News and information
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Permanent Link: http://ufdc.ufl.edu/UF00091048/00001
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Title: News and information
Physical Description: Serial
Language: English
Creator: National Older Driver Research & Training Center, University of Florida
Publisher: National Older Driver Research & Training Center, University of Florida
Place of Publication: Gainesville, Fla.
Creation Date: 2005
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Source Institution: University of Florida
Holding Location: University of Florida
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-~ -I t

IFrom the Director

\\Wrlh rthis booklet, we provide you with information on the
i rIi\crI i\ .:'f Florida National Older Driver Research and Training
Cenrcr NODRTC. Our focus is on helping older persons maintain
rleiir s;te driving ability just as long as possible, and for those who
'!, I!:, l:i. !'.ner drive, developing satisfactory alternatives. We operate
a ser\' i program called Independence Drive, where we conduct
accsesc~- I, irs, offer remedial strategies to ensure safe driving, and for
rlthi.c \i hI, -an no longer drive we provide counseling in approaches
r.: nn, a'i ri ning active community mobility. We have a large
rese ar,l h pr.:,gram focused on older driver assessment, remediation
A!id C-:i. !ise!ling. We also offer professional training in older driver
assccecc-- er, remediation, and counseling. These research, service, and
trarin iiig projects and programs are described in more detail in this

The Narional Older Driver Research and Training Center was
foundedd in 2000, and initially named the Seniors Institute on
Tr.ansp.orr.rion and Communications. With funding from the Centers
t.o:r Divsease Control and Prevention, and from the Federal Highway
Adiinisrr.traion in 2003, we changed our name to reflect our national
to::.s. \\'e now have, or have had, funding for our work on older
d ri\ cr ace r issues from additional sources including the National
H .:!li \ i Traffic Safety Administration and the Florida Department of
Trinip ',rrjrion.

Ou r Cen 'ter has assembled an excellent interdisciplinary group
:'t tiu lr\ ind Ph.D. students, with backgrounds in occupational
rltherapi. '.:: native psychology, medicine, civil engineering, mechanical
ieng neer! !ccr and computer science. We have excellent facilities for our
ser\ ,e pr. gram, a high-fidelity driving simulator, and instrumented
\vehi- Ic-. !! of which are described in more detail within this booklet.

NOD )RTIC offers opportunities for Research Assistant positions
;aId dc':- r:'ril study within the Rehabilitation Science Ph.D. program
and \ir hiii the College of Engineering at the University of Florida.
Fu r rher. \ie have post-doctoral fellowships and faculty positions.
\\Ve \i.el'-me inquiries from those interested in working with us at
NOD)RTC We also have a strong collaborative model for our work,
L:rlthi N ithin the University of Florida, and with other institutions,
.atcii.i-s.: id corporations in the United States and around the
N.-,rld PlFiese contact me at wmann@phhp.ufl.edu to discuss ideas for
i::ll,:'-r:rat\r e work. I look forward to hearing from you!

William C. Mann, PhD, Director, NODRTC

rAW.Mw". a- w' wk _L 'S r &s

The University of Florida and the

College of Public Health

and Health Professions

UF is a major, public, comprehensive, land-grant,
research university. The state's oldest, largest and -ii.:-,r -.:. --iprce lhc!i-i
university, Florida is among the nation's most academy! i-Ill di ere-c
public universities. Florida has a long history ofestabli-hed pr.:-.gri' -r iI
international education, research and service. It is one .:.t .:'-!i 1. pI.,bll-. !ind-
grant universities that belongs to the Association of Ai e-ri n _i rncr iric I
is now one of the five largest universities in the nation
Florida has 16 colleges and more than 100 research. ser\ ie rcnd cdi.ir.:. 'i
centers, bureaus and institutes. More than 100 undergr.cdi.iire ii.:.r- rce
offered. The Graduate School coordinates almost 20(0 .r:d.li..ir pr.: rAnis
UF's extensive capital improvement program has resulted inI t. lt !iric
ideal for 21st century research including the McKnighr Br.iin! In -rrei.rc. he
Genetics and Cancer Research Center, the Proton-beain' TI-erAtpi Cienr, r.
and the new HPNP building housing Public Health and Heilrlh Pr.:,tessi.:.-,!
Nursing and Pharmacy.
The College of Public Health and Health Professi.:.n-! is .-:.e .:t rn e !r.'resr
and most diversified health education institutions in the ni r.:.n Es r.i-li-hed
in 1958, the College of Health Professions was the firs-r I.-:lle:e II! rl!e Uinired
States dedicated to educating students of different heilrt pr.:.tessi. :n- In 2-' "11
the College expanded to include public health. The C.:'lle.e .:'t F'P.ubli He.ilrli
and Health Professions is one of six colleges that corrprise rle _i!-, !\ r-~ .-:.
Florida Health Science Center. The other colleges are De rs r r. edit !ie.
Nursing, Pharmacy, and Veterinary Medicine.
The College of Public Health and Health Professi.:.!- is -I ntr.-.rinl
leader in the education of health professionals with pr.:-rAin- i ni.c idnI:
Clinical and Health Psychology, Communicative Dis -,rders. He !i rli SI e' !c.
Health Services Administration, Health Services Rese-ir-, I. t, 'pI.pr n.A:-!iAl
Therapy, Physical Therapy, Public Health, Rehabilitat: .:-. C.:.. !iccli!.::.
and Rehabilitation Science.The College emphasizes the devel.c-.p'le!ir .-:.
intellectual resources and skills enabling our graduates r..:- pr.:-per in rc.:.di'
complex health delivery systems. In addition, the Colle.e i-s -.:.-'iiii ir red r.:
the development of cutting edge science in areas such i- hel!ilr!' :!'d beh .:.r,
the rehabilitation of central nervous system impairme r. :ind he. lr-i -% re i'
The College of Public Health and Health Professi.:.n-s als.:- .:..-.cc 12'
research and training centers including: Brooks Center t.-:r Rehc biliriri.:.!
Studies, Craniofacial Center, Center for Telehealth and He al rh-, are
Communications, Center for Pediatric Psychology and Faimk!l S .dies.
Center for Research in Psychophysiology, Center for rlhe Srud\ .:.t E .-':.-!.r
and Attention (CSEA), Center for Behavioral Health Reseairt Ii iO -r.::
Transplantation and Donation, Center for Pain Researc h -ind Behl, I .:.-ril
Health, Rehabilitation Engineering Research Center .:.n A-.::' !: RERC .
National Rural Behavioral Health Center, Center for Ne.ir. :,pc I. 1.::,-:i- I
Studies, Florida Center for Medicaid and the Uninsured. i!'d rlce NNrm.:.!'il
Older Driver Research and Training Center which is dc- riLed iI! r-hi
For further information on the College of Public Health and Health
Professions, visit www.phhp.ufl.edu.

