Driving for Individuals With a Neurological Disability

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Some people are born with conditions like autism spectrum disorder (ASD) or epilepsy, while others develop disabilities due to brain injuries or age-related diseases like Alzheimer’s. Neurological disorders can impair vision, hearing, mobility, communication, and cognition. Depending on the severity of the disability, driving may or may not be possible. Learn more on considerations and strategies to prepare for getting behind the wheel with a neurological disability and how to shop for the right auto insurance.

Determining Driving Readiness

It can be hard to know if someone with a neurological disability is able to drive safely. Safe driving requires a complex set of motor, cognitive, visual and judgment skills. Clinical assessments and driving tests can help determine if someone has the necessary capabilities to get behind the wheel.

A Sense of Independence

Driving can give people with neurological disabilities a sense of independence and freedom. Greater mobility gives people tangible access to employment, education, health care and social activities. Especially in suburban and rural areas where public transportation may be limited, driving can allow people to reach their destination easily.

Snapshot: Individuals With a Neurological Disability Can Be Safer Drivers

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Research suggests that some drivers with neurological disabilities may actually be safer drivers than people who do not have a condition. In a study from the Children’s Hospital of Philadelphia, drivers with ASD were 45% less likely than other young drivers to get a moving violation, and 83% less likely to have their license suspended. Drivers with ASD were also less likely to crash due to unsafe speed.

The Guardian’s Role

Teaching someone else how to drive can be both nerve-wracking and exciting. But parents or guardians of people with neurological disabilities may face extra hurdles in supporting their student drivers.

1

Get a professional evaluation

Staying objective in relation to the neurological condition of a loved one can be hard for parents or caregivers. Certified professionals can take the emotion or family dynamic out of the equation and provide neutral, fact-based assessments to determine whether somebody can safely drive.

2

Research the requirements

People with certain conditions or disabilities may be required to take additional tests or have their vehicle modified. Before you get too far in the process, make sure you know the rules in your state.

3

Practice

Any new driver needs to practice, but drivers with neurological disorders may need to spend additional time getting accustomed to the road. Help your loved one gain practice by showing them how to drive on minor roads until they feel ready to handle any situation.

4

Model good behavior

Parents and guardians can set a good example by obeying the rules of the road and being courteous to fellow drivers. Teens or adults with neurological disabilities may need more explicit guidance.

Acknowledging Driving Challenges

Neurological disabilities have different characteristics and levels of severity, but several common features can make driving more challenging.

  • Information processing: People with neurological disabilities such as ASD may not be able to process information adequately. These challenges can make it hard to navigate or adapt to changing road conditions.
  • Motor skills: Neurological disabilities may limit drivers’ hand-eye coordination, which can make operating a vehicle difficult, especially in more difficult road conditions. Braking, accelerating, turning, or handling curves may be especially tough.
  • Executive functioning: Drivers need to concentrate, process information, make quick judgments and adapt quickly. People with neurological disorders may lack these abilities, making it harder to follow traffic rules, focus, or anticipate danger. They may also struggle with unexpected events, such as a breakdown or detour.
  • Anxiety: Many drivers suffer from anxiety, but people with neurological conditions may find driving-related stress to be a bigger challenge. One bad experience, such as an accident or moving violation, can exacerbate fears.
  • Lack of social skills: Some people with neurological disabilities may lack social skills which can help them to interpret other drivers’ gestures and actions.

Making a Plan

A good plan can help drivers with neurological disabilities to feel more comfortable behind the wheel.

1

Get a clinical evaluation

Visual, physical, and cognitive evaluations can shed light on whether someone is ready to drive. This foundational information should form the basis of a plan to get someone behind the wheel.

2

Take a behind-the-wheel assessment

For people who drove before the onset of a disability, a professional assessment of their driving capabilities illuminates any skill gaps.

3

Sign up for training

New or returning drivers need training to learn the basics. Experienced drivers need training to bridge any skill gaps caused by their disability.

4

Practice

Everyone seeking a driver’s license benefits from practice. Time behind the wheel improves confidence, comfort, and driving skill. Log hours to keep track of progress.

5

Map out different scenarios

Bad weather, flat tires, mechanical problems and other issues can throw less confident drivers for a loop. Minimize the risks by staying prepared for any situation.

Driving Readiness Resources

Evaluations can help assess the driving readiness level of people with disabilities. Tests often include an assessment of reaction times, visual acuity, and decision-making or judgment skills. Several entities also provide or oversee adaptive technology for vehicles.

