Driving for Individuals With a Neurological Disability

Some people are born with conditions like autism spectrum disorder (ASD) or epilepsy, while others develop disabilities due to brain injuries or age-related diseases like Alzheimer’s. Neurological disorders can impair vision, hearing, mobility, communication, and cognition. Depending on the severity of the disability, driving may or may not be possible. Learn more on considerations and strategies to prepare for getting behind the wheel with a neurological disability and how to shop for the right auto insurance.

It can be hard to know if someone with a neurological disability is able to drive safely. Safe driving requires a complex set of motor, cognitive, visual and judgment skills. Clinical assessments and driving tests can help determine if someone has the necessary capabilities to get behind the wheel.

Driving can give people with neurological disabilities a sense of independence and freedom. Greater mobility gives people tangible access to employment, education, health care and social activities. Especially in suburban and rural areas where public transportation may be limited, driving can allow people to reach their destination easily.

Neurological disabilities have different characteristics and levels of severity, but several common features can make driving more challenging.

• Information processing: People with neurological disabilities such as ASD may not be able to process information adequately. These challenges can make it hard to navigate or adapt to changing road conditions.
• Motor skills: Neurological disabilities may limit drivers’ hand-eye coordination, which can make operating a vehicle difficult, especially in more difficult road conditions. Braking, accelerating, turning, or handling curves may be especially tough.
• Executive functioning: Drivers need to concentrate, process information, make quick judgments and adapt quickly. People with neurological disorders may lack these abilities, making it harder to follow traffic rules, focus, or anticipate danger. They may also struggle with unexpected events, such as a breakdown or detour.
• Anxiety: Many drivers suffer from anxiety, but people with neurological conditions may find driving-related stress to be a bigger challenge. One bad experience, such as an accident or moving violation, can exacerbate fears.
• Lack of social skills: Some people with neurological disabilities may lack social skills which can help them to interpret other drivers’ gestures and actions.

Evaluations can help assess the driving readiness level of people with disabilities. Tests often include an assessment of reaction times, visual acuity, and decision-making or judgment skills. Several entities also provide or oversee adaptive technology for vehicles.

• American Occupational Therapy Association: Find a driver rehabilitation specialist through the national directory offered by the American Occupational Therapy Association.
• The Association for Driver Rehabilitation Specialists (ADED): ADED is a nonprofit association of professionals working in transportation equipment modification for people with disabilities.
• The Next Street: Operating in Connecticut, Massachusetts and Rhode Island, The Next Street's occupational therapists and instructors provide driving lessons and adaptive driving programs for individuals with medical challenges. Certified driving rehab specialists conduct medical driving evaluations and help determine whether someone can get back to driving.
• Quality Assurance Program (QAP): QAP is a national accreditation program for auto mobility businesses in North America. It offers a directory of trusted vehicle modification resources.
• Rehabilitation Engineering and Assistive Technology Society of America (RESNA): RESNA offers consumer information and resources to help people find certified professionals, state programs and financing for assistive technology.
• Rehabilitation Services Administration (RSA): The RSA helps states and agencies provide vocational rehabilitation services to people with disabilities. The goal is to support the independence and community integration of people with disabilities.
• TeenDrivingPlan Practice Guide: Produced by the Children’s Hospital of Philadelphia (CHOP), this program guides new drivers through a series of lessons and activities to build driving skills.

Driving rules differ for people with neurological disorders depending on the state. In some places, drivers with epilepsy must demonstrate they are seizure-free for some time and/or provide a doctor’s assessment showing they are fit to drive. In other spots, doctors must report uncontrolled seizures to the Department of Motor Vehicles.

Each state has its own rules and processes for people with disabilities to get handicap parking permits. Typically, a state’s Department of Motor Vehicles issues permits and placards. A doctor or other qualified healthcare professional usually needs to confirm a condition. Bumper stickers can also be used to indicate that a driver has a disability.

Some people with disabilities cannot manage their own affairs independently and need to have an appointed guardian make decisions on their behalf. In some states, people under complete legal guardianship cannot hold a driver’s license. People with limited guardianship can usually keep or get a driver’s license.

Finding the right car insurance is vital for people with disabilities. Insurers cannot deny coverage or charge higher rates based on a driver’s disability, but some disabled drivers may choose to spend more to get comprehensive coverage. Car insurance rates can vary widely by carrier, so it’s important to compare prices. People with disabilities may be able to save by staying on their parent’s car insurance or bundling their car insurance with home insurance.

Basic defensive driving techniques can help people feel safe behind the wheel.

• Avoid distractions: More than 3,000 people are killed each year in the U.S. due to distracted driving. Don’t text, talk on the phone, or even play loud music while driving.
• Get comfortable with your vehicle: Make sure you are completely at ease with your car before going out on the road, especially if you have made unique modifications.
• Avoid unsafe conditions: If the roads are slick or slippery due to inclement weather, try to avoid driving. If you have trouble seeing at night, aim to arrive at your destination before dark.
• Follow the rules: Stick to speed limits and observe the rules for turning, yielding, and stopping.
• Acknowledge the risks: Talk openly with your doctor and family members about your condition and make sure they agree it is safe for you to drive.
• Avoid driving on certain medications: Some medications have side effects that can impair your driving. Discuss any new medication with your doctor or pharmacist to make sure you understand the potential risks.
• Make an emergency plan: Getting into an accident or getting lost can be scary and disorienting. Make sure to know who to call and what to do in emergency situations.

Many organizations provide resources and support to people with neurological disabilities.

• National Mobility Equipment Dealers Association (NMEDA): NMEDA is a nonprofit trade association representing the automotive mobility industry. Its members are dedicated to expanding opportunities for people with disabilities by providing resources and guidance for adaptive equipment.
• International Bureau for Epilepsy (IBE): IBE provides worldwide support and addresses the social issues affecting people with epilepsy, such as driving-license restrictions.
• Epilepsy Foundation: The Epilepsy Foundation is a national nonprofit organization that provides research, information and advocacy about epilepsy. It also gives detailed information on each state’s driver’s license requirements.
• The Center for Self-Determination: This nonprofit provides information and training about self-determination to empower people with disabilities, their families and allies. Resources on guardianship are particularly relevant to people who want to drive since some types of guardianship can nullify driver’s licenses in some states.
• Center for Injury Research and Prevention: This research center at the Children’s Hospital of Philadelphia (CHOP) provides research and resources about driving with autism.
• Brain Injury Association of America: The association works to advance research, awareness, treatment and education about brain injuries and provides resources on driving after a traumatic brain injury.