Low Vision Driving Instructor: A New Role for Vision Rehabilitation Specialists

Printer-friendly versionSend by emailPDF version Article
Envision Low Vision Rehabilitation Center, Wichita KS
Dec 19 2009
thamilton's picture

The loss of the privilege of driving is perhaps the number one issue of concern to the low vision population. In a world of instant gratification where people can just hop in the car and everything is at their fingertips, the loss of America’s primary mobility tool can be devastating. Many people are unable to drive to work or continue living in an area without public transportation. People who have been independent for a lifetime suddenly must rely on relatives or friends to drive them to where they want to go. Since the driver’s license is such a symbol of independence, the loss can result in psychological and emotional trauma.1-2 However, with proper instruction, and in some cases the right tools, many people with low vision can remain safely on the road.

 

O&M and Visual Skills are Required for Safe Driving.  The necessary skills to be a safe and independent driver are similar to those used for pedestrian orientation and mobility (O&M). If you want to travel through an environment, you must understand the environment. You must understand the layout of the area, establish landmarks, and identify passing traffic. Just as you would plan a trip using a road map, so must the visually impaired driver prepare for a trip before traveling in unfamiliar areas. Cardinal directions are always important. If the sun is not out, how would you orient to your surroundings? That is where basic orientation techniques come in. Today, we also have the benefit of various forms of GPS-based navigation systems that are widely available to help with orientation.

 

Driving safely requires a number of important skills such as: ability to perceive changes in a rapidly changing environment, managing to judge and take action on the information in a timely and safe manner, and the motor ability to execute the actions needed. Both visual and cognitive impairments can reduce the driver's useful field of view (UFOV), which is defined as the area of the visual field where one can shift attention to extract visual information without head or eye movement. Problems resulting from a reduced UFOV include slowed reaction time, missed events and important environmental hazards, and problems processing "visual clutter."3 If one area is diminished, it is up to the driver to compensate in another area. If there is a problem perceiving changes in the environment, it will become imperative for the driver to take compensatory action. For example, braking at a stop light is a mixture of identifying the sign, then applying the brake. If you perceive the sign later than average, you must apply the brake sooner than normal. A complex and busy visual environment may be confusing to a driver, with hazards overlooked.

 

There is far more than simple visual acuity involved in the complex task of automotive travel.4 Many people need practice scanning and spotting the various indicators that allow a person to maintain a proper distance from other motorists. The person must locate intersections, traffic signs, and estimate distance using a variety of visual techniques. For example, when a vehicle is not present on a perpendicular street, how would a person identify that there is an intersection? These are the types of concepts that orientation and mobility specialists teach.5 Many people with a loss of depth perception have to pay attention to other visual cues. As with pedestrian mobility, familiar techniques such as visual trailing of the sides of buildings, grass-lines and curbs also play an important role in low vision adaptive driving.

 

Are Low Vision Drivers Safe?  A topical study found that low vision drivers have deficits with visual processing speed, reduced contrast sensitivity and visual field sensitivity.6 The same study also found that highway travel was not significantly different for the low vision driver and sighted drivers. With these findings, it can be said that by practicing adaptive behavior, low vision drivers can be safe drivers.

 

Reduced contrast sensitivity has been proven in numerous studies to be associated with poor performances on driving tests, increased difficulties in driving and higher involvement in at-fault car crashes.7 Currently, no state has a contrast test to assess the sensitivity of its licensed drivers. Many low vision drivers have issues concerning contrast that can severely impair their perception of the environment. These individuals may need to practice spotting and scanning techniques to help assure they can take appropriate actions. Low vision drivers with reduced contrast sensitivity also are likely to benefit from glare reducing (e.g., neutral density), or contrast enhancing (e.g., amber or yellow tint) filters.

 

Many individuals continue to drive, telling themselves, “It’s only down the street,” or “No one will be out at night.” However, driving at night and in residential areas is often hazardous. It is seldom worth putting people at risk when simple adaptive visual techniques can be learned and practiced.