Reprinted from Spring 2005 issue
E plore
Research at the
University **t I rn,i

I-i~J~a 1
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SPriscilla Milliman considers
herself an experienced driver.
A Southern California native,
she learned to drive as a teenager by navi-
gating the Los Angeles-area freeways. For
most of her life she has driven in urban
areas and in Europe, where she and her
husband lived for many years.

But at 75, Milliman, of Gainesville, had been reluctant to
drive outside of the city limits, feeling insecure on the inter-
state and in heavy traffic. And as an avid tennis player, she also
recognized that her physical reaction time had slowed in recent
So she turned to the University of Florida National Older
Driver Research and Training Center at the College of Public
Health and Health Professions for help in making a decision
about her driving abilities.
Introduced in 2003, the National Older Driver Research and
Training Center is supported by $1.6 million in funding from
the Centers for Disease Control and Prevention and the Federal
Highway Administration. It is the nation's leading research and
service center dedicated exclusively to older drivers.
Directed by William Mann, chair of the college's Depart-
ment of Occupational Therapy, the center aims to enable
seniors to remain independent within the community by pro-
longing safe driving abilities and, for those unable to continue
driving safely, the center offers alternatives to driving for obtain-
ing goods and services.
Center researchers are also working to determine which
methods are best for evaluating seniors' driving abilities and
to determine if roadway deign features might affect safe driv-
ing performance. The data are being gathered from the center's
assessment programs in Gainesville and Ocala, as well as col-
laborating sites in Jacksonville and Orlando.
"We must better understand how to assess driving perfor-
mance as America's population ages," Mann says. "Not only are

the numbers and proportion of older Americans incirctding,
but a greater proportion of seniors continue to drive, and the
incidence of injury and fatality resulting from motor vehicle
crashes involving seniors continues to grow at a rate faster than
that of the overall population.
"Research indicates that older drivers are o%-rreprccmnrlc in
crashes at intersections and that older driver safety problems
are concentrated among seniors who are either unaware of their
difficulties or unable to make compensating adjustments to
their driving." he adds.
In the last decade, the number of licensed drivers over the
age of 70 rose 39 percent, to more than 18 million, according
to the National Highway Traffic Safety Administration. And by
2024, an estimated one in four drivers will be 65 or older.
Vision problems, cognitive deficits, physical limitations and
even some medications can contribute to difficulty driving as
people age.
The center's assessment program, Independence Drive, offers
two-hour evaluations that include physical and cognitive test-
ing and assessments of on-road driving skills. For those who are
found to be unsafe drivers, the driver rehabilitation specialist
offers additional services, such as training and/or the use of
equipment to enable a person to drive safi.ly, and counseling on
transportation alternatives.
"Our driving evaluation is comprehensive because we look
at the entire person," says Desiree Lanford, a licensed occupa-
tional therapist who specializes in driving rehabilitation. "Get-
ting older does not necessarily mean that an indi\ dual wll be a
worse driver. It all depends on a person's physical and cognimve
status. Our goal is to keep older drivers safely on the road for as
long as possible by forming a holistic I iew of the person and his
or her environment."
Milliman's assessment by Lanford demonstrated that she
is a safe driver, but the results confirmed Milliman's suspicion
that she was too cautious in her driving at times. Millinian
scheduled a training session with Lanford to brush up on some. i':
driving tips, which included how closely she should follow hie...,ii
car in front of her and how to use mirrors and scan dhe road '
that she is fully aware of the environment.

Explore 33

STUDENT DRIVER "It made me realize that my observation powers were not
That good," Milliman says. "Desiree would ask me 'what did
888-248-5005 you see on the sidewalk?' I realized that I don't really observe
I .__ . lthe whole picture. She told me that scanning the area is a form
of driving defensively so that in case a child or dog runs our
onto the street there is more time to react.
The assessment and training have helped Milliman feel more
secure in her driving skills and given her hope that as a socially
Active senior who loves to travel she can return to driving on
the interstate.
"I feel like I'm a better driver than I thought I was and that
S gives me more confidence," she says. "My goal is to drive to
Jacksonville International Airport and St. Augustine with confi-
dence. This would be an achievement for me.
Desiree Lanjfrd is a licensed occupational therapist Milliman is among a group of Florida seniors whose assess-
who specializes in driving rehabilitation, ment experiences are contributing to the center's research that
will hopefully aid older drivers all over the country who are fac-
ing decisions about their driving capabilities.
The center's research activities kicked off with a conference
in 2003 convening the world's experts in driving assessment

,C.Getting older does not
necessarily mean that an
ind.it ual will be a worse PER 100,000 POPULATION BY AGE. 2003
driver. It all depends on 20
a person's physical and
.'.....cogn.itive sta.tus. ': 1
.. Desiree Lanford

14 I


5 ,


34 Spring 2005

I .

to determine the "state of the science" and identify areas of
research the center would explore.
Several major research projects are now in the works. The
first examines problematic roadway conditions such as
intersections, iriterchangcs and construction zones and their
effect on older drivers. The second will help determine which
clinically administered tests can accurately predict older drivers'
on-road performance, killing the need for a reliable, standard-
ized method that can be used by driving specialists nationwide.
The third compares younger and older drivers in a high-quality
driving simulator, which mimics real road conditions. And a
fourth project examines the ability of physicians to help their
patients stay safe on the road.
"Our research is expected to find out how accurate common
paper-pencil tests are at predicring driving performance in older
drivers," says Dennis McCarthy, the center's co-director. "We
have a 180-degree field-of-view simulator that can be viewed
from inside the cabin of a stationary compact car. Custom sce-
narios are being reproduced to replicate real-life situations and
compare driving performance with behind-the-wheel driving
Armed with a career development grant from the Centers tor
Disease Control and Prevention, Sherrilene Classen, an assistant
professor in the UF Department of Occupational Therapy, is
developing a public health model for addressing the issue of
safe elderly driving that will complement the center's research
Widespread need for more trained experts in driving assess-
ment is also being addressed. Fewer than 300 certified driving
rehabilitation specialists are now working in the United States

"My goal is to drive to

Jacksonville International

Airport and St.Augustine

with confidence.This would

be an achievement for me."