  • American Occupational Therapy Association: Find a driver rehabilitation specialist through the national directory offered by the American Occupational Therapy Association.
  • The Association for Driver Rehabilitation Specialists (ADED): ADED is a nonprofit association of professionals working in transportation equipment modification for people with disabilities.
  • The Next Street: Operating in Connecticut, Massachusetts and Rhode Island, The Next Street's occupational therapists and instructors provide driving lessons and adaptive driving programs for individuals with medical challenges. Certified driving rehab specialists conduct medical driving evaluations and help determine whether someone can get back to driving.
  • Quality Assurance Program (QAP): QAP is a national accreditation program for auto mobility businesses in North America. It offers a directory of trusted vehicle modification resources.
  • Rehabilitation Engineering and Assistive Technology Society of America (RESNA): RESNA offers consumer information and resources to help people find certified professionals, state programs and financing for assistive technology.
  • Rehabilitation Services Administration (RSA): The RSA helps states and agencies provide vocational rehabilitation services to people with disabilities. The goal is to support the independence and community integration of people with disabilities.
  • TeenDrivingPlan Practice Guide: Produced by the Children’s Hospital of Philadelphia (CHOP), this program guides new drivers through a series of lessons and activities to build driving skills.

Obtaining a License

An illustration of a young woman in an automatic wheelchair is preparing to enter her truck after obtaining her driver’s license.

To get a driver’s license, people with disabilities need to complete the same steps as any other driver. But they may need to get additional help from instructors, make special modifications to their vehicles or get special documentation showing their fitness to drive.

1

Take a written driver’s test to get a learner’s permit

People with conditions such as ASD may do better on written driving tests.

2

Take driver’s education with a licensed instructor who specializes in disabled driving

Disabled driving lessons are tailored for people with physical impairments, including those caused by neurological disorders.

3

Choose a car with helpful features

Push-button ignition switches, power steering, power windows and locks, and automatic transmissions can all make driving easier.

4

Make necessary vehicle modifications

Some people with disabilities can drive safely but need to modify their vehicles to do so. Adaptive equipment may include hand controls or a second set of controls installed in the passenger seat. In a manual transmission vehicle, additional changes may be needed.

5

Take a road test

Drivers with disabilities who want to obtain a license can take their road test with a specialist in disabled driving.

Special Requirements

Driving rules differ for people with neurological disorders depending on the state. In some places, drivers with epilepsy must demonstrate they are seizure-free for some time and/or provide a doctor’s assessment showing they are fit to drive. In other spots, doctors must report uncontrolled seizures to the Department of Motor Vehicles.

Handicap Parking Permits And Other Placards

Each state has its own rules and processes for people with disabilities to get handicapped parking permits. Typically, a state’s Department of Motor Vehicles issues permits and placards. A doctor or other qualified healthcare professional usually needs to confirm a condition. Bumper stickers can also be used to indicate that a driver has a disability.

Additional Requirements

Some people with disabilities cannot manage their own affairs independently and need to have an appointed guardian make decisions on their behalf. In some states, people under complete legal guardianship cannot hold a driver’s license. People with limited guardianship can usually keep or get a driver’s license.

Purchasing Car Insurance

An illustration of a young woman in an automatic wheelchair is purchasing car insurance by handing a stack of cash to a female representative.

Finding the right car insurance is vital for people with disabilities. Insurers cannot deny coverage or charge higher rates based on a driver’s disability, but some disabled drivers may choose to spend more to get comprehensive coverage. Car insurance rates can vary widely by carrier, so it’s important to compare prices. People with disabilities may be able to save by staying on their parent’s car insurance or bundling their car insurance with home insurance.

Getting Comfortable Behind the Wheel

An illustration of a young woman in an automatic wheelchair is checking off driver safety tips with a large pencil on a clipboard.

Basic defensive driving techniques can help people feel safe behind the wheel.

