Assessment of fitness to drive after head injury is a vital but complex clinical issue. Recent reviews show a failure of published research to find clear links between neuropsychological assessment and everyday driving. As such there is currently a limited knowledge base to guide clinical psychologists in establishing assessment protocols and providing clinical advice. The aim of the study was to survey the practice of clinical psychologists in neuropsychological settings in the UK in assessing fitness to drive after head injury. A questionnaire was developed and distributed to members of the Special Group in Clinical Neuropsychology. This paper reports on the response of 92 members who returned the completed questionnaire. Responses revealed that many clinicians were not fully aware of clients' legal responsibilities. Most report advising clients about returning to driving based on neuropsychological test results and behavioural observations, albeit often acknowledging a low level of confidence in that advice. Perceptual and attentional tests were most frequently reported to be useful in assessing fitness to drive but there was a lack of consensus both about assessment and recommended action. Few reported a specific policy on driving. Clinical psychologists were asked infrequently for advice about driving by medical practitioners or the Driver and Vehicle Licensing Agency (DVLA). Most clinicians identified a need for more information on assessment of fitness to drive. The survey highlights a number of important service issues. In particular, there is a need for clear and collaborative service policies and protocols to integrate medical, neuropsychological, and driving assessment data in advising clients and the DVLA about fitness to drive. (A)
Abstract