- not enough to meet the demands of a growing elderly driv-
ing population. In partnership with the American Occupational
Therapy Association, the center is developing a model site for
educating ot.LLpationil therapists as driver safety intervention
The center's research has particular significance in Florida
where nearly 4 million residents are 60 years or older, 3 mil-
lion of whom have driver's licenses. More than 25 percent of
Florida's older drivers report some limitations in their driving or
do not drive at all. The reasons they cite include health prob-
lems, financial limitations and difficulty driving long distance,.
in bad weather or at night. Yet only about 10 percent of older
Floridians use public transportation, raising questions about the
options available to those who can no longer drive but wish to
remain independent.
George Price, 76, recently faced that predii imeent.
Follhi img an assessment at Independence Drive, Lanford
recommended that Price discontinue driving until he switched
from his pickup truck to a smaller vehicle with automatic trans-
mission, completed driver training with Lanford and fitted his
new car with adaptive devices, such as a spinner knob, to make
turning the steering wheel easier.
Physical problems, including a nerve disorder in his legs, had
made maneuvering the large truck difficult for Price, and
Lanford didn't feel he was safe to drive until the right adjust-
ments were made.
"It upset me, of course, but I had to acknowledge that what
she said was true," says Price, a retired UF scientist.
Although Price, who lives on Lake Santa Fe, is content in his
home surrounded by the books and music he loves, and has lots

-Priscilla Milliman

of friends to assist him with tranrportr.riln needs, he recognizes
that the idea of not driving is a difficult one to face.
In the meantime, he plans to get a different car and follow
Lanford's recommendations.
"There are places to go and people to see," he says.
Through Independence Drive's counseling services and
referrals to alternative transportation, the center hopes to keep
otherwise healthy, independent older adults on the road as long
as possible and influence public policy in the development of
transportation options for seniors.
"Loss of a driver's license can have significant impact on a
person's life," McCarthy says. "For those former drivers without
financial resources or social supports, revocation of the driving
privilege may result in the inability to live independently within
the community," he says, adding that the loss of a driver's
license may start a process that can lead to a senior needing to
enter a nursing home or other care facility.
That's a prospect that Philip Spear of Gaines\ ille has been
contemplating for some time. He and his wife have been work-
ing with a geriatric care manager to prepare for a time when he
may no longer be able to drive to medical appointments, the
grocery store and the pharmacy.
At 90, Spear has seen many friends struggle with the loss
of a driver's license when they weren't prepared for such a life-
changing event. He also remembers being forced to take the car
keys away from his mother when she was no longer fit to drive.
With those personal experiences in mind, Spear decided to
have a driving assessment at Independence Drive. While the
results showed Spear is a safe driver, Lanford identified physical
problems that hadn't been previously diagnosed by his health-
care providers.

"During the comiputcr tests, there were several instances in
which I had visual problems and in one set of tests, the results
indicated that my two eyes weren't working together," Spear
A follow. -up visit to an ophthalmologiks confirmed the
problem, and he was given a new eyeglass prescription. He also
received physical therapy on his neck to improve flexibility
when turning his head, another recommendation from Lanford.
"It was most reassuring when I was told I didn't have defi-
ciencies in my driving skills, because it's scarcely imaginable
how important it is for people in my age group to be able to
drive," Spear says. "My wife and I have been retired in Gaines-
ville for nearly 25 years, living in the house we built, and we
intend to stay here for the rest of our lives.
"I have told more than one of my friends about the assess-
ment," he says. "It has given me considerable comfort and
peace of mind and the reassurance that this life can continue
the way it is for awhile." 0

Desiree Lanford
Coordinator. Driver Rehabilitation
(352) 273-6057

William Mann
Director, National Older Driver Research and raiining Center
(352) 273-6135

Dennis McCarthy
Co-Director, National Older Driver Research and Training Center
(352) 273-6024
. -.,i K .l",l 'l, I ..I

Related Web site:

During 2002, 81 percent
of traffic fatalities involving
older drivers occurred dur-
ing the day and 75 percent
of the crashes involved
another vehicle.

17 percent of older drivers'
crashes involved left turns.
The oldest drivers show
the greatest proportion
of left-turn crashes-16
percent of 65-74 year-old
drivers and 21 percent of
drivers 75 or older.

About half of fatal crashes
involving drivers 80 years
and older occur at intersec-
tions and involve more than
one vehicle. This compares
with 23 percent of drivers
up to age 50.

Between 1998 and
2023, the percentage
of drivers 70 or older is
expected to increase
from 9 percent to
almost 14 percent.

Older drivers are more
than three times as likely
to die in a wreck than
younger drivers because
of medical complications.

Sources: National Highway Traffic Sf1f' Administration, Centers for Disease
Control and Prevention, Federal Higlh, .i Administration.

Explore 37


Available in June 2005
through Wiley-lnterscience

SSmart Technology

C ^ A for Aging, Disability
f and Independence

The State of the Science

Edited by William C. Mann, PhD
I:l-i I 4' 1 i ,,:. 1'4-3 Hardcover 440 Pages

Smart Technology forAging, Disability, and Independence: The State of the Science
brings together current research and technological developments from engineering,
computer science, and the rehabilitation sciences, and details how their applications
can promote continuing independence for older persons and those with disabilities.
This book contains chapters on:

* Assistive Devices
* Smart Homes
* Home Modifications
and Universal Design

* Teleheath
* Injury Prevention
* High Technology Devices

Students and professionals in the rehabilitation sciences, health care providers,
researchers in computer science and engineering, and non expert readers will all
appreciate this texts thorough coverage and clear presentation of the state of the
Ordering Information
Visit www.wiley.com or 1-877-762-2974 or email custserv@wiley.