 

Who Should Train the Low Vision Driver?  With various professionals working with people with low vision (i.e. ophthalmologists, optometrists, occupational therapists, orientation and mobility specialists, and low vision therapists), there are a variety of skills and techniques that can be taught to allow someone with low vision to be a safe and independent driver. Low vision professionals are available to provide adaptive training and to make people feel confident in their ability to continue driving. Certain low vision professionals are equipped to help people regain their independence by finding the right visual aids, but most importantly, to teach low vision individuals how to properly use the adaptive driving aids.8 Each state has different requirements regarding the instruction of low vision drivers, so check with your individual state regarding certification of specialists in your area. National Certification is available through the Association for Driver Rehabilitation Specialists (ADED) and should be the goal of any vision professional wanting to work in the driver rehabilitation field.

 

Candidates may take the certification examination if they meet the education and/or experience requirements listed below. Current experience and eligibility listed by ADED are as follows:

  • An undergraduate degree or higher in a health related area of study with 1 year full time experience in degree area of study and an additional 1 year full time experience in the field of Driver Rehabilitation.
  • Four year undergraduate degree or higher with a major or minor in Traffic Safety and/or a Driver and Traffic Safety Endorsement with 1 year full time experience in Traffic Safety and an additional 2 years of full time experience in the field of Driver Rehabilitation.
  • Two year degree in a health related area of study with 1 year experience in degree area of study and an additional 3 years full time experience in the field of Driver Rehabilitation.
  • Five years of full time work experience in the field of Driver Rehabilitation.

Not all vision rehabilitation professionals and/or occupational therapists have acquired the requisite knowledge to train low vision drivers in bioptic or adaptive low vision driving techniques. This is why preparing to gain certification as a driver rehabilitation specialist (CDRS) is so important for those who choose to provide those services. Vision professionals and occupational therapists should not attempt to instruct a low vision driver without being properly trained to provide that instruction. There are liability issues and rehabilitation services are only as good and as safe as the practitioner providing them.

 

Teaching Bioptic Driving.  Bioptic driving has existed since the 1920s.9 Several types and models of bioptics have been dispensed throughout the decades. One major issue still pertinent today is training with the devices. A prevalent misconception is that bioptics/telescopic devices will instantly “fix” low vision. Training with low vision rehabilitation specialists and practice on the part of the low vision person can help make this tool effective.

 

Prescribing the device is only the beginning of the process, not the end. This is why loaning the device before a purchase is more reliable than simply prescribing and purchasing a device. Studies have found that persons with low vision who received training with the device showed statistically significant improvement compared to those prescribed bioptics without training. When driving-related tasks were independently assessed, the trained group displayed greater improvement than did the untrained group.10

 

My Personal Experience Pursuing Certification as a Low Vision Driving Instructor.  I spent my Masters education learning about human vision and the effect various diseases have on what my patients see. Extensive training with adaptive visual aids, an understanding of visual sensation vs. perception, eccentric viewing instruction , visual compensation techniques and overall mobility issues/needs put me in a position as a professional to be an asset to the low vision driving field. However, I still must complete the requirements designated by ADED if I am to gain certification.

 

I currently teach the usage of bioptic devices and prerequisite skills required to utilize the devices while driving a vehicle. I am certified as a Certified Orientation and Mobility Specialist (COMS) working in a CORF certified multi-disciplinary vision rehabilitation center. I have utilized various mentors through ADED’s mentorship program and am pursuing an internship with a CDRS in Kansas City, MO. The certification process through ADED requires a considerable amount of time and devotion on the part of the rehabilitation professional.

 

Certified Orientation and Mobility Specialists have the skills needed to instruct a person, who is ineligible to drive, to find alternate forms of transportation. I have the training and skill required to help an ineligible driver utilize mass transit, special services and even personal mobility devices. When I inform someone they are no longer legal to drive, I have a plan of action for them to minimize the impact losing the license will have on them. Social support groups are invaluable for someone losing their ability to drive. They are able to speak with people who experienced the same issue and have resources others are more than willing to share.

