Impact of partial administration of the Cognitive Behavioral Driver's Inventory on concurrent validity for people with brain injury.

OBJECTIVES: We sought to determine whether the partial administration of the Cognitive Behavioral Driver's Inventory (CBDI) has a significant effect on its concurrent validity. METHOD: Data were extracted from charts of clients with cerebrovascular accident or traumatic brain injury from three centers. The CBDI was administered either completely or partially (right and left perimetry or Wechsler Adult Intelligence Scale-Revised (WAIS-R; Wechsler, 1982; Picture Completion and Digit Symbol tests were not completed). Concurrent validity indicators were calculated for the CBDI and three different scenarios of partial administration of the CBDI. RESULTS: Only 52% of the road test failures were predicted correctly by the completely administered CBDI. Nonadministration of the WAIS-R rarely modified the CBDI results. Omission of perimetry scores tended to increase the sensitivity and decrease the specificity (not significantly). CONCLUSION: The CBDI should be used as a complement, not a substitution, for a road test. Partially administrating the CBDI, specifically excluding perimetry measures, can affect its concurrent validity.

Driving, brain injury and assistive technology.

Individuals with brain injury often present with cognitive, physical and emotional impairments which impact their ability to resume independence in activities of daily living. Of those activities, the resumption of driving privileges is cited as one of the greatest concerns by survivors of brain injury. The integration of driving fundamentals within the hierarchical model proposed by Keskinen represents the complexity of skills and behaviors necessary for driving. This paper provides a brief review of specific considerations concerning the driver with TBI and highlights current vehicle technology which has been developed by the automotive industry and by manufacturers of adaptive driving equipment that may facilitate the driving task. Adaptive equipment technology allows for compensation of a variety of operational deficits, whereas technological advances within the automotive industry provide drivers with improved safety and information systems. However, research has not yet supported the use of such intelligent transportation systems or advanced driving systems for drivers with brain injury. Although technologies are intended to improve the safety of drivers within the general population, the potential of negative consequences for drivers with brain injury must be considered. Ultimately, a comprehensive driving evaluation and training by a driving rehabilitation specialist is recommended for individuals with brain injury. An understanding of the potential impact of TBI on driving-related skills and knowledge of current adaptive equipment and technology is imperative to determine whether return-to-driving is a realistic and achievable goal for the individual with TBI.