RERC on Technology for Successful Aging

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No technology experience required!

a Are You Ovr Age?

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Come Help Us Leam From YOu and you may be
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If you are interested, or would like more information,
please contact


Community Mobility: Driving and Transportation
Alternatives for Older Persons
Edited by William Mann, PhD, OTR
Professor and Chair, Department of Occupational Therapy
University of Florida, Gainesville
S- This book explores differences in commu-
*-- -- nity mobility for elders living in the northern
section of the United States compared with
those in the South, and examines changes
in driving patterns over time. Other topics
include self-regulation of driving as we
... agae and the relationship of health and
Itunclional status to driving. The book also
1. IllClde summaries of two important,
recent international consensus conferences
on older driving safety, one held in Canada,
Ihe olher in the United States.
Available Fall 2005
F .29 95 hard. ISBN-13: 978-0-7890-3084-9
I: Be-r. 10: 0-7890-3084-5.
$19 95 soft. ISBN-13: 978-0-7890-3085-6 /
ISBN-10: 0-7890-3085-3.
(Published simultaneously as Physical &
Occupational Therapy in Geriatrics, Vol. 23,
Nos. 2/3.)
For complete contents and to order:
hli)p Iiw haeorlhpress conmisloreiprod-

'Published by The Haborlh F'ress In11 10
Alce 'lreel B Pnhamlon [ii 1J1:14.-158 0


5N L ,e.- -- ,-
.1 3. *d .0- 0-, -

Cathy LckIear, M HS, OFt IL
(352) 273-6124
dockl eaV2ph hhp.ufl.ed u


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inci~i-~ ~ttt#~~sgaya perspi, sabbitvitQVie J
Howe ViI~ o npje ~ijert o dqa ot life *To 1hdip-older tdutt
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Reliability and Predictive Validity of the American
Medical Association's Older Driver Screening Protocol
Funded by: NationalHighway Traffic SafetyAdministration
Principal Investigator: Dennis McCarthy

The physicians are often forefront in the decision to
stop driving but until recently, they have not had guidelines
for screening those older persons who might be at risk of
crashes. The American Medical Association (AMA) recently
published The Physician's Guide to Assessing and Counseling
Older Drivers (2003). This guide offers a screening tool, the
Assessment of Driving Related Skills (ADReS) that can be
administered within a 10 to 15 minute timeframe. Results of
the ADReS assist the physician in making recommendations
to, and provide referrals for, their patients. However, the
reliability and validity of the ADReS has yet to be established.
This study will determine: 1) physicians' current practices with
regard to their patients' safe driving abilities; 2) physicians'
knowledge and use of both the Guide and the ADReS; 3)
the interrater reliability of ADReS administration, and; 4)
the reliability and validity of the ADReS screening tool.
Working closely with the AMA, NODRTC has assembled
an expert team of physicians, researchers, and practitioners to
help develop questions to ask physicians about their current
knowledge and practices regarding older drivers. Additionally,
research participants will undergo an on-road, behind-the-
wheel driving evaluation following ADReS administration.
The results will be analyzed to determine the sensitivity of
this screening tool in identifying those who may need further
evaluation of driving performance.

Public Health Model to Promote Safe Elderly Driving
Funding: Centers for Disease Control and Prevention
Principal Investigator: Sherrilene Classen

This project uses a public health perspective and health
promotion framework to develop a model for older driver

safety. An integrated approach, grounded in a unifying
public health model, will help us understand how behavioral,
ecological, health education, administrative, policy and
regulatory strategies may promote safe elderly driving.
The Precede phase of the Precede-Proceed Model of Health
Promotion provides the theoretical framework to: 1) review
the current older driver literature systematically by applying
the Cochrane Collaborative Descriptive Methodology; 2) test
the fit of existing population-based quantitative and qualitative
data, and 3) develop an intervention plan for safe elderly

Reliability and Validity of the Consensus Conference
Assessment Protocol
Funding: Centers for Disease Control and Prevention
Principal Investigator: Wendy Stay

This project will PrincipalInvestigator,
determine the Wendy Stav
reliability and
validity of the older
driver assessment
outlined at the
2003 International
Older Driver
The first stage of
this project is to
identify clinical
assessments that
predict on-the-
road driving
performance. The goal is to improve the efficiency and efficacy
of the off-road component of driving evaluations by possibly
reducing the number of assessment instruments used. These
assessment instruments measure vision, visual perception,
cognition, motor performance and reaction time. Areas of
vision tested include static acuity, color perception, depth
perception, extraocular control, visual scanning, visual closure,
visual spatial organization, and contrast sensitivity. Cognitive
assessments measure memory, divided attention, selective
attention, attention shift, processing speed, and knowledge.
Tests of physical performance include grip and gross muscle
strength, coordination, range of motion, ambulation and
functional mobility. All study participants complete: (1) a
comprehensive telephone interview to obtain background
driving and health-related information; (2) a clinical
assessment battery; (3) a standardized road course.

The Impact of Highway Design on Driving Errors in an On-
The-Road Test of Older Persons
Funded by: FederalHighwayAdministration
Principal Investigator: Sherrilene Classen

This project tests older driver performance on roadway design
features identified by FHWA as potentially problematic.


This study also explores the effectiveness of implementation of
guidelines designed to make the roadways safer for the older
driver. The FHWA proposed that these guidelines for highway
design may increase the safe driving ability of older drivers,
but no empirical evidence exists to support this.This project
examines differences in driving performance between roadway
conditions that meet and do not meet design guidelines and
identifies the type of errors made by older adults. Participants
engage in a telephone interview, brief clinical assessment, and
an on-the-road driving assessment in an instrumented vehicle.
This vehicle is outfitted with a dual brake system and a variety
of sensors and cameras that allow researchers to evaluate vehicle
kinematics (e.g. yaw, lateral and longitudinal acceleration),
control responses of the driver (e.g., steering wheel movements
and brake actuation), driver observation approaches, and head

The Impact of Highway Design on Driving Errors in a
Driving Simulation Test of Older Persons
Fundedby: FederalHighwayAdministration
Principal Investigator: Orit Shechtman

This project uses a driving simulator to replicate on-road
conditions identified as "problematic" for older drivers and the
corresponding road conditions recommended by FHWA to
make the roadways safer for the older driver. The purpose of
this project is to determine the effect of roadway conditions on
safe driving both in young adults (age 25-45 years) and seniors
(age 65-85 years). Certain roadway conditions have been
identified by the FHWA as problematic for older drivers.These
roadway conditions may contribute to an increased risk of
driving errors and crashes. The FHWA also proposes guidelines
for highway design that may increase the safe driving ability of
older drivers. However, no empirical evidence currently exists to
support this theory. This study replicates the "safe" and "unsafe"
road conditions in the driving simulator to investigate the
effects of FHWA guidelines implementation on creating safer
roadways for the older driver.