 

I propose that vision rehabilitation professionals and occupational therapists practicing low vision rehabilitation consider adding low vision driver rehabilitation to their repertoire. The low vision population is growing as elderly drivers are on the rise. Orientation and mobility specialists, in particular, could transfer their existing knowledge and skills to the problem of low vision driving. However, irrespective of professional preparation, each service provider must demonstrate a clear understanding of the issues low vision drivers face and acquire the specialized training and required certification.

 

 


References

  1. Corn, A. L., & Sacks, S. Z. (1994). The impact of nondriving on adults with visual impairments. Journal of Visual Impairment & Blindness, 88, 53–68.
  2. Rosenblum, L. P., & Corn, A. (2002). Experiences of older adults who stopped driving because of their visual impairments: Part 1. Journal of Visual Impairment & Blindness, 96, 389–398.
  3. Visual Awareness. (n.d.). What is UFOV? Retrieved April 2, 2009, from http://www.visualawareness.com/Pages/whatis.html.
  4. Higgins, K. E., & Tait, A. (1998). Vision and driving: Selective effect of optical blur on different driving tasks. Human Factors, 41(2), 224-232.
  5. Blasch B, Wiener W, Welsh R. Foundations of Orientation and Mobility, Second Edition. American Foundation for the Blind, New York, NY. 1997.
  6. Wood, J., McGwin., G., Elgin, J., Vaphiades, M., Brasell, R., DeCarlo, D., Kline, L., Meek, C., Searcey, K. & Owsley, C. (2009) On-road driving performance of persons with hemianopia and quadrantanopia. Investigative Ophthalmology & Visual Science, Febuaray 2009, Vol. 50, No. 2, p. 577-588.
  7. Peli, E. & Peli, D. (2002). Driving with confidence: A practical guide to driving with low vision. World Scientific Publishing Co. p. 26-28.
  8. Huss, C. P. (2000). Training the low vision driver, Vision ’99. In C. Stuen, A. Arditi, A. Horowitz, M. A. Lang, B. Rosenthal, & K. Seidman (Eds.), Vision rehabilitation: Assessment, intervention and outcomes (pp. 264–267). New York: Swets & Zeitlinger.
  9. Corn, A., Huss, C. (2004) Low Vision Driving with Bioptics: An Overview. Journal of Visual Impairment & Blindness, 98.
  10. Szlyk, J., Seiple, W., Laderman, D.J., Kelsch, R., Stelmack, J., & McMahon, T. (2000). Measuring the effectiveness of bioptic telescopes for persons with central vision loss. Journal of Rehabilitation Research and Development, 37, p. 101-108.

1 Corn, A. L., & Sacks, S. Z. (1994). The impact of nondriving on adults with visual impairments. Journal of Visual Impairment & Blindness, 88, 53–68.

 

2 Rosenblum, L. P., & Corn, A. (2002). Experiences of older adults who stopped driving because of their visual impairments: Part 1. Journal of Visual Impairment & Blindness, 96, 389–398.

 

3 Prevent Blindness America, National Eye Institute. Vision Problems in the U.S.: Prevalence of Adult Vision Impairment and Age-Related Eye Disease in America. Schaumburg, IL: Prevent Blindness America; 2004.

 

4 Visual Awareness. (n.d.). What is UFOV? Retrieved April 2, 2009, from http://www.visual awareness.com/Pages/whatis.html.

 

5 Higgins, K. E., & Tait, A. (1998). Vision and driving: Selective effect of optical blur on different driving tasks. Human Factors, 41(2), 224-232.

 

6 Blasch B, Wiener W, Welsh R. Foundations of Orientation and Mobility, Second Edition. American Foundation for the Blind, New York, NY. 1997.

 

7 Wood, J., McGwin., G., Elgin, J., Vaphiades, M., Brasell, R., DeCarlo, D., Kline, L., Meek, C., Searcey, K. & Owsley, C. (2009) On-road driving performance of persons with hemianopia and quadrantanopia. Investigative Ophthalmology & Visual Science, Febuaray 2009, Vol. 50, No. 2, p. 577-588.

