Identifying safe versus unsafe drivers following brain impairment: the Coorabel Programme.

The Coorabel Driver Assessment and Training Programme commenced in January 1988, with the aim of providing assessments of the ability of people with a disability to resume or commence driving. This programme incorporates assessments by a medical practitioner, a neuropsychologist, an occupational therapist and a driving instructor, conducted both off and on the road. The first 129 consecutive referrals were reviewed. Non-brain-impaired clients demonstrated a lower failure rate relative to brain-impaired clients. Diagnosis was not found to have predictive value within the brain-impaired clients, and there was no statistical difference in failure rates between left and right hemispheric strokes. Whilst only six cases failed the medical assessment, in 47 cases the medical practitioner was unable to make a final decision regarding driver competence. Neuropsychological and on-road assessments resulted in definitive decisions for 39 of these 47 cases. Twenty cases passed the medical assessment but subsequently failed the neuropsychological or on-road assessment. Only three cases passed at neuropsychological assessment subsequently failed on-road testing. It is suggested that multidisciplinary assessment of driver competence, inclusive of on-road testing, is essential, as medical guidelines alone are insufficient to predict driver fitness.