Background Information
The DRIVINGHEALTH® INVENTORY including TOUCHTRAILSTM and UFOV® screening program builds on the results of decades of scientific research investigating which age-related declines in functional abilities best predict the likelihood that a driver will have a motor vehicle crash. Guiding principles for the proper use of this screening program for screening and assessment are outlined below.
Research & Development
Crash involvement — especially ‘at-fault crashes’ — is the most stringent criterion for the validation of screening measures. The research behind the DRIVINGHEALTH® INVENTORY has been sponsored primarily by the National Highway Traffic Safety Administration and the National Institute on Aging. More of these studies have been led by investigators from TransAnalytics and Visual Awareness, Inc. than by any other organizations.
The particular screening measures included in this software tool evolved from the Gross Impairments Screening (GRIMPS) battery that is noted in the NHTSA research cited below. Only the significant crash predictors from this earlier work were adapted for computer test administration, to improve both their standardization and reliability; then data management features and report options were added to produce the DRIVINGHEALTH® INVENTORY.
Please visit the links below for additional information pertaining to the development of these screening measures. Validation data, specifically, may be inspected via the first link, through reference to summary tables included in the main body of the report and raw data tables contained in the report appendices.
Our software development team is committed to continuously updating the DRIVINGHEALTH® INVENTORY as new data allow greater precision in specifying cutpoints for each functional measure, and users give us feedback suggesting ways to improve its operation and reliability. To facilitate the proper use and interpretation of results from DRIVINGHEALTH® INVENTORY, certain basic principles need to be understood by administrators as well as drivers.
Screening & Assessment of Medically At-Risk Drivers: Basic Principles
In our aging society, where most people remain dependent on private automobiles to maintain the mobility so essential to a good quality of life, identifying at-risk drivers is a priority for both public and personal safety. As some states move toward greater involvement by licensing authorities to ensure fitness-to-drive, and others encourage private sector initiatives in this arena, a common understanding of core concepts is useful.
Screening is the “first tier” in evaluating fitness-to-drive. Its distinguishing features include:
- Almost all drivers “pass,” with some getting an early warning of a mild or potentially impairing condition and others establishing a baseline against which later changes in key functional abilities can be measured. For a few individuals who appear to have a serious impairment, further, in-depth evaluation is recommended.
- Screening may lead to further testing, but in itself does not lead to any licensing action.
- Screening may be conducted by a qualified test administrator in any office or clinical setting affording a reasonable degree of privacy, and absence from distractions.
- A variety of manual and computer-based driver screening tools are available. Most important is that screening encompasses a comprehensive range of visual, mental, and physical abilities needed to drive safely; that test procedures are standardized and reliable; and that screening measures are scientifically validated as predictors of motor vehicle crashes.
Assessment is the “second tier” in evaluating fitness-to-drive. Key points include:
- Drivers may choose or be required to obtain a diagnostic evaluation of the underlying reason for a deficit identified during screening through more in-depth clinical testing, through laboratory testing, through in-car assessment, or through a combination of procedures.
- Assessments are typically performed by (or on behalf of) physicians, optometrists, occupational and physical therapists, and driving rehabilitation specialists.
- In most states, a formal driver assessment is necessary (and sufficient) to trigger a licensing restriction or other action.
It is the degree of impairment in one or more essential safe driving abilities that determines a person’s fitness to drive, not his or her medical diagnosis per se. For example, some symptoms of diabetes place individuals at great risk when they drive, while others do not; likewise, a person diagnosed with a progressive dementia may drive (within limits) safely in the earliest stages, given frequent reassessment to determine when there is a marked increase in the risk of impaired driving.
The most extensive and rigorous research to date linking crash risk to age-related functional decline, sponsored by the National Highway Traffic Safety Administration and the National Institute on Aging, points to just a handful of basic abilities that are most important for safe driving. In addition to having good vision under both high and low contrast conditions, certain aspects of physical fitness are also important—sufficient head-neck flexibility to quickly check to the sides and rear, and enough leg strength to control the pedals effectively in routine situations and when react-ing to emergencies. A cluster of cognitive abilities also are highlighted: working memory, to retain and apply traffic rules and regulations, and remember directions while driving; visual search, especially under divided attention conditions, to spot all manner of signs, signals, hazards, landmarks, and other elements in or near the road that help one drive safely; visualizing missing information, to help drivers anticipate and recognize threats, even when only a part is in view; and visual information processing speed, which makes it possible to pay attention to what is happening directly ahead, while still perceiving threats at the edge of the “useful field of view.”
Early detection of changes in safe driving abilities helps people keep driving safely longer!
UFOV is a registered trademark of Visual Awareness, Inc.