Development of a ""'J",
Driving Assessment
of Older Adults
Investigator: i,

This study seeks to
standardize scoring
driver assessment, focusing on older drivers. The behind-the-
wheel (BTW) driving assessment has been identified as the
most appropriate method to determine driving competence.
Despite attempts to quantify driving performance, the accepted
global criterion outcome (pass/fail) is determined by evaluator
judgment rather than a quantifiable driving score. Information
gathered from expert consensus was utilized to develop the
on-road driving assessment. Recommendations were given
for a fixed-route, a gradual progression of driving difficulty,
and total driving time of approximately one hour. Scoring is
based on behavioral errors during driving maneuvers. The
difference in scoring compared to previous research is that
maneuvers are scaled for severity of error and grouped into
three levels of driving complexity. A total performance score is
then calculated. This score is compared to the Global Outcome
Rating determined by the evaluator. The outcome rating is
based on evaluator judgment (criterion standard) and has four
levels: Safe (3), Safe with restrictions or recommendations (2),
Unsafe Remediable (1), Unsafe not remediable (0). This study
will analyze the criterion validity, inter-rater reliability, internal
consistency, and test-retest reliability of this measurement tool.
After test-retest reliability has been established, the stability
of this scoring mechanism will be analyzed across to different
road courses of similar design to see if it can account for
geographic variability. An analysis of performance items will
be conducted using modern test theory to verify the hierarchy
of item difficulty and its ability to discriminate levels of driving



William C. Mann, PhD, OTR/L

Di. nl. I is i' Pi.:t c i.:.r and Chair of the
Deop .ii rlir .. T t: O:: 1., national Therapy and
DI)!i !: r.:! :ft rl! Ro ., bilitation Science
L).:.: .:.! ., I .:! ..! i. r the University of
F.:.rida (UF). Dr. Mann also directs
rth National Older Driver Research
.,.1i Training Center. His current work
t.:..: ~ i. i on older driver assessment and
rehabilitation. Dr. Mann has authored more than 100 article
and book chapters on aging and independence in the past 15
years, authored three books including two that will be published
in 2005, produced a video on compensatory strategies for older
drivers and passengers, and served as founder and co-editor
of the journal Technology and Disability from 1990 2000.
His work over the past 15 years has focused on approaches
to promoting independence in ADLs and IADLs, including
driving, for persons with disabilities.

Dennis P. McCarthyn Med, OTR/L

11,:e ':!",",Z L im-,,n ersity of Florida's
!,i .li, .r.. :, S, :Ir!,,, Doctoral Program
n January 2002, Dennis' studies have
focused on issues involving older drivers.
ennis is co-director for the University of
lorida's National Older Driver Research
I ,d Training Center where he coordinates
thi, Center's many research projects. He
is currently a member of the AOTA Older Driver Advisory
Council. He served on the Expert Panels of the Canadian
Driving Research Initiative for Vehicular Safety in the Elderly,
the International Older Driver Consensus Conference, and the
AOTAs Older Driver's Consensus Conference. He also served
as a reviewer for the American Medical Association's Physician's
Guide to Assessing and Counseling Older Drivers.


David M. Angaran MS, FCCP, FASHP
David Angaran is Assistant Director of
Experiential Programs in the College of
Pharmacy at UF and Clinical Professor of
Pharmacy. He is exploring the impact of
medications on older driver performance.

She i ilene Classen, PhD, MPH, OTR/L

) I. C i ii ,, is .a i. instant Professor in
DL)p, i! nr it .:.t- Occupational Therapy.
-he completed Post-Doctoral research
'ad a Masters Degree in Public Health
C concentration area: Epidemiology)
2002-2004) as a Fellow of the Advanced
ostgraduate Program in Clinical
investigation, and the National Institute for
Disability Rehabilitation Research. She is Principal Investigator
of a Centers for Disease Control and Prevention (CDC) Career
Development Award (K-01) (2004-2007), and project leader of
a Federal Highway Administration's (FHWA) Demonstration
Project (2003-2005). Her career development research focuses
on establishing a population-based public health model for
promoting and predicting safe driving among older adults.'Ihe
FHWA project investigates differences between younger and
older drivers on different road conditions.

Joln Ebe hard, PhD
ic,' Ia .,t0@msn.com
-I.e. E bi 1ii r.rd is a consultant to UF's
N ..:.- ,! Older Driver Research and
T .lhI 1 t C enter. He has been involved in
:older p! :.:.n transportation issues for over
Nt \ne l. He is retired from the National
Sh e \ Traffic Safety Administration
21111 .1.- has remained active in the area
S.t. b ter Pi.: ability for older people. While at
NHTSA he challed die Oiganization of Economic Co-operation
and Development working group that produced "Ageing and
Transport" in 2001 that addressed the mobility and safety needs
of older people in the developed world. He also co-produced "Safe
Mobility for a Maturing Society: Challenges and Opportunities"
in 2003 which laid out what the United States needed to do to
prepare our transportation systems for the baby boom generation.
Currently he is on the Howard County Commission on Aging
where he chairs the transportation committee and is developing a
transportation and mobility guide for seniors in Howard County.
Nationally, he is working with the American Society on Aging and
the Transportation Research Board where he edits their newsletter
on "Safe Mobility for Older Persons." He is the co-chair for the
transportation area for the 2006 International Conference on
Aging, Disability and Independence.

L ih Eleftel iadou, Ph.D.

