Traumatic brain injury hinders learning of road hazard awareness by repeated exposure to video-based hazards.

Abstract

Objective: To better understand hazard awareness abilities among traumatic brain injury (TBI) survivors of which little is currently known. TBI survivors express degradation in driving abilities, particularly the proactive strategy in which indicators of potentially hazardous situations are sought and identified. The current study examined differences in hazard awareness learning between TBI survivors and noninjured control individuals matched for age and driving experience. Method: Forty individuals equally divided among the 2 groups were assessed by exposure to repetitive video-based hazard scenarios, which have been shown to improve hazard awareness in noninjured individuals. Differences in participants’ eye movements and behavioral response while watching video clips of genuine traffic scenes were recorded. Results: Although survivors of TBI demonstrated relatively intact hazard awareness abilities under baseline conditions, they failed to learn from repetitive presentation of the same hazardous situation (i.e., they did not improve hazard detection) and thus failed to adjust their scanning and behavioral reaction (e.g., time to reaction, adapt of scanning behavior). Differences were more prominent for hidden hazards. Our results show impoverished anticipation abilities in driving simulation tasks performed in the subacute recovery phase after TBI and that differences in materialized hazards awareness are distinguishable between TBI survivors and noninjured drivers of similar age and driving experience. Conclusions: Our findings signal the need for further research to clarify the relationship between TBI and hazard awareness training that might be supportive of driving rehabilitation after TBI.