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Driving Evaluations by a Certified Driver Rehabilitation Specialist for people Driving from their Wheelchair or Driving with Hand Controls or Other Adaptive Equipment

               

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Let's start right off with the most important questions.

Do I really need to use a CDRS (certified driver rehabilitation specialist)?  Do I?  Do I?

 YES! YES! YES! I know they're expensive, I know they're going to push you towards buying equipment that is going to cost you more, I know it is time consuming, I know some people feel like they should be able to buy whatever they want and not be required to use a CDRS, etc. etc.  I know all that.  I also know that there are some very good dealers and modifiers who are going to steer you in the right direction anyway.  Each case is unique but if you were to ask me whether a CDRS would help the vast majority of people with disabilities obtain and safely use a wheelchair accessible car, then my resounding answer would be YES!  The number one reason why a CDRS is not used is due to money.  They cost more and can be frankly expensive especially if you are self funding your wheelchair accessible vehicle.  I'm not going to say that isn't a real concern but I'm telling you that the BEST answer is to use a CDRS, not what is the CHEAPEST answer.  A driving evaluator is also hard to find but we'll talk a little bit about that later.  The reason that I'm so big on using a CDRS is that without a doubt, they are the expert when it comes to what wheelchair van and adaptive equipment will be right for you.  Having seen many people buy the wrong equipment, my bias is towards consulting with an expert that is the CDRS.  They can save you a lot of time and money in preventing you from purchasing the wrong equipment.  Plus they'll make sure you have the right adaptive equipment and training so that you are SAFE and comfortable driving your wheelchair van.  The CDRS also represents you during the installation and fitting process.  They make sure the equipment is installed right and meets your needs.  So again, I'm presenting what is BEST PRACTICE in the industry, that is to use a CDRS, not what is the CHEAPEST PRACTICE. 

   

What is a CDRS (certified driver rehabilitation specialist)?

A CDRS is first of all a DRS - driver rehabilitation specialist sometimes referred to as a driving evaluator.  A driver rehabilitation specialist or driving evaluator is one who plans, develops, coordinates and implements driver rehabilitation services for individuals with disabilities.  It's the "C" in the "CDRS" that is an important distinction.  A CDRS is a DRS certified through the ADED accreditation program.  The certification is not easy.  There is a lot of work and prior experience required to achieve the certification.  In fact, there is a real shortage of certified driver rehabilitation specialists in this country and one thought is perhaps the criteria for getting certified is unrealistic and therefore too difficult.  In order to become a CDRS you most likely would have to train under a CDRS and if there is a shortage of certified driver rehabilitation specialists, then it's hard just to find one to train under so it has a compounding effect.  Related to this is the fact that there is no real certification for a DRS, at least not one that is widely recognized.  A DRS is a self certification meaning anyone can say they are a driver rehabilitation specialist simply by doing so.  For someone who wants to be a DRS and is looking to obtain certification, there is either no certification OR the "ultimate" certification, CDRS, and nothing in between.  Some agencies are trying to correct this gap by coming up with a DRS certification but one of the problems is the field of DRS is a real hybrid of skills.  For instance, it would be nice to have a DRS who is also an OT (occupational therapist) but does one really absolutely have to be an OT to be a DRS?  I don't think so.  The other problem is that the real trend in driver rehabilitation services is to work with the elderly.  That is a huge market and only getting bigger as opposed to the disability market which by comparison is small.  Hand in hand with this, there is also a lot more money in working with the elderly than there is working with the disabled and the equipment costs are much smaller when a DRS only works with the elderly.      

Note:  States typically regulate driving instructors or CDI (certified driving instructors) and the driving instructor schools.  A DRS or CDRS by definition has to be a driving instructor but don't get fooled into thinking a driving instructor is therefore a DRS or CDRS.  So if a DRS is telling you that they are a certified driving instructor that's not telling you a whole lot about what she/he can offer you as a person with a disability.      

How do I find a CDRS (certified driver rehabilitation specialist)?

You can find a list of Certified Driver Rehabilitation Specialists in your state by visiting the website http://www.driver-ed.org and looking in the "CDRS Directory".  Note: the "Members Directory" will likely include businesses and individuals affiliated with ADED but who are not necessarily CDRS qualified.  It is actually important to look for a CDRS through ADED because you'll hear some driver rehabilitation specialists claim to be a certified driver rehabilitation specialist who really aren't.  Surprised?  Don't be.  Where there is state and federal money, there will always be people willing to take it and claim to be something they aren't.  You want to review the driver rehabilitation specialist's credentials.  You should ask what specific experience they have with your particular disability.  As you probably are aware of, there is no single "disabled" category when it comes to vehicle modifications.  The accessible equipment needs of a quadriplegic, paraplegic, person with MS, etc. are all going to be very different.  You also want to see what demonstration equipment and training vehicles the driving evaluator has available.  A CDRS will tend to specialize on certain population groups.  Some certified driver rehabilitation specialists who work with the disabled will only have a sedan with hand controls set up for someone in a wheelchair who can transfer.  That may not do you any good if you're in a wheelchair and can't transfer.  Then too you should also see what specific equipment brands the CDRS has available for evaluation.  A driving evaluator will tend to push you towards equipment that they have available so if the driving evaluator only demonstrate one set of hand controls, chances are your prescription will be for that one set of hand controls even if another type would be a better choice.  You want to make sure the driving evaluator has a good variety of equipment to evaluate you with.  Last but not least you want to make sure the driving evaluator has insurance in case there is an accident.  Ensure you carefully read and understand the policies and all documents that the driving evaluator requires you to sign prior to commencing training.

