Learning to drive with neurological conditions: profile of users of an adapted driver training program and cognitive factors associated with success

To describe the sociodemographic and cognitive profile of participants enrolled in an adapted driving program for individuals with neurological conditions, to explore the association between cognitive functioning and driving program outcome, and to describe driving habits after program completion.
This study combined retrospective chart review and cross-sectional data collection.
The sample included 71 participants with neurological disorders (aged 15–56 years, M = 22.2 ± 8.6; 39% women). Driving program was either successful (47%), failed (7%), discontinued (34%), or ongoing (13%). Among 35 participants with complete neuropsychological and driving program outcome data, those who successfully completed the program showed better attention functioning, and better performance relative to global functioning for attention, executive functions, and working memory, compared to those who discontinued/failed the program. Among 21 participants who completed a telephone questionnaire on average 3.7 years after program enrollment, 67% obtained their driver’s license and drove regularly. Participants reported high levels of satisfaction with the program.
These results suggest that approximately half of the persons enrolled in a driver training program designed for learners with neurological conditions, obtain a driver’s license; and that attention, and to a lesser extent executive functioning and working memory, are related to driving program success.IMPLICATIONS FOR REHABILITATION
In individual with neurological conditions, learning how to drive can be challenging.
An adapted driver training program, involving collaboration between driving instructors and healthcare professionals, simplification of theoretical learning, and increasing driving practice opportunities, can be effective, both in terms of licensing success and client satisfaction.
Conducting a pre-driving program neuropsychological assessment, with identification of cognitive strengths and weaknesses, can provide valuable information for clinicians and driving instructors for optimizing training and predicting outcome.
Better performance in attention, and better relative to global cognitive functioning in attention, executive functions, and working memory, are related to higher success rate of an adapted driving program.

In individual with neurological conditions, learning how to drive can be challenging.
An adapted driver training program, involving collaboration between driving instructors and healthcare professionals, simplification of theoretical learning, and increasing driving practice opportunities, can be effective, both in terms of licensing success and client satisfaction.
Conducting a pre-driving program neuropsychological assessment, with identification of cognitive strengths and weaknesses, can provide valuable information for clinicians and driving instructors for optimizing training and predicting outcome.
Better performance in attention, and better relative to global cognitive functioning in attention, executive functions, and working memory, are related to higher success rate of an adapted driving program.

本研究旨在描述适配式驾驶培训项目（adapted driving program）中神经系统疾病（neurological conditions）参与者的社会人口学特征与认知概况，探究认知功能与驾驶培训项目结局的关联，并阐明项目完成后的驾驶习惯。
本研究结合回顾性病历审查与横断面数据采集两种研究方法。
研究样本共纳入71名神经系统疾病患者，年龄范围为15~56岁，均值±标准差为22.2±8.6，女性占比39%。驾驶培训项目结局分为四类：成功完成（47%）、未通过（7%）、中途终止（34%）及仍在进行中（13%）。
在35名具备完整神经心理学测评与驾驶项目结局数据的参与者中，与中途终止/未通过项目的参与者相比，成功完成项目者的注意力功能更优，且在注意力、执行功能与工作记忆方面的表现在整体认知功能中的相对表现更佳。
在21名于项目入组后平均3.7年完成电话问卷调查的参与者中，67%已取得驾驶证并定期驾车。参与者对本项目的满意度较高。
上述结果表明，约半数参与适配式驾驶培训项目的神经系统疾病学员可成功取得驾驶证；注意力功能，以及程度稍弱的执行功能与工作记忆，与驾驶培训项目的成功结局相关。
【康复启示】
对于神经系统疾病患者而言，学习驾驶颇具挑战。
由驾驶教练员与医护人员协作开展、简化理论学习环节并增加驾驶练习机会的适配式驾驶培训项目，在驾驶证考取成功率与学员满意度两方面均具备有效性。
在驾驶培训项目开展前实施神经心理学测评，明确认知功能的优势与不足，可为临床医师与驾驶教练员优化培训方案、预测项目结局提供有价值的参考依据。
注意力功能表现更优，且在注意力、执行功能与工作记忆方面相对于整体认知功能的表现更佳，与适配式驾驶培训项目的更高成功率相关。

对于神经系统疾病患者而言，学习驾驶颇具挑战。
由驾驶教练员与医护人员协作开展、简化理论学习环节并增加驾驶练习机会的适配式驾驶培训项目，在驾驶证考取成功率与学员满意度两方面均具备有效性。
在驾驶培训项目开展前实施神经心理学测评，明确认知功能的优势与不足，可为临床医师与驾驶教练员优化培训方案、预测项目结局提供有价值的参考依据。
注意力功能表现更优，且在注意力、执行功能与工作记忆方面相对于整体认知功能的表现更佳，与适配式驾驶培训项目的更高成功率相关。