)i. E It.rri i:., is the Director of the
.I '-i !.:.! r.,..-:.,-1 Research Center (TRC), and
k .:.: irr P .:-fessor of Civil Engineering
rhle Li! r r!\ of Florida. Her research
:.:.i. i t : .:. operations, traffic flow theory
,,.1 i!! i., u!h n .:.,,. md she has approximately


15 years of experience as a transportation researcher and
practitioner. Dr. Elefteriadou has served as the principal
investigator for several federal and state projects and authored
or co-authored more than sixty publications and reports
related to traffic operational quality and highway design. She
serves as the Secretary of the TRB's Highway Capacity and
Quality of Service Committee, and has chaired several of its
subcommittees (simulation, ramps/weaving, paper review, and
two-lane highways).

Michael Marsiske, PhD
inumi ssk "p//p. t/l.ed i
)i. 1Nih I: ikl't I, .:.!k i in the area of
:_4! tn tl .i particular focus on
rIiLi, a 4Ik o, -! i ,a..ering and problem-
11en s!,, 4 iI !I tri! life might impact
i t-. ..id independence.
l.i prkr' ,! re! r i ,.: k has examined areas
ke ied ,-. e. i rincial management,
nutrition and transportation use are affected by age-related
differences and changes in mental functioning. Marsiske is a
principal investigator on a large multi-site clinical trial aging
study, which includes an examination of "Useful Field of View"
(UFOV), a measure of speeded visual attention. UFOV has
been shown, to be a strong predictor of behind-the-wheel
driving performance. New work will examine alternative
home-based approaches to improving speeded visual attention,
including certain kinds of video games, and to investigate
whether such approaches yield measureable improvements in
driving outcomes.'The goal is to find strategies that older adults
can use to keep their basic driving-related mental skills sharp.

Chris Niezrecki, PhD
Dr. Niezrecki is Associate Professor and director of the Smart
Structures and Acoustics Laboratory in the Department of
Mechanical Engineering, University of Massachusetts at
Lowell. Dr. Niezrecki is currently helping to instrument the
NODRTC test vehicle with a variety of sensors and a data
acquisition system. The vehicle will be used to help quantify
the driving characteristics of older drivers during on-the-road
driving assessment.

Orit Shechtman, PhD, OTR/L
r. Shechtman is an Associate Professor
t the Department of Occupational
ii p\ Hi! i!search is in the areas
.t :.i. .! f.:.rt, sincerity of effort,
I,. I i.. Kr 1 disorders, and reliability
ii,.1 validity of grip strength measurement
instruments. Dr. Shechtman is also

involved in the older driver research projects. She is a member
of the National Older Driver Research and Training Center
(NODRTC) Assessment Group and was the co-leader
of Panel A Assessment and Screening Protocols in the
NODRTC International Consensus Conference in 2003.She
is currently the project leader (PI William Mann) of the Older
Driver Infrastructure Simulator Research Project, funded
by the U.S. Department of Transportation's (DOT) Federal
Highway Administration (FHWA).

Wendy Stav, PhD, OTR/L, CDRS
)r 'Str i a Research Assistant Professor
i I l D) apartment of Occupational
i! ,p" She has focused her work on
i i, :I4 i.1. ring the past eight years, including
\i nI.!..lp! driver assessment programs,
:.1 11d i medical reporting policies,
searching driving assessments and studying
occupation t erapy practice related to driving. She is co-author
of the American Occupational Therapy Association's (AOTA)
Older Driver Initiative's official documents and chairs the
specialty certification panel in Driver Rehabilitation/Community
Mobility. She serves on the Older Driver Expert Panel and
contributes to the evidence-based literature review and practice
guidelines on community mobility. Dr. Stav collaborated with
the American Medical Association on their older driver project
as a representative of the AOTA, contributor and reviewer. She
also authored a book for occupational therapists titled "Driver
Rehabilitation: A Guide for Assessment and Intervention". At
the state level, Dr. Stav represents the University of Florida in
the Florida At-Risk Driver Council. Her current research is
focused on identifying clinical assessments predictive of driving
performance and examining the influences on occupational
therapy practice related to driving.

Bn ton Stephlens
l.t.,/*,.',,2p,/ /, 3, ,.,
Bu. r .!. St, pir!il i i transportation and
l..,ii. .! .i i:ta! :.! Itmt to the National
S 01.1 IDr i Rn ii :i and Training
Cr i. ,i NODRTtC i He was a co-
t.:.,ni .-.t ri i IiF 'ri diors Institute for
Ti i.,, p.:. rt., ti':.! id )mmunications.
D ,. 4! !, 1: F-Il:. I:.t -! reer, he was a
researcher and program manager at the Federal Highway
Administration in Washington, DC and subsequently served as
Director of the International Clearinghouse for the Intelligent
Transportation Society of America. He has been an instructor
in the Civil Engineering Departments at the Universities of
Maryland and Florida.



Stephanie Fueyo is an occupational therapist assisting
with NODRTC research projects.

Desiree Lanford is an occupational therapist and
a driving rehabilitation specialist serving as the
NODRTC Driving Rehabilitation Coordinator.
She conducts driving evaluations, behind the wheel
training and consultations for research projects and
Independence Drive.

Jason Rogers holds a Computer Engineering degree
from the University of Florida, and directs the IT unit
for the Department of Occupational Therapy and the
NODRTC. He installed and oversees the operation of
the driving simulator and the development of simulator


Patricia da Cunha Belchior is an occupational therapist
and a doctoral student in the Rehabilitation Science
Doctoral Program at the University of Florida. She is
studying the use of cognitive training to improve older
drivers performance.

Sarah Cook is a doctoral student in Clinical
Neuropsychology in the Department of Clinical and
Health Psychology at the University of Florida. She is
studying use of neuropsychology with older people and
predictors of poor driving performance.