Note:  EMC high tech driving controls have their own driver rehabilitation specialist certification so if you happen to know ahead of time or from your current equipment set up that you will need EMC high tech equipment, your choice of CDRS will be further limited.  The certified driver rehabilitation specialist will need to have EMC high tech driving controls in an evaluation vehicle which is not cheap.

 

What should I look for in a CDRS (certified driver rehabilitation specialist)?

If I had to list attributes that a driver rehabilitation specialist must have, they would be:

 

Services performed by a CDRS (certified driver rehabilitation specialist)

The evaluation is the first step of the process of hopefully getting someone to drive in an accessible vehicle.  It should first involve a clinical evaluation which is where the driving evaluator tests your vision, movement, strength, dexterity, and cognitive ability prior to being put in the vehicle.  This lets the driving evaluator know what areas or weakness to look for in the driving portion of the evaluation.  Sometimes people will perform better in an actual vehicle than they will in the clinical portion of the test.  Next, the evaluation will include an on the road evaluation during which the evaluator will see how you drive with various primary controls (steering, brakes, accelerator).  In most states you'll need either a learner's permit or a previous driver's license in order to perform an in-vehicle evaluation.  The driving evaluator should also evaluate your ability to access secondary controls (lights, dimmer, horn, turn signals, etc.).  You should receive a written report of the evaluation which includes results of the clinical portion, the on road portion, as well as a detailed list of vehicles that will meet your needs or an assessment of your current vehicle and adaptive equipment that will enable you to drive safely.  The CDRS should also recommend to the client any driving restrictions such as limiting driving during daytime, on familiar roads, or below certain speeds based on the clinical and road evaluations.  You also need to be able to enter and exit the vehicle safely as well as transport your wheelchair so the evaluation report should address those areas as well.  Any recommended training should also be written in the report. 

The driving evaluation report should list any training requirements recommended by the evaluator.  In most cases, the in-vehicle evaluation will be 1-2 hours long.  Sometimes a driving evaluator will want to see the person drive in a training environment prior to making final adaptive equipment recommendations.  The goal of the training should be to make the consumer competent in the prescribed equipment and to allow the consumer to obtain a valid driver's license.  In almost all cases, you should have a restricted license prior to proceeding with purchasing vehicle adaptive equipment for the following reasons:

  1. The hand control manufacturers require the consumer to have a properly restricted driver's license and to be properly trained prior to the installation of their product.
  2. It is illegal to drive without a properly restricted license.
  3. You are exposed to tremendous liability if you happen to be involved in an accident without a valid license.
  4. Your state's DMV is usually the only authority that can grant a driver's license.  A DRS can make recommendations to the state DMV but they are not able to get you a license.  Often the sate DMV will not issue a license until some sort of medical review occurs.  It's rare but it does occur that a DMV decides not to grant a license even if the DRS recommends that they do.
  5. In most cases the licensure only occurs after some amount of training.  This training will sometimes lead to changes in the adaptive equipment prescription.  This is sort of like the saying "measure twice, cut once."  The training that normally occurs with the licensure also should ensure some level of minimum competency in operating a vehicle with the adaptive equipment. 
  6. It is ideal to think that after your adaptive driving equipment is installed, you will first receive any recommended training prior to driving on your own.  In reality, scheduling conflicts with the trainer occur, the consumer is anxious to try out their newly adapted vehicle, and what really occurs is the client sometimes ends up driving the vehicle.  See the reasons listed above why this is not a good idea. 

The driver rehabilitation specialist will assess existing vehicles as to their ability to be adapted to meet your needs.  If the existing vehicle(s) cannot be adapted to meet your needs, the driving evaluator will provide vehicle recommendations including year, make, and model including any standard equipment options (power doors, automatic transmission, etc.).  The evaluation really needs to be performed PRIOR TO the consumer going off and purchasing a vehicle.  Taking a newly purchased vehicle to a driving evaluator is a little like closing the barn gate after the animals have already left.  This is where patience can be a virtue. 

The recommendations are a complete list of adaptive equipment required for a particular vehicle.  You may be given multiple vehicle and adaptive equipment recommendations listed in order of dollar cost or ease of use.  Usually the recommendations only last for a year due to changes that can occur in the future.  Some people think of this as a prescription. 

The adaptive equipment needs to be installed and adjusted to meet your specific needs.  Especially for wheelchair drivers, it is typical for the vehicle modifier to locate you in the vehicle with your wheelchair prior to installing and in some cases ordering the equipment.  This is to allow the vehicle modifier to order and properly locate the equipment in your car.  The modifier will also determine at this initial fitting, any custom adaptations or modifications that need to occur to the standard equipment.   At delivery, final adjustments and modifications can also occur.  A driver rehabilitation specialist should be present at all fittings to ensure the equipment is properly located and installed to meet your needs.

The vehicle and adaptive equipment are inspected at delivery to ensure the adaptive equipment properly installed according to the manufacturing specifications and is operating properly.  The driver rehabilitation specialist should also ensure that all recommended equipment was installed. 

The client will drive the vehicle with the driver rehabilitation specialist.  This is to ensure the equipment is operating properly and meets the clients needs and can be safely used.

The driver rehabilitation specialist will perform any training required in order to make the client comfortable safely driving their newly adapted vehicle. 

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