Psychological assessment for driver competency in the elder
Cornelia R. Dougall (2003)
Neuropsychological assessments that psychologists who are members of the American Psychological Association with an expressed interest in Division Forty (Neuropsychology) use to test competency to drive an automobile in the elder population was examined. One-hundred eleven of 400 randomly selected surveys were returned. Respondents were requested to indicate from the list of 57 assessments the ones they use to test elders for automobile driver competency. Forty-three additional tests were written in by respondents. The most frequently utilized tests of all respondents (in decreasing order) were: Trails A & B sub-test, Dementia Rating Scale, WAIS, Wechsler Memory Scale, Block Design sub-test, Digit Symbol sub-test, Rey-Osterrieth Complex Figure Test, Wisconsin Card Sort, Hooper Visual Organization, and the Grooved Pegboard test. Other questions on the survey relate to demographics of practice, training, and knowledge of elder driver assessment for competency. Thirteen different states and one Canadian province were represented on the returned surveys. Knowledge of the functions that must be intact for driving was indicated as the most influential or next to the most influential factor concerning what neuropsychological test assessments are selected by all respondents. Respondents were asked to rank the human functions necessary for safe driving. The function of attention received the highest ranking, followed by vision, concentration, reaction time, executive function, orientation, and motor functioning. Emotion and intelligence were ranked the lowest in influence in elder driver assessment. Many respondents were unable to identify whether their state had graduated (age-based) licensing requirements for elder drivers. Respondents appeared more accurate at identifying general licensing requirements for elders. It is suggested that an interdisciplinary committee develop a valid, reliable, standardized, and cost effective test battery to identify unsafe drivers. Representatives of the DMV, physicians, psychologists, rehabilitation specialists, ophthalmologists, and elder groups should convene to sort out these important public safety issues. The psychologist's role in elder driver issues include: development of standards for predictive identification of cognitively impaired elder drivers, protection of the rights of elders, provide psychological support for elders who must stop driving, and to be involved in the psychological assessment of elders for competency to drive an automobile.