 

8 Peli, E. & Peli, D. (2002). Driving with confidence: A practical guide to driving with low vision. World Scientific Publishing Co. p. 26-28.

 

9 Huss, C. P. (2000). Training the low vision driver, Vision ’99. In C. Stuen, A. Arditi, A. Horowitz, M. A. Lang, B. Rosenthal, & K. Seidman (Eds.), Vision rehabilitation: Assessment, intervention and outcomes (pp. 264–267). New York: Swets & Zeitlinger.

 

10 Corn, A., Huss, C. (2004) Low Vision Driving with Bioptics: An Overview. Journal of Visual Impairment & Blindness, 98.

 

11 Szlyk, J., Seiple, W., Laderman, D.J., Kelsch, R., Stelmack, J., & McMahon, T. (2000). Measuring the effectiveness of bioptic telescopes for persons with central vision loss. Journal of Rehabilitation Research and Development, 37, p. 101-108.

Comment viewing options

Select your preferred way to display the comments and click "Save settings" to activate your changes.
Aug 4 2016
Tammyphilip's picture

That's right, the loss of the


That's right, the loss of the privilege of driving is perhaps the number one issue of concern to the low vision population. Even though we can watch most accidents happened by those who doesnt have any vision issues and just because of carelessness. So there is no point in denying driving privilege for low vision people. 

directv vs dish

Feb 18 2016
joes's picture

スーパーコピーブランド


propose that vision rehabilitation professionals and occupational therapists practicing low  vision rehabilitation consider adding low vision driver rehabilitation to their repertoire. The low vision population is growing as elder http://www.allpurse.ru for  for acclimation prices. http://www.allpurse.ru/mall

perfect replica http://www.enreplica.ru fake Michael Kors purses

http://www.bagsky.ru/Michael-Kors-184.htm

Feb 14 2016
pogulete's picture

Low vision Driving is the


Low vision Driving is the great way to improve driving for low vision patients.

 

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.
Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.
Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 16 2016
daborrelli's picture

MXQ PRO


Thanks for the post and great tips, even i also think that hard work is the most important aspect of getting success.

 

Feb 14 2016
kumesawi's picture

Many specialists are already


Many specialists are already offering their services as Low Vision Driving Instructor

Feb 13 2016
logoqohu's picture

Really great article and I am


Really great article and I am happy that Vision Rehabilitation Specialists are helping others

Jan 5 2016
daborrelli's picture

MXQ PRO


Good article,thank you very much.

Dec 16 2015
renuka's picture

You did really good work. I


You did really good work. I really appreciate your new and different post. Please guys keep it up and share with us some unique post in the future…

ipad service center in Mumbai

Nov 26 2015
zhangopen's picture

Good information, you shared


Good information, you shared such a interesting points.

http://www.wonderful-watch.co.uk

Nov 26 2015
zhangopen's picture

This year the Genevan brand


This year the Genevan brand is celebrating its 260th anniversary and has delved into its wealth of the http://www.yezong.co.uk
of archives to create a new collection. Its softly edgy geometric shapes and pure Art Deco style are inspired by a pendant http://www.handbag4you.co.uk designed by the brand in 1919. Its shy body, concealed by a fan, hides a secret. Glide your fingertips over the diamond-covered folds and Heure Discrète reveals a white mother-of-pearl dial whose décor echoes the fan. Two silver “poire” hands skim http://www.dressesshow.co.uk over the shimmering triangle to display the hours and minutes brought to life by the manual wind 1055 calibre inside the white gold case.

Nov 26 2015
zhangopen's picture

This year the Genevan brand


This year the Genevan brand is celebrating its 260th anniversary and has delved into its wealth of the http://www.yezong.co.uk
of archives to create a new collection. Its softly edgy geometric shapes and pure Art Deco style are inspired by a pendant http://www.handbag4you.co.uk designed by the brand in 1919. Its shy body, concealed by a fan, hides a secret. Glide your fingertips over the diamond-covered folds and Heure Discrète reveals a white mother-of-pearl dial whose décor echoes the fan. Two silver “poire” hands skim http://www.dressesshow.co.uk over the shimmering triangle to display the hours and minutes brought to life by the manual wind 1055 calibre inside the white gold case.

