On-Road Driving Remediation After Acquired Brain Injury: Driving Performance at Follow-Up

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Published 21st April 2026

Background

Return to driving following acquired brain injury enhances participation in community-based occupations, yet may be difficult to achieve and not without risk. Evidence supports on-road driving remediation to achieve functional fitness to drive post-acquired brain injury. 

Purpose

To determine if skills acquired through on-road driving remediation are maintained. Method. Secondary analysis of randomized controlled trial findings compared functional fitness to drive status and driving performance as rated by on-road occupational therapy driver assessment post-intervention and six-month follow-up. 

Findings

Of 25 participants with acquired brain injury (26–65 years), 95% of the 19 deemed functionally fit and 50% of the six deemed not functionally fit to drive retained that status at follow-up. Four changed status, with most (n = 3) shifting from not fit to fit. No significant change in functional fitness to drive status or driving performance observed at follow-up (p = .625). Being fit to drive at follow-up was significantly associated with competent observation, awareness, speed control, planning, judgement, and self-navigation. 

Conclusions

Following on-road driving remediation devised by an occupational therapist with advanced training in driver assessment and delivered by a qualified driving instructor, skills were maintained six-month follow-up post-acquired brain injury.

Citation

Bassingthwaighte, L., Gustafsson, L., Molineux, M., Pinzon Perez, W., Bell, R., & Shah, D. (2026). On-Road Driving Remediation After Acquired Brain Injury: Driving Performance at Follow-Up. Canadian Journal of Occupational Therapy. 

Authors

Louise Bassingthwaighte

Louise Gustafsson

Professor