Ethan Davis is a Masters student in Mechanical and
Aerospace Engineering at the University of Florida. His
area of interest is dynamic systems and controls. Ethan
joined the NODRTC team in May, 2004 to instrument
a driving evaluation vehicle with transducers and a data

acquisition system. These transducers are capable of
measuring forward and lateral acceleration, yaw, steering
wheel position, braking and turn signal activation, and
vehicle position via GPS.This system allows researchers
to analyze objective kinematic measures, which can be
used to reinforce the subjective measures from a driving

MichaelJustiss serves as a research assistant for the
National Older Driver Research and Training Center.
He has served as a University of Florida representative
on the Florida At-Risk Drivers Council and served as
an Expert Panel member of the International Older
Driver Consensus Conference. His doctoral research
focuses on the development of a behind-the-wheel
driving assessment for older adults.

Cristina Posse is an occupational therapist and
is a doctoral student and research assistant in the
Rehabilitation Science Program at UE Her area of
study focuses on older adults and driving rehabilitation.

Milap Sandhu is a physical therapist and a doctoral
student and research assistant in the Rehabilitation
Science program at UE He is currently working on the
NODRTC driving simulator research project.

Swathy Sundaram is a doctoral student in the
Department of Health Services Research, management,
and Policy at the University of Florida working as
a research assistant for the Public Health Model to
Promote Safe Elderly Driving project.

Sandra Winter is an occupational therapist and
doctoral student in the Rehabilitation Science Program
at UF As a research assistant for the Public Health
Model to Promote Safe Elderly Driving project, she
is synthesizing qualitative literature addressing older
driver safety.


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In America, driving a personal automobile is the preferred
method for transportation. As a person ages there is a greater
likelihood that continuation of driving may not be safe. It is
therefore important to (1) develop and utilize techniques that
permit us to assess whether the requisite capabilities and skill
levels inherent in one's driving are adequate to permit continued
driving, (2) remediate the individual or re-engineer the driving
task for those with correctable conditions, and (3) for those who
are unable or unwilling to continue to drive their own vehicle,
provide counseling on alternatives so they may continue to
remain active and enjoy a high quality of life.

On December 1 and 2, 2003, 63 international experts on older
driver issues met to examine three critical issues related to the
safe mobility of older persons. Conference participants addressed
standards and protocols for screening and evaluating the skills
of older drivers. For drivers judged to lack the necessary skills
to drive safely, participants addressed methods ofremediation
that could enable older persons with limited cognitive or
physical abilities, to continue to drive safely. For those persons


Summary Report
International Older Driver
Consensus Conference
Dacmba 1 -2 22003
Arimngren. VA


National Older Driver
Research and Training Center

The summary reort is available at http://driving.phhp.ufl.edu/

whose skills are judged inadequate for safe driving, conference
participants discussed how to best counsel individuals and their
caregivers on practical alternatives to driving,

At this conference, participants agreed on the fundamental
domains and components of driving that need to be evaluated
for safe driving by older persons. They also agreed on a group
of specific candidate measures and operational tests that are
appropriate for such assessments or screenings. Likewise, the
participants who considered such appraisals rejected a number
of commonly used tests that are judged superficial or for which
there is no established relationship to driving safety.

The panel charged with identifying and selecting methods for
remediation of unsafe driving performance agreed that no single
strategy or technique is appropriate for all drivers. Panelists
examined the applicability of a number of techniques, within
both traditional and non-traditional remediation categories.
Emphasis was placed on the process of identifying specific
limitations of drivers and tailoring responsive remediation

Many senior adults will spend a significant number ofyears
as non-drivers. Their continued mobility is dependent upon
the availability and utilization of various modes of alternative
transportation. Longer-term solutions involve individual
advanced preparation for the transition from driving to non-
driving, improved community planning for larger numbers of
non-drivers, and improved access to various forms of transit. In
the short run both formal and informal individual counseling
related to explicit means of travel are needed. Although there
are a variety of counseling techniques aimed at both older
non-drivers and caregivers, virtually no evaluations of the
effectiveness of such techniques have been made. The panel
concerned with such matters recommends systematic research
to determine the most cost-effective techniques for supporting
sustained or increased mobility for persons not able or willing to
drive their own vehicles.

Consensus was achieved as to the current methods for best
assessing and screening drivers, remediation techniques, and
providing advise and counsel for those persons and the caregivers
as to appropriate actions for those no able to drive safety, There
were many areas of agreement by participants on tools and
procedures to aid in the screening and assessment processes.
There was also divergence on some issues. It was agreed that
many of these issues could best be resolved through research. The
foundations for remediation and counseling are substantially
based on experience of professionals rather than firmer empirical
or theoretical underpinnings. It was agreed that there is a clear
need for research in these critical areas.







A key concern for older adults with disabilities involves
transportation in and beyond their communities. The
Transportation Track of the Third International Conference
on Aging, Disability, and Independence (ICADI 2006)
offers a venue for experts from around the world to discuss
issues surrounding older drivers and their transportation
alternatives. The transportation track will continue the work
of ICADI 2003 held in December 2003 in Washington,
DC. (Proceedings from ICADI 2003 are available at http://
www.icadi.phhp.ufl.edu/2003/proceedings.php). The 2006
ICADI Transportation Track will focus on new technologies
that make personal driving easier and safer. It will address
advances in driver assessment and will 1) emphasize enabling
people with disabilities to drive safely longer and 2) assist
with the transition to other transportation options when
driving is no longer a possibility. It will also explore safe
driving through alleviation of an underlying disability such
as cataract surgery or by driver rehabilitation processes that
include adaptive equipment or adaptation of driving itself.

From a broader perspective,
the transportation track will
address improvements to the
built environment that will make
it easier for people to drive, walk
or utilize transportation options.
Built environment presentations
will include features in new
construction and techniques in
rebuilding existing facilities to
improve roadway safety. Special
attention will also be given to
public and private transportation
and how it can enable people
to remain independent in their

John Eberhard, transportation
track chair for ICADI 1999 and
2003, will co-chair the 2006
ICADI Transportation Track

with Helen Kerschner, the executive director of the Beverly
Foundation. An advisory panel for the track is being formed
and those interested should contact John Eberhard at
jeberhard2@msn.com or Helen Kerschner at hkerschner@be

The 2006 ICADI Call for Submissions has been issued
with a due date of September 1,2005. Submissions will be
accepted for the following:

Lecture (single paper, approximately 20 minutes)
Poster (sessions held during evening receptions)
Technology Demonstrations (a demonstration of
prototype applications or new products to support

All presenters must submit an abstract and brief
description. Accepted abstracts will be published in the
Proceedings (ISBN Number 0-9754783-0-4.) For more
information, visit www.icadi.phhp.ufl.edu.

