Assessing fitness to drive after head injury: A survey of clinical psychologists

Evaluation of Competency: Ethical Considerations for Neuropsychologists

“…There have been few studies examining the real-life translation of neuropsychological tests (Sbordone & Long, 1996). Indeed, a recent survey of clinical psychologists in the United Kingdom concerning neuropsychological predictors of driving ability found that, although 70% of surveyed clinicians used neuropsychological tests in evaluating fitness to operate an automobile, more than 50% of these same psychologists were "not confident" or "not very confident at all" about their recommendations in this capacity (Christie, Savill, Buttress, Newby, & Tyerman, 2001). These findings suggest concerns about the translation of findings on standardized measures of neurocognitive function into real-life situations.…”

Contributo da avaliação psicológica no exame clínico de condutores com doença neurológica e psiquiátrica: revisão teórica

“…Em condutores víti-mas de TCE, a atividade de condução é considerada um fator determinante na manutenção da independência, no processo de reintegração social e na qualidade de vida 63 . No entanto, mais de metade dos casos retoma essa atividade sem qualquer avaliação clínica especializada e aconselhamento 64,65 . As pessoas com TCE grave, em particular, tendem a sobrevalorizar o processo de reabilitação física e a negligenciar os eventuais problemas cognitivos e emocionais persistentes, suscetíveis de diminuir a aptidão para conduzir um automóvel em segurança 28 .…”

The use of neuropsychological tests to study the effects of aging on driving performance in the UK

“…Due to the lack of a reliable standard protocol, some clinicians make their judgments based on selfreport (of drivers), which has risks associated with it as lack of insight and judgment are potential common traits of the population experiencing neuropsychological decrements. In this context, Christie et al [10] while carrying out a survey of clinical psychologists with regard to neuropsychological settings in the UK in assessing fitness to drive after head injury, observed: "Overall, clinicians' decisions about a client's fitness to drive seem to be based on an eclectic approach with considerable reliance on clinical impression". Seldom is recourse made by health professionals to driving assessment as a first alternative as it requires a fee and such centres are not readily available everywhere.…”

“…The development of a particular selection of neurophysiological tests for the screening of drivers has been prevented by hurdles like unawareness of specific neurophysiological domains that are relevant to driver behavior [29]. Also, sound neurophysiological testing protocols and service policies are lacking which would allow the integration of neurophysiological, driving evaluation data and medical data in order to facilitate DVLA and drivers make decisions regarding fitness to drive [10]. While evaluating neurophysiological status in primary care settings, researchers through survey data established that physicians exhibited a lack of confidence in assessment of drivers [31].…”

“…Subsequently, it is the responsibility of the DVLA Medical Branch to make judgment regarding a person's fitness to drive. Before making a judgment, the DVLA may adopt the following course of actions [10]: (a) request additional information from the GP/ Consultant, (b) referral for specialist clinical assessment, or (c) acquiring an independent medical opinion. Some times as the DVLA deems necessary, it may require individuals to re-take the standard driving test or may refer him or her to a specialist driving assessment centre.…”