  • Avoid distractions: More than 3,000 people are killed each year in the U.S. due to distracted driving. Don’t text, talk on the phone, or even play loud music while driving.
  • Get comfortable with your vehicle: Make sure you are completely at ease with your car before going out on the road, especially if you have made unique modifications.
  • Avoid unsafe conditions: If the roads are slick or slippery due to inclement weather, try to avoid driving. If you have trouble seeing at night, aim to arrive at your destination before dark.
  • Follow the rules: Stick to speed limits and observe the rules for turning, yielding, and stopping.
  • Acknowledge the risks: Talk openly with your doctor and family members about your condition and make sure they agree it is safe for you to drive.
  • Avoid driving on certain medications: Some medications have side effects that can impair your driving. Discuss any new medication with your doctor or pharmacist to make sure you understand the potential risks.
  • Make an emergency plan: Getting into an accident or getting lost can be scary and disorienting. Make sure to know who to call and what to do in emergency situations.

How to Prepare

Drivers are often required to process multiple inputs simultaneously, including stopping at traffic lights, switching lanes, and staying focused on the road. People with ASD or other neurological conditions may fixate on one thing or struggle to filter out unnecessary stimuli. Developing strategies to process information can help.

1

Break down tasks into bite-sized chunks

Breaking down the complex task of driving can help drivers learn the building blocks on a more manageable scale.

2

Prepare for the unexpected

Adapting to unforeseen situations is an integral part of learning how to drive.

3

Train with a Certified Autism Specialist

Driving presents numerous challenges for people with neurological conditions like ASD. Specialists can help drivers process stimuli and manage the challenges.

How to Be Supportive

Parents and guardians may have to make a concerted effort to adjust their expectations for potential drivers with neurological conditions.

1

Don’t force it

Driving may not be the right move for everyone with a neurological condition. Parents and guardians can be supportive by accepting that their child or loved one may not be ready to drive, now or ever.

2

Be patient

Parents and guardians may need to set longer timeframes—or abandon schedules altogether—when working with someone who has a disability. Students with neurological disorders may need to take frequent breaks or shorter driving lessons.

3

Retrace old ground

Driving familiar routes can help people with neurological disorders to feel more confident and relaxed.

4

Stay calm

Student drivers with a disability may need extra coaching to stay calm when other drivers break the rules or drive aggressively.

Expert Insight on Driving for Individuals with Special Needs

  1. What is the value of driving for people with neurological disabilities?
  2. What policies, programs, strategies or individual actions can enable people with neurological disabilities to drive?
Matt Abisamra
Matt Abisamra

Driving Program Supervisor, Assistive Technology Department at Shepherd Center

Andrew Arboe
Andrew Arboe

Director of Community Outreach at Planning Across The Spectrum

Additional Resources

Many organizations provide resources and support to people with neurological disabilities.

  • National Mobility Equipment Dealers Association (NMEDA): NMEDA is a nonprofit trade association representing the automotive mobility industry. Its members are dedicated to expanding opportunities for people with disabilities by providing resources and guidance for adaptive equipment.
  • International Bureau for Epilepsy (IBE): IBE provides worldwide support and addresses the social issues affecting people with epilepsy, such as driving-license restrictions.
  • Epilepsy Foundation: The Epilepsy Foundation is a national nonprofit organization that provides research, information and advocacy about epilepsy. It also gives detailed information on each state’s driver’s license requirements.
  • The Center for Self-Determination: This nonprofit provides information and training about self-determination to empower people with disabilities, their families and allies. Resources on guardianship are particularly relevant to people who want to drive since some types of guardianship can nullify driver’s licenses in some states.
  • Center for Injury Research and Prevention: This research center at the Children’s Hospital of Philadelphia (CHOP) provides research and resources about driving with autism.
  • Brain Injury Association of America: The association works to advance research, awareness, treatment and education about brain injuries and provides resources on driving after a traumatic brain injury.

About the Author


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Deb Gordon is author of The Health Care Consumer’s Manifesto (Praeger 2020), a book about shopping for health care, based on consumer research she conducted as a senior fellow in the Harvard Kennedy School’s Mossavar-Rahmani Center for Business and Government between 2017 and 2019. Her research and writing have been published in JAMA Network Open, the Harvard Business Review blog, USA Today, RealClear Politics, TheHill, and Managed Care Magazine. Deb previously held health care executive roles in health insurance and health care technology services. Deb is an Aspen Institute Health Innovators Fellow, and an Eisenhower Fellow, for which she traveled to Australia, New Zealand, and Singapore to explore the role of consumers in high-performing health systems. She was a 2011 Boston Business Journal 40-under-40 honoree, and a volunteer in MIT’s Delta V start-up accelerator, the Fierce Healthcare Innovation Awards, and in various mentorship programs. She earned a BA in bioethics from Brown University, and an MBA with distinction from Harvard Business School.


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