Oct 7 2015
scalett's picture

This can be why the


This can be why the http://www.careerbliss.co.uk produced by acclaimed designers are actual top priced. You may await on which you will get your income's amount whenever you access a person. Did you apperceive that a artist http://www.skyteamtrade.com is absolute allowance for every woman?. Regardless of area on this planet they ambition to biking or whatever break they would like to accord with

Aug 27 2015
Ninsea123's picture

Presque toute l'augmentation


Presque toute l'augmentation est construit à côté de l'autre mélange de Boa ou 18 kt ciel orange combinaison bleue. omega Tout cela dans un très favorable lourd donnent accès à 41 millimètres, mais aussi chérissent la chicane peut être appliqué rocher décoratif. L'édition spéciale replique montres Hublot Big Bang roi Montres Royaume-Uni 72 pièces rectangulaires andalousites, plus l'obscurité à travers le voir, thorugh Quarta développer un bijou.

Feb 18 2016
joes's picture

年LV GUCCI全新登場


<p>propose that vision rehabilitation professionals and occupational
therapists practicing low&nbsp; vision rehabilitation consider adding low
vision driver rehabilitation to their repertoire. The low vision
population is growing as elder <a href="http://www.allpurse.ru">http://www.allpurse.ru</a> for&nbsp; for acclimation
prices. <a href="http://www.allpurse.ru/mall">http://www.allpurse.ru/mall</a><br><br></p>

perfect replica http://www.enreplica.ru fake Michael Kors purses

http://www.bagsky.ru/Michael-Kors-184.htm

Feb 18 2016
joes's picture

年LV GUCCI全新登場


propose that vision rehabilitation professionals and occupational therapists practicing low  vision rehabilitation consider adding low vision driver rehabilitation to their repertoire. The low vision population is growing as elder http://www.allpurse.ru for  for acclimation prices. http://www.allpurse.ru/mall

perfect replica http://www.enreplica.ru fake Michael Kors purses

http://www.bagsky.ru/Michael-Kors-184.htm

Dec 11 2015
joes's picture

http://www.skypurse.com 


http://www.skypurse.com  ugmentation est construit à côté de l'autre mélange de Boa ou 18 kt ciel orange combinai Tout cela dans un très favorable lourd donnent accès à 41 millimètres, mais aussi chérissent la chicane peut être appliqué rocher décoratif. L'édition spécia http://www.bagsky.ru  72 pièces rectangulaires andalousites, plus l'obscurité à travers le voir, thorugh Quarta développer un bijou.

 

perfect replica http://www.enreplica.ru fake Michael Kors purses

http://www.bagsky.ru/Michael-Kors-184.htm

Dec 11 2015
joes's picture

propose that vision


propose that vision rehabilitation professionals and occupational therapists practicing low  vision rehabilitation consider adding low vision driver rehabilitation to their repertoire. The low vision population is growing as elderly http://www.skypurse.com drivers are on the rise http://www.bagsky.ru

perfect replica http://www.enreplica.ru fake Michael Kors purses

http://www.bagsky.ru/Michael-Kors-184.htm

Dec 11 2015
joes's picture

propose that vision


propose that vision rehabilitation professionals and occupational therapists practicing low  vision rehabilitation consider adding low vision driver rehabilitation to their repertoire. The low vision population is growing as elderly http://www.skypurse.com drivers are on the rise http://www.bagsky.ru

perfect replica http://www.enreplica.ru fake Michael Kors purses

http://www.bagsky.ru/Michael-Kors-184.htm


share
Follow PPLVR on Facebook Follow Emerald Education Systems on Twitter Follow PPLVR on RSS Email Us

Join our Mailing List:

Click HERE to learn more about the Driving course!
view counter