PROGRAM HELPS GET INJURED PEOPLE BACK BEHIND THE WHEEL

Driving is a skill most of us take for granted.

Advancing age, accident or affliction, however, can make driving a car seem almost impossible.

Impossible, that is, without help.

"Driving is the highest level of daily activity we perform," said Ellen K. Holcomb, senior occupational therapist at the St. Francis Center for Health and Rehabilitation.

"You have to have a lot of components to drive safely -- good reaction time, good thought processes and the ability to judge the right reaction."

In September, St. Francis launched a new pre-driving advisement and on-the-road evaluation program to help people determine if they should be driving and to learn new skills that can allow them to get back on the road.

"Our goal is not to take people's driver's licenses away but to determine if they can drive safely," Holcomb said.

The program, which requires a doctor's referral to enroll in, is geared for people whose driving may be impaired for a variety of reasons, including strokes, head injuries, physical disability or decreased skills due to old age.

The pre-driving advisement portion of the program, which usually requires just one office visit, includes a vision screening plus range of motion and strength and coordination tests.

A computerized driving simulator helps judge reaction time and cognitive skills, including judgment, mental processing speed, ability to adjust to changes, self-control, eye-hand coordination, consistency, field of view and ability to recover from errors.

When the simulation is complete, the computer produces a printed report evaluating the patient's performance.

Holcomb said a report showing a poor performance can help convince someone that perhaps they shouldn't be driving.

"It makes it easier for someone to accept that they shouldn't be driving," she said.

The results can also show people they need to change their driving habits, such as not driving at night, in high traffic areas or on the interstate.

Victims of neurological problems face the most difficulties in getting back on the road because of the effects on judgments and vision.

"With some cognitive and visual problems, there is really nothing that can be done for that," Holcomb said.

"A lot of times those things are gone and you can't get them back," Holcomb said. "With a physical disability, you can adapt a lot better."

With physical impairments, such as paralysis or amputation, vehicle adjustments can be made or new skills taught to overcome the problem.

The on-the-road training portion of the program requires that patients already have a valid driver's license or learner's permit.

Jim Edds conducts the driver instruction in a specially equipped car that can be modified to compensate for whatever deficiency the patient has.

As a longtime driving instructor, it can literally be said that Edds wrote the book on driving, having published a book on learning to drive.

He has been helping people overcome disabilities to get back on the road for more than five years.

His technique varies from patient to patient, because each has a different problem they need to overcome.

Several on-the-road instruction sessions are usually required.

Like anything else, adjusting to a different way of driving is a learning experience.

"It takes a lot of practice," Edds said. "For a lot of people in rehab, it's just another thing they have to learn. The hardest part is to get people to try it."

While vehicle modifications -- such as installing hand controls or moving the accelerator to the left of the brake -- can be easily done, Edds said drivers using new equipment shouldn't just get in the car and go.

"People should get training first if they have to drive differently," he said.

Warning signs

A number of symptoms might indicate if people should have their driving skills evaluated:

-- Decreased sensitivity and speed of motor responses.

-- Increased trouble seeing well at dawn, dusk and at night.

-- Feeling confused or disoriented.

-- Difficultly in shifting eyes from something near to something far.

-- Diminished peripheral vision.

-- A shortened attention span or easily distracted.

-- Blurred or double vision.

-- Difficulty differentiating foreground from background.

-- Difficulty in comprehension.

-- Trouble with judgment or decisions when driving.

-- Impulsiveness.

-- Eye-hand-foot coordination problems.