A Verbal Cuing Device for Persons With Brain Injury: Development and Proof-of-Concept Case Study

Abstract The ability to successfully return to driving following neurologic injury is one of the most critical factors in re-establishing independence and the most notable safety concern of health providers and family members. This assistive technology study describes the development of a verbal cuing device called the Electronic Driving Coach used as an adjunct to driver training following brain injury. We review literature on rates of return to driving following brain injury and factors associated with predicting return to driving and driving ability. We then address critical factors to return to driving addressed by this emerging technology and describe how the verbal cuing device called the Electronic Driving Coach was designed. We provide a proof-of-concept case study that evaluates use of the verbal cuing device with a person who has experienced a traumatic brain injury. Last, we discuss practical considerations for developing and using assistive driving devices in persons with cognitive impairments, including drivers who have experienced a stroke.

[1]  J. Haselkorn,et al.  Characteristics of drivers and driving record after traumatic and nontraumatic brain injury. , 1998, Archives of physical medicine and rehabilitation.

[2]  J Duncan,et al.  Rehabilitation of executive functioning: An experimental–clinical validation of Goal Management Training , 2000, Journal of the International Neuropsychological Society.

[3]  G. A. Riley,et al.  Threat appraisal and avoidance after traumatic brain injury: why and how often are activities avoided? , 2004, Brain injury.

[4]  J. Gehrels,et al.  Psychosocial outcomes 1–7 years after comprehensive milieu-oriented neurorehabilitation: The role of pre-injury status , 2006, Brain injury.

[5]  H. Finestone,et al.  Driving and Reintegration Into the Community in Patients After Stroke , 2010, PM & R : the journal of injury, function, and rehabilitation.

[6]  J. Rönnberg,et al.  Factors influencing driving 10 years after brain injury , 2008, Brain injury.

[7]  J. Arango-Lasprilla,et al.  Caregivers' Concerns about Judgment and Safety of Patients with Brain Injury: A Preliminary Investigation , 2009, PM & R : the journal of injury, function, and rehabilitation.

[8]  Scott R Millis,et al.  Predictors of driving outcome after traumatic brain injury. , 2002, Archives of physical medicine and rehabilitation.

[9]  M. Mccarthy,et al.  Risk of Posthospitalization Mortality Among Persons With Traumatic Brain Injury, South Carolina 1999–2001 , 2005, The Journal of head trauma rehabilitation.

[10]  L. Diller,et al.  The Systematic Remediation of Specific Disorders: Selected Application of Methods Derived in a Clinical Research Setting , 1982 .

[11]  H. Finestone,et al.  Driving difficulties of brain-injured drivers in reaction to high-crash-risk simulated road events: A question of impaired divided attention? , 2009, Journal of clinical and experimental neuropsychology.

[12]  J. DeLuca,et al.  Driving Behaviors Following Brain Injury: Self‐Report and Motor Vehicle Records , 2002, The Journal of head trauma rehabilitation.

[13]  David Salisbury,et al.  UFOV performance and driving ability following traumatic brain injury , 2006, Brain injury.

[14]  C. Hawley Return to driving after head injury , 2001, Journal of neurology, neurosurgery, and psychiatry.

[15]  G. Fox,et al.  On-road assessment of driving competence after brain impairment: review of current practice and recommendations for a standardized examination. , 1998, Archives of physical medicine and rehabilitation.

[16]  M. Dijkers,et al.  Community activities and individuals' satisfaction with them: quality of life in the first year after traumatic brain injury. , 2005, Archives of physical medicine and rehabilitation.

[17]  Marco Tamietto,et al.  To drive or not to drive (after TBI)? A review of the literature and its implications for rehabilitation and future research. , 2006, NeuroRehabilitation.

[18]  K A Dunn,et al.  Traumatic brain injury in the United States: A public health perspective. , 1999, The Journal of head trauma rehabilitation.

[19]  Marco Tamietto,et al.  Role of premorbid factors in predicting safe return to driving after severe TBI , 2005, Brain injury.

[20]  Sherrilene Classen,et al.  Traumatic brain injury and driving assessment: an evidence-based literature review. , 2009, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[21]  A. Schanke,et al.  Driving behaviour after brain injury: a follow-up of accident rate and driving patterns 6-9 years post-injury. , 2008, Journal of rehabilitation medicine.

[22]  V Sahgal,et al.  Driving safety after brain damage: follow-up of twenty-two patients with matched controls. , 1990, Archives of physical medicine and rehabilitation.

[23]  L. Rapport,et al.  Driving and community integration after traumatic brain injury. , 2008, Archives of physical medicine and rehabilitation.

[24]  W. Walker,et al.  Moderating Factors in Return to Work and Job Stability After Traumatic Brain Injury , 2003, The Journal of head trauma rehabilitation.

[25]  T Galski,et al.  Off-road driving evaluations for persons with cerebral injury: a factor analytic study of predriver and simulator testing. , 1997, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[26]  J. Powell,et al.  Return to driving within 5 years of moderate–severe traumatic brain injury , 2010, Brain injury.

[27]  T. Novack,et al.  Driving following traumatic brain injury: prevalence, exposure, advice and evaluations. , 1998, Brain injury.

[28]  S Hartley,et al.  Is there a link between alertness and fatigue in patients with traumatic brain injury? , 2008, Neurology.

[29]  M Sommer,et al.  Cognitive and personality determinants of post-injury driving fitness. , 2010, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.