicle modifications assessments? Email admin@drivingwell.com.au to see if we can help you.

Article by Lauren Jackson OT Driver Assessor and Jenny Gribbin OT Driver Assessor

Blog by Zeta Griffiths, Practice Manager extraordinaire
Photo : Zeta and Jenny (Director of Driving Well)

From an intake perspective the best advice I could give to any client would be, be involved in the process.

Our OT team is amazing, but they aren’t mind readers. A lot of the important information will come from you. For example…. What are your capabilities and limitations? Do you really have 20/20 vision, or might the Optometrist have a different opinion of your eyesight. The information that you gather for us before you actually meet your OT for the first time is invaluable.

Be prepared, make that appointment with your GP (make sure it’s a long one) and don’t leave without the paperwork we’ve asked you to get. Sometimes the GP thinks they know the process and can be a little stubborn, be patient and insistent and it will save you a second trip back to see them if you don’t come away with what we need.

Sometimes there are other things holding people back from getting everything organised. You may need a family member to take you for the appointments or you have scanner or fax limitations. Don’t get too hung up on how I’m going to get the paperwork back, I’ve got a whole bag of tricks up my sleeve. Get the process started and we’ll help you with the returns policy 🙂

I was once told I was being a pest by a lovely young man (98 years young) who needed an assessment. He didn’t have his paperwork and his assessment was quickly approaching. I would call him every second day, and ask if he’s made his appointments with the GP and Optometrist. He knew he needed to get them, but something was holding him back. On my last call to him I asked him what was really stopping him? His answer, “it’s time to stop and I just didn’t want to admit it. Not to mention Zeta, I though about what you said about all the money I’ll save when I get rid of the car and insurances etc and you know what, that’s a lot of beer!” We had a laugh and he gracefully retired from driving.

Everyone’s situation is different and our team would like to help you find your destination.

Check out these 5 helpful tips for partnering with us.

Our website explains in detail the process and forms needed for an OT driving assessment:
Email your referral to admin@drivingwell.com.au for support with driving assessments and vehicle modifications.

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Phone

0407 671 621

Postal Address

PO Box 2146 Runcorn QLD 4113

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).

Acknowledgement to Country

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.

Acknowledgement to Country

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