Addressing return to driving goals in the community after acquired brain injury: a scoping review

Published 22nd April 2026

Purpose
Neurological changes after acquired brain injury (ABI) can prevent or delay medical clearance for return to driving. Individuals attending community-based services often have goals to return to driving. This review aimed to explore approaches used in community-based services to support return to driving goals after ABI.

Material and method
The Arksey and O’Malley scoping review approach was followed, with additional quality appraisal. Inclusion criteria were: articles reporting on community-based services for people with moderate to severe ABI and who held a driver’s licence at onset of ABI. Papers focused on driving assessments or predictors of driving performance were excluded.

Findings
Thirty-three articles met inclusion criteria. Eight approaches were identified with variable levels of evidence: on-road remediation, simulator training, assistive technology and vehicle modifications, skill component training (e.g. pen and paper activities), community-based activities, education, support for emotional adjustment, and mobile applications.

Conclusion
On-road remediation and simulator training have developing evidence but require specialised skills and are considered high-cost healthcare. Alternative approaches to support skill development by clinicians without specialised driving training are described but require further investigation. Developing a systematic approach within a service based on models of driving is suggested as a first step to building evidence-based practice.

IMPLICATIONS FOR PRACTICE
 There is limited research-based evidence for active approaches that community-based clinicians can implement to support the goal of returning to drive after ABI.
There is emerging support for simulator training and on-road remediation in the form of driving lessons, however these require clinicians with specialist training and skills.
Community-based skill training and education integrated within a hierarchical model of driving may prove beneficial but further research is required.

Citation

James, S., Gustafsson, L., Watter, K., Nielsen, M., & Bassingthwaighte, L. (2026). Addressing return to driving goals in the community after acquired brain injury: a scoping review. Disability and Rehabilitation, 1–24. 

 

Authors

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