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In January 2005, the construction of a high-
fidelity driving simulator was completed for use by
researchers at the National Older Driver Research
and Training Center (NODRTC) at the University
of Florida. This simulator is the first of two driving
simulators to be used for investigations primarily
related to the capabilities and limitations of older
drivers; hence it has been referred to as the Early
Availability Driving Simulator (EADS).

The Visual Display: This simulator provides a
large forward field-of-view (fov) of 180 degrees and
displays virtual objects behind the car. As shown
below, the entire scene is computer-generated.

The wide fov is accomplished by connecting
three flat screens with scenes provided by three high
intensity projectors (Sanyo, 2000 ANSI Lumens).
Although a continuous curvilinear surface would
provide a better representation of the forward
scene, after a few minutes of practice the process
of"perceptual filling" prevails and subjects indicate
that they notice no partitioning of the three separate
segments. The wide fov allows drivers to make

changes in direction at intersections in a very natural
way. Overall contrast can be altered to simulate
reduced visibility associated with heavy rainfalls or

The Vehicle Configuration: In the 1997 Dodge
Neon car, the "driver" operates normal accelerator,
brake, and signalizing and steering controls with the
corresponding visual scene responding accordingly.
Longitudinal and lateral movement allows the
driver to speed up or slow down, come to a halt,
steer laterally including lane changes and changes of
direction at intersections. All changes are controlled
by software that interface a junction box under the
hood of the vehicle.

The simulator is built on a computerized platform
developed by the Systems Technology Inc. (STI) of
Hawthorne, CA. The specific configuration is the
STISIM Drive Model 500W produced by STI. The
vehicle and tire model runs on a dedicated processor
that is linked to the simulation via a network. It
operates at fast update rates necessary to provide
high-fidelity simulation of the vehicle dynamic

responses as well as provides proper steering force/
feel feedback. Road-feel is also captured via a low-
frequency audio woofer and amplifier providing
engine, transmission and road noise at varying
intensities and frequencies.

Auditory Display and Apparent Motion
Sounds related to vehicle performance and
external factors are simulated by the STISIM
Drive software. These sounds include engine
sound mentioned above, tire screech due to heavy
braking or high cornering loads, horn, and the turn
indicators. External sounds include a crash sound,
siren sound, and tire noise that can discriminate
between on and off-road surfaces. We also have the
capability of substituting standard sounds provided
with the simulator's customized sound files and
playing recorded messages at specific locations in the
driving scenario.

A control area situated to the rear of the vehicle
overlooks the driver, vehicle and viewing screens.
At this workstation the three visual screens are
duplicated and a fourth control monitor allows
the experimenter to set parameters for each
trial and to monitor data being collected. Two-
way communication is
maintained via speakers and '.
microphones in the vehicle
and at the workstation.

Measurement and
Performance Recording
The recording software
permits the acquisition
of up to 40 vehicle, driver
and simulation parameters.
Specific data recorded
depends upon the driving
scenario being used and the

assessment goals. For our present studies, the
parameters below are recorded:

Elapsed time from beginning of run (sec)
Total distance traveled from beginning of
the run (feet)
Longitudinal velocity (feet/second)
Longitudinal acceleration (feet/second2)
Lateral acceleration (feet/second2)
Lateral lane position with respect to the
roadway dividing line, positive to the right
Lateral control during turn (Difference
between vehicle and roadway curvature)
Yaw rate (radians/second)
Vehicle heading angle (degrees).
Steering wheel angle input (degrees)
Brake Actuation
Left signal
Right signal
Current traffic signal light position
Visual Scanning
Roadway traffic data.
SVehicle collisions includes: other vehicles,
off-road and pedestrians

In addition to these parameters, statistical data
such as mean and standard deviation of parameters
such as lane deviation, speed, steering angle can
be included. An Open Module can also be used to
develop additional performance measures such as
physiological indices of GSR, EMG, or EEG.

Older Drivers

and the

(Y The American
Occupational The
Association, Inc.

The American Occupational Therapy Association (AOTA) is
the nationally recognized professional association of approximately
35,000 occupational therapists, occupational therapy assistants, and
students of occupational therapy.

Occupational therapists work with people experiencing
health problems such as stroke, spinal cord injuries, cancer,
congenital conditions, developmental problems, and mental
illness. Occupational therapy helps people regain, develop, and
build skills that are essential for independent functioning, health,
and well-being. Occupational therapy can prevent injury or the
worsening of existing conditions or disabilities and thereby promote
independence in individuals who might otherwise require long-
term care. Occupational therapy can help reduce health care costs
while maximizing the quality of life for individuals, families, and

Staying connected to the community is an important component
of well-being. For most of us, driving our own car is how we stay
mobile. Driving provides the means for getting together with
people and the means for doing the things we want to do at our
convenience. But changes in our physical, mental, and sensory
abilities can challenge our continued ability to drive safely.

Occupational therapists trained in driver rehabilitation
understand the critical demands of driving and how our ability to
move about our community affects the quality of our lives.These
occupational therapists have the skills to evaluate an individual's
overall ability to operate a vehicle safely, and, where appropriate, to
provide rehabilitation to strengthen skills used in driving.

Occupational therapists have the science-based knowledge
to understand progressive conditions and life changes that can
affect driving. Because occupational therapists take the time to
understand the role that driving plays in life, they are able to help
people make a smoother transition from driving to other forms
of transportation. In doing so, they help people maintain their
autonomy, independence, and sense of worth.

The University of Florida works closely with the American
Occupational Therapy Association. Collaborative efforts are
underway to create an evidence-based literature review of
interventions utilized with older drivers; development of a clinical
practice guideline on driving; and creating and maintaining an older
driver microsite within AOTAs Website. UF and AOTA efforts
also enabled the creation of an Older Driver Advisory Panel to
guide the organization in decision making.

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University of Florida
Department of Occupational Therapy
Box 100164
Gainesville, FL 32610-0164

U.S. Postage
Gainesville, FL
